• Phytness

Spine-Related Problems that Cause Back Pain

Updated: Feb 18


Would it surprise you to know that back pain is a common problem experienced by Australians? The Australian Institute of Health and Welfare (AIHW) reports that in 2014-2015, one in six Australians reported experiencing some form of back pain – that’s 16% of the Australian population.


Back pain can last anything from a few hours to days, months or longer. For a small proportion of these cases, back pain can be debilitating and may get in the way of everyday life causing distress. However, you would be pleased to know that there are things you can do to help improve and manage the pain.


To discuss your back pain and get an accurate diagnosis, why not book an appointment with one of our friendly, professional physiotherapists? We’re here to help you diagnose, treat and recover from your lower, upper back or neck pain.


What is back or spinal pain?

Back pain covers a range of conditions affecting the neck (cervical spine), upper back (thoracic spine), lower back (lumbar spine), the sacrum and lastly, the tailbone (coccyx) and can relate to the bones, nerves, muscles, joints and connective tissue in the back.


There are two types of back pain i.e. specific and non-specific back pain. Specific back pain can be linked to a very specific back problem, which is rare. In fact, only one to five per cent of back pain can be related back to a specific cause. In 90-95% of the cases, back pain is non-specific i.e. there is no one single medical cause that can be defined.


What causes back pain?

Back pain can have many causes. Bad posture, injuries, diseases such as arthritis, osteoporosis, disc disease, degeneration and even some genetic conditions can cause back pain. In most cases, the back pain comes from the muscles, ligaments and joints and not from any significant spinal damage.


Some of the common causes of a sore back are:

  • Stress – stress often leads to increased muscle tension resulting in stiffness, pain, and back fatigue.

  • Muscle and ligament strains – excessive force, repetitive use, and having pre-existing conditions can lead to soft tissue damage, in other words, muscle, tendon and ligament strains and tears.

  • Sciatica – This is when a bulging intervertebral disc or other structures adjacent to the sciatic nerve squeezes the nerve that runs from the lower back to the leg, causing pain.

  • Structural problems – the lifelong habit of bad posture, curvature of the spine (e.g. kyphosis or hunchback, and scoliosis), osteoporosis and some genetic conditions can put added pressure on the spinal column contributing to back pain.

  • Arthritis – some forms of arthritis can cause back pain such as osteoarthritis and ankylosing spondylitis.



Symptoms of back problems and back pain

Some of the symptoms of back problems people experience can be:

  • back pain related to an injury or condition

  • tingling, numbness and weakness in the arms or legs

  • pain caused by pressure on specific parts of the spinal nerves

  • loss of bowel or bladder control

  • difficulty with sitting, standing or walking.

What are the lifestyle factors that impact back pain?

Lifestyle factors can exacerbate or increase the risk of getting back pain. These include:

  • age

  • physical fitness

  • being overweight or obese

  • smoking

  • sitting for long periods

  • stress

  • posture

  • the type of work you do.

How is back pain diagnosed?

Back pain is diagnosed through questioning and examining you. A physiotherapist can help you diagnose your back pain and rule out other conditions that may require additional testing and treatment. They do this by asking detailed questions about your back pain, such as potential triggers of pain and your medical history. By using biomechanical diagnosis techniques, your physiotherapist can identify any areas of the spine that have dysfunctional movement, contributing to your symptoms.


How is back pain treated?

Once you have a diagnosis, your physiotherapist can give you advice about your recovery time, how they can help you with your recovery and what you can do to speed up your recovery. Treatment will usually include a combination of physiotherapy treatment such as mobilisation, manipulation, soft tissue treatment, and exercises as well as things you can do at home such as how to manage pain and exercises you can do to help. They’ll also be able to review the pros and cons of different treatment options with you. The goal of your physiotherapist will be to help restore pain-free movement and function of your spine.




How can I reduce and prevent back pain?

One of the best things you can do to prevent back pain is to keep your back flexible and strong.


There are some basic lifestyle changes can also help prevent back pain and reduce the risk of having back problems. Here are eight things you can do at home to help reduce the risk of getting back pain:

  • Get regular exercise. Including 30 minutes of moderate exercise such as walking, low impact aerobics, swimming, yoga, Thai Chi, Pilates or group exercise classes as well as incorporating core muscle strengthening and stretching exercises into your exercise regime will help keep your back strong by improving muscle support and posture.

