Back pain - causes and treatment

Usually, when we say that our back hurts, we mean pain located “somewhere in the back” in the area of the vertical axis of our body. However, the spine consists of 33-34 vertebrae divided into 5 sections. When we experience pain, it can affect different sections of the spine and its structures. For example, we often talk about lumbar spine pain, and by that we mean discomfort felt in the lumbar region, i.e., the lower back.

Starting from the top of the spine, all its sections are:

• the cervical section — consisting of 7 vertebrae,
• the thoracic section — consisting of 12 vertebrae,
• lumbar spine — consisting of 5 vertebrae,
• sacral spine — consisting of 5 fused vertebrae,
• coccyx — consisting of 4-5 fused vertebrae.

Between the vertebrae of each section of the spine are intervertebral discs, which absorb shock. The whole structure is stabilized by ligaments, and muscles enable movement. Inside the vertebrae is the spinal canal, whose function is to protect the spinal cord.

The structures that most commonly contribute to back pain are:

• vertebrae,
• ligaments,
• intervertebral discs,
• facet joints,
• paraspinal muscles.

Sometimes we may be convinced that our spine hurts, but the discomfort actually originates in another part of the body. This is known as referred pain, a perfect example of which is the pain regularly experienced by many women during menstruation. This is pain in the lumbar and sacral regions, which is not directly caused by any spinal pathology, but most often by strong uterine contractions.

We distinguish between three types of spinal pain depending on how long it lasts:

• acute pain lasts up to 3-6 weeks,
• subacute pain lasts longer than 3-6 weeks but less than 3 months,
• chronic pain lasts longer than 3 months.

Depending on the cause of the pain, we distinguish between:

• specific pain — pain that can be associated with a specific pathology in the structure of the spine, e.g., a vertebral fracture, tumor, infection, advanced discopathy with clinical symptoms, or sciatica with nerve root compression;
• nonspecific pain — pain for which it is not possible to clearly identify a specific cause related to the structure of the spine. In the vast majority of patients, back pain is nonspecific pain.

We have already mentioned that the cause of back pain can originate in various structures of the spine and be associated with various pathologies, such as cancer, infection, vertebral fracture, or sciatica. Referred pain may also occur, which causes pain in the spine, but is not the source of the discomfort. Other potential causes include overload and degenerative changes, myofascial overload, congenital defects, poor posture, injuries, and inflammation.

Most often, however, it is not possible to identify a specific cause of pain that would be clearly related to a specific spinal pathology. In many cases, pain is simply a consequence of an unhealthy lifestyle — daily habits that are not good for us. That is why it is so important to take care of the overall well-being of the body. At NAMI Medical Resort and Clinic, we help you develop healthy habits and avoid pain in the future.

The main factors that contribute to back pain are:

• lack of physical activity,
• heavy physical work,
• overweight and obesity,
• chronic stress,
• smoking,
• age — unfortunately, after reaching the age of 30, the risk of experiencing pain in the lumbar spine or other sections increases.

Research also shows that women are more likely to experience lumbar spine pain than men, partly due to their body structure, which is more prone to this condition. In addition, it is worth knowing that mental health issues, such as depression, can exacerbate back pain.

Unfortunately, there is no single effective way to protect ourselves from back pain. The best preventive measure is to develop habits that are good for our body. The key is a healthy lifestyle.

Things to keep in mind include:

• following the principles of workplace ergonomics, whether we do physical or office work;
• regular physical activity, at least 2-3 times a week;
• taking care of your mental health and reducing stress;
• eating a balanced diet and maintaining a healthy weight, as obesity and being overweight increase the risk of back pain by as much as 50-80%;
• avoiding stimulants such as tobacco and alcohol — smoking impairs blood supply to the intervertebral discs, and alcohol contributes to inflammation in the body.

Any back pain should be relieved with painkillers and anti-inflammatory drugs. However, this is only a temporary solution that will alleviate the discomfort but will not address the source of the problem. If we do not know why our spine hurts and how to remedy it, or if we notice worrying symptoms (e.g., the pain begins to radiate to the limbs, the medication does not work, or a part of the body begins to go numb) — you should see your family doctor, who will advise you on what to do or refer you for further diagnosis or to a specialist (orthopedist, neurologist, physical therapist).

At NAMI Medical Resort and Clinic, we teach you how to take care of your body and mind holistically, which is an excellent way to prevent back pain. We take care of, among other things, diet, physical activity, stress reduction, and the support of an interdisciplinary team. For many patients, their stay at our center was the beginning of a new, healthier life, in line with the spirit of longevity.

The last of the available options for treating back pain is surgery. However, surgery is a last resort, used only when other methods have truly failed.

If your spine hurts, it is always worth visiting a physiotherapist. Unfortunately, patients often put it off and only visit the clinic when drug therapy stops working. Non-steroidal anti-inflammatory drugs will relieve pain, but they will not address the cause of the problem. It is important to visit a specialist as soon as the pain appears, as this increases the chances of making an accurate diagnosis and selecting an effective form of therapy. Imaging tests, such as magnetic resonance imaging, can be helpful, but contrary to appearances, they are not necessary to start working with a specialist.

Physiotherapy, as a method of treating back pain, is based on finding the cause of the discomfort and then implementing the appropriate therapy tailored to the patient’s needs. To find the source of the problem, the physical therapist uses functional tests, i.e., examinations and observations that allow them to check the body’s behavior during movement. This allows them to assess, among other things, the efficiency of muscles and joints.

Working with a specialist usually takes the form of manual therapy and kinesitherapy, i.e., appropriate exercises performed by the patient. All this is aimed at eliminating pain and restoring full mobility. At NAMI Medical Resort and Clinic, we offer our patients more than just effective physiotherapy methods. We believe that the best results come from caring for the whole body. That is why our patients have access to an interdisciplinary team, appropriate nutrition, and stress-reducing activities.

At NAMI, we know how challenging back pain can be. Patients who experience it have trouble functioning on a daily basis, and their quality of life significantly declines. That is why we always focus on thorough diagnosis to find the source of the problem, and we tailor the forms of therapy to each patient’s individual situation. We work with modern equipment and follow the latest therapeutic methods to effectively relieve patients of pain. Don’t delay your visit to a specialist. Find out the source of the problem and learn how to prevent it. Physiotherapy is an effective way to restore your life without pain.

NAMI Medical Resort and Clinic exclusively offers medical programs.

1. Gibbs D, McGahan BG, Ropper AE, Xu DS. Back Pain: Differential Diagnosis and Management. Neurol Clin. 2023 Feb;41(1):61-76. doi: 10.1016/j.ncl.2022.07.002. Epub 2022 Oct 29. PMID: 36400559.
2. Hanley EN Jr. Distinguish the specific from non-specific low back pain. Bull Hosp Jt Dis. 1996;55(4):195-6. PMID: 8933949.
3. GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 May 22;5(6):e316-e329. doi: 10.1016/S2665-9913(23)00098-X. PMID: 37273833; PMCID: PMC10234592.
4. Lacroix M, Nguyen C, Burns R, Laporte A, Rannou F, Feydy A. Degenerative Lumbar Spine Disease: Imaging and Biomechanics. Semin Musculoskelet Radiol. 2022 Aug;26(4):424-438. doi: 10.1055/s-0042-1748912. Epub 2022 Sep 14. PMID: 36103885.