  • Manage your weight. Working towards a healthy weight will help reduce the pressure placed on your spine and reduce the risk of back pain and injuries.

  • Quit smoking. Smoking is a risk factor for back pain.

  • Work on your posture. Having a good posture will reduce your risk of developing back pain. Try and be aware of your posture; don’t slouch and use supports for your back and footrests where needed.

  • Lift and carry safely. If the load is too heavy for you, then use a trolley or get another person to help you. When lifting heavier things in general, remember to squat, keep your back straight, hold the object as close to your body as possible and use your legs to help you lift and rise.

  • Take time to relax. Stress is a known risk factor in non-specific back pain. Learning relaxation techniques can help manage and reduce muscle tension caused by stress.

  • Get a good night’s sleep. Sleep is an important part of your overall health. To ensure your back is properly supported while you sleep, use a mattress that is firm enough to ensure your shoulders, hips and buttocks are supported and your spine is straight. Avoid using a pillow that pushes your neck into a steep angle while sleeping.

  • Stretch regularly. If you have to sit or stand for long periods of time, try and take an hourly stretch break to loosen your muscles and prevent stiffness.

If you are experiencing back pain, then staying active is important – slow gentle movements will be far more beneficial than bed rest. You can also use heat and simple medications such as ibuprofen or another anti-inflammatory to help with back pain relief. If you are concerned about your back pain, then book an appointment to see your local physiotherapist.


Spine-related problems

At Phytness HealthCare we treat a wide range of spine-related problems. Here are a few of the spine pain problems we’ve helped patients with;


Lower Back Pain

Research indicates that at least 80% of people will experience pain in their lower back (lumbar spine) at some point in their lives. It is one of the most common causes of people staying home from work and seeing a doctor or physio. It can be sudden or come on slowly and can vary in pain intensity and symptoms. In many cases, it will resolve on its own in a few weeks. Lower back pain can usually be easily treated and remedied. With the right knowledge and strategies, future issues with the lower back can be reduced and prevented.

Lower back pain can be contributed to by:

  • muscle strain or spasms

  • herniated discs

  • bulging discs

  • compression fractures eg Osteoporosis

  • sciatica

  • age-related degeneration

  • injuries for example being in a car accident

  • non-musculoskeletal causes such as infections, arthritis, pregnancies, tumours

Where no specific structure of the back has been injured and a person has lower back pain it is called non-specific lower back pain (NSLPB). In these cases, your health practitioner has ruled out specific spinal pathologies and syndromes as a cause of the back pain.


While lower back pain is common, it is important to have your individual problems diagnosed and managed. Your chance of recovery is impacted by how long you’ve been having back pain for, especially in the case where specific and treatable conditions are present. Early diagnosis and treatment is the best way to recover quickly and avoid future recurrences. A spinal health care professional, such as a musculoskeletal physiotherapist can help with prompt diagnosis and treatment.


Upper Back Pain

Upper back pain (or thoracic pain) is quite common and can be simple or complex in nature. This is pain felt in the upper (or thoracic region) of the back and spine.


Injuries to the upper back can be caused by poor posture, lifting, falls or physical activity such as throwing, swinging the arm or swimming. While most of these issues can be easily diagnosed and treated, there are some types of chest and upper back pain and discomfort that require urgent attention. See your health care professional as soon as possible if you are experiencing:

  • constant, severe and progressive pain

  • pain that has lasted longer than 2-4 weeks

  • pain accompanied by severe stiffness

  • a recent injury or trauma

  • a minor trauma, for example, an injury from heavy lifting

  • muscle weakness in your legs or arms

  • new and acute back pain.

Neck pain

The neck is a fairly exposed part of the spine, and as such can be vulnerable to injuries and disorders that cause pain and restrict movement. For many people, this will be temporary, for others, a medical diagnosis and treatment may be needed to return normal movement and reduce pain.


Neck pain can be caused by a wide variety of things from abnormalities (in the muscles, ligaments, nerves, bones or disks), injuries, or age-related degeneration. Neck problems can cause pain in the upper back, shoulders or arms as well as the neck itself.


Cervicogenic Headache

A cervicogenic headache (often referred to as a Neck Headache) is a headache caused by a disorder of the upper cervical spine and its component bony, disc, and/or soft tissue elements (usually due to a disorder in one of the top three or four joints in the neck). A cervicogenic headache is a secondary headache, in other words, the pain is referred from another part of the body which in this case is the neck. Although the headache can be accompanied by neck pain, this is not always the case. The headache will usually be felt at the top of the head and at the base of the skull.


People who are suffering from a cervicogenic headache will often experience reduced movement in their neck and find that some neck movements ease or worsen the headache. They will also experience tenderness at the top of their neck as well as the base of their skull. These headaches are often on one side only (side-locked or unilateral) and the pain from them may radiate from the back of the head or neck, up to the front of the head or even behind one eye.


Your physiotherapist will assess a range of symptoms and will use a physical examination to diagnose the headache. The correct Physiotherapy treatment on your neck, after accurate diagnosis, can reduce or relieve your headache.


Whiplash

Whiplash is a term used to describe an injury caused by a sudden vigorous sideways, backwards, or forwards movement (or jolt) of the head. Although best used to describe the way in which the injury occurred, whiplash is when the neck is strained, sprained, or there is a tear in the soft tissues (the muscles and ligaments) of the neck, or even if compression of the spinal nerves.


Although neck pain is the most common symptom of whiplash, sufferers can also experience headaches, dizziness, light-headedness, or aches in their shoulders and arms. Pain from whiplash is usually initially felt between 6-12 hours after the injury occurs. It can last anything from a few days to weeks or longer depending on the extent of the injury and other factors.

While most commonly caused by motor vehicle accidents, whiplash can also be caused by:

  • a sudden blow to the head during sports such as boxing or rugby.

  • a slip or fall in which the head is jarred or jolted

  • being hit by a heavy object on the head.

If you are experiencing pain in your neck and shoulders and have had a recent injury, consult your physiotherapist for accurate diagnosis and treatment.


Disc Bulge and Lumbar Disc Bulge

A bulging disc, or disc bulge, is a common injury in which the outer layer of the disc bulges. A spinal disc, or intervertebral disc, is the rubbery disc found between each of your 24 bones (vertebra) in your spine. They are often described as a jelly doughnut, soft on the inside with a firmer surface. The discs act as a cushion or shock absorber in your spine and allow you to bend and twist. The spinal discs and vertebrae protect your spinal cord, the bundle of nerves that run up your spine connecting your brain to the nerves in the rest of your body.


Disc bulges, also called slipped discs or protruding discs, are usually caused by normal wear and tear to the disc and are commonly seen in normal people who have no pain. In some cases, a bulging disc can put pressure on or irritate the nerve where it exits from the spine potentially causing cramping, back pain, spasms, numbness, pins and needles, or pain in your legs. Pain and discomfort can sometimes be aggravated by bending forwards, sitting, coughing or sneezing, or lifting.


You can sustain a bulging disc in your lower back (lumbar disc bulge), upper and middle back (the thoracic spine) or neck (cervical spine).


If you are experiencing any form of mild to severe back pain, you should speak to your health professional to get a medical diagnosis and treatment.


Disc Herniation

The difference between a bulging disc (as described above) and a herniated disc is that a herniation occurs when the disc actually ruptures or cracks and some of the gel-like fluid inside the disc bulges out. If a disc has multiple herniations and connected bulges, it is referred to as a multi-focal herniation. A disc herniation is also called a prolapsed or ruptured disc and is quite common. A herniated disc can occur anywhere along the spine, however, it is most common in the lower or lumbar spine.


Surprisingly, a herniated disc is more likely to cause back pain than a bulging disc even though it's often much smaller. This is because it generally protrudes further and is more likely to put pressure on nerve roots. The disc material may also release a chemical irritant that can contribute to inflammation. The irritated nerve root may cause pain, numbness or weakness in an arm or leg (sometimes called sciatica).


Not every disc herniation needs intervention and some may cause no pain or discomfort at all. When needed, treatment can include medication, physiotherapy, and possibly surgery. Although a herniated disc can cause considerable pain, many people find relief within a few weeks or months of non-surgical treatment. A disc herniation can be confirmed using an imaging scan such as an MRI (Magnetic Resonance Imaging) or CT (Computerized Tomography) scan.


Sciatica

Sciatica occurs when the nerve that runs from your lower back, through your hip and buttock, to your leg (the sciatic nerve) is squeezed by a bulging or herniated disc in your lower spine or another structure (eg: a spasming muscle adjacent to the nerve), causing pain. The sharp knife-like pain caused by sciatica can be felt in your lower back, or your hip, and often radiates down the back of your thigh into your leg. It can be felt for weeks. Other symptoms include pain when moving, sneezing or coughing, weakness, 'pins and needles/, or a tingling or burning sensation down the leg.


Sciatica can be caused by degeneration due to age, spinal injury or trauma, tight swollen muscles in the buttocks, bone spurs or other growths that may narrow the spinal canal. Often people are unable to pinpoint the injury that led to the condition. 80-90% of people find that sciatica improves over time. If you have any pain in your back or legs, you should go to your health practitioner for a proper diagnosis and treatment.


A physical examination can help pinpoint the irritated nerve root, while medical imaging such as x-rays, or a Magnetic Resonance Imaging (MRI) scan can confirm the diagnosis.

There are a range of treatments available for sciatica depending on the severity and how long you have had the condition for. Treatment can include:

  • education and changes to your lifestyle

  • physiotherapy

  • applying gentle heat or cold

  • pain relief medications, for example, paracetamol and anti-inflammatories

  • in rare cases, surgery may be recommended.

It is important that you don't rest too much, but instead that you continue to move and stretch. Your physiotherapist can give you guidelines on what activities are suitable for you.


Osteitis Pubis

Osteitis pubis is a condition that affects the joint between the pubic bones (called the symphysis pubis) causing inflammation in the joint. It is usually caused by overuse (in other words repeated trauma) or instability of the pelvis and is commonly experienced by athletes who kick (such as football players) or runners. It is uncommon for a specific incident to trigger the symptoms, although not unheard of. Some people who undergo invasive procedures around the pelvis may also experience this condition.


The pain caused by osteitis pubis comes on gradually and is worsened by certain activities such as running, pivoting, or kicking across the body. Pain is felt in the groin, lower abdomen, and inner thigh. It can hurt to lie flat.


If you are experiencing groin pain, it is important to seek medical diagnosis and treatment. There may be many reasons why you are experiencing groin pain and early diagnosis can prevent problems from becoming severe. Osteitis pubis can be hard to diagnose. Diagnosis can be assisted by a bone or MRI (Magnetic Resonance Imaging) scan to confirm inflammation or injury in the pubic symphysis.


Rehabilitation and treatment should be guided by your Physiotherapist to help you recover and avoid reaggravation. You can help prevent this condition by incorporating flexibility training into your daily routine, and specific exercises to address any identified deficits in your movement control that are unnecessarily adding loading to the symphysis pubis.


Thoracic Outlet Syndrome

Thoracic outlet syndrome is a term used to describe several different conditions that can occur when the nerves and/or blood vessels in the thoracic outlet (the space between your collarbone, or clavicle, and your first rib) are compressed or irritated. This narrow passageway is crowded with blood vessels, muscles, and nerves. If your shoulder muscles aren't coordinating well to support the collarbone and ribs, they can move in ways that place pressure on the nerves and blood vessels causing a variety of symptoms, collectively called thoracic outlet syndrome.


Thoracic outlet syndrome is most often experienced by people who repetitively rotate and move their shoulder. It can also be the result of an injury, disease or genetic disorder such as an abnormal first rib. It is more common in women and can be aggravated by obesity and poor posture. Athletes such as swimmers, water polo players, baseball players, and tennis players can experience this syndrome.


The symptoms will depend on where the pressure is occurring. Pressure on the nerves can result in a vague ache in the neck, shoulder, arm or hand as well as numbness or tingling on the inside of the forearm and some fingers on your hand. Pressure on the blood vessels can cause swelling and redness in the arm, making your arm and hand feel fatigued. The condition may limit your range of movement.


Physiotherapy, pain medication, exercises, and lifestyle changes can help manage the condition. It is important to have the condition properly diagnosed before commencing a treatment plan.


Spinal Stenosis

Spinal stenosis, also called spinal canal stenosis, is when the canal surrounding the spinal cord arrows putting pressure on your back nerves. Spinal stenosis can result in pain and weakness in your arms or legs. Spinal stenosis can be classified as:

  • lumbar spinal stenosis (LSS) - spinal stenosis in the lower back

  • cervical stenosis - spinal stenosis at the top of your spine

  • central canal stenosis

  • lateral recess stenosis.

Spinal stenosis can be congenital in nature or can be from acquired degenerative changes (spondylosis) such as arthritis, hypertrophy, arthropathy, bone spurs, intervertebral and epidural fat, bulging or herniated discs. It can also be caused by injury when a thickened ligament bulges into the spinal cord or a tumour.


The symptoms of spinal stenosis depend on which nerves they are affecting and may include:

  • back and/or neck pain

  • weakness, numbness or tingling hands, feet, arms or legs

  • cramping in one or both legs, which reduces when you bend forward

  • problems with your bowel or bladder.

Physiotherapy can help you build your strength, balance, and flexibility while medication or injections may be used to help reduce pain. Hot and cold packs can also help. For severe cases, surgery called laminectomy may be an option. In a laminectomy, part of the spinal bone (vertebra) is removed along with some ligaments to remove pressure and create space. It can also include joining two bones together, which is called a fusion. Surgery is recommended as a last resort.


Sacroiliac Joint Dysfunction

Sacroiliac Joint Dysfunction or SIJ Dysfunction is when your sacroiliac joints don't move normally because of either stiffness or excessive movement. Your Sacroiliac Joints (SI Joints) connect the tailbone to your pelvic bones on the left and right sides. They typically only allow small amounts of movement to help with shock absorption and bending forwards or backwards.


Trauma, muscle weakness or extra mobility can cause your sacroiliac joints to have excessive uncontrolled motion causing an abnormal or stressed joint position which can result in pain and inflammation. Pain can be felt in the lower back or the leg. In the case of leg pain, it can be hard to differentiate the source of the pain from SI joint dysfunction or lumbar causes.


There are two main types of SIJ Dysfunction:

  • too much movement (hypermobility or instability) causing the pelvis to be unstable and lead to pain in the lower back and/or hip, possibly radiating into the groin

  • too little movement (hypomobility or stiffness) inhibiting movement and causing muscle tension and pain on one side of the lower back or buttocks, potentially radiating down the back of the leg (similar to sciatica).

Young and middle-aged women, as well as women who are pregnant or have recently given birth, are more susceptible to sacroiliac joint pain.


In most cases, SIJ pain is successfully treated without surgery. Treatment can include:

  • Initial resting

  • Pain medication

  • Manual manipulation

  • Supports or braces

  • A sacroiliac joint injection.

Treatment for SIJ Dysfunction depends on the individual and their specific contributing factors. If you are experiencing any pain in your lower back, hips or legs, seek help from your health practitioner.


Wryneck

Also called Torticollis, Wry Neck is a complaint where you suddenly develop stiffness and neck pain, usually accompanied by a spasm of the neck muscles causing the neck to twist (or wry) to one side suddenly, reducing your neck motion.


Wryneck can cause pain in the middle of the neck, shoulders and head. It may hurt to massage the area and your range of movement may be severely limited. It is extremely common and usually only lasts a short period of time with treatment. There are two types of Wry Neck:

  1. Facet Wry Neck - when a facet joint locks (the most common form of Torticollis)

  2. Discogenic Wry Neck - caused by a cervical disc injury (and injury to an intervertebral disc at the top of the spine)

Wry Neck can be caused by:

  • sleeping restlessly

  • an uncomfortable pillow

  • poor posture

  • carrying heavy bags causing your neck to strain

  • having a very cold draught constantly blowing on your neck

Your physiotherapist will use a combination of low-risk manipulation and soft tissue massage to help alleviate the stiffness, however, the swelling may take a few days to go down.


Phytness Healthcare is here to help you with your back pain

We take your health and recovery seriously. So much so, that we are committed to longer opening hours, generous consulting times, as well as ongoing staff education, qualifications and training. We believe all our patients should receive tailored programs, innovative treatments and prevention based on their needs and research.


We offer the convenience of:

  • longer opening hours 8am-7pm Monday-Thursday, 8 am - 6 pm Friday and Saturday mornings

  • free easy parking at all clinics.

  • HICAPS on-site health fund claims.

Book an appointment

If you are experiencing any ongoing or sudden back pain that is leaving you uncomfortable or making life challenging, why not book an appointment with our physiotherapy team. We’ll be able to assess your back pain and help identify what can be done to help reduce your pain and bring your life back to normal. Book your appointment online or call us on (02) 4285 1725 to make an appointment.


The information in this article is general in nature and is intended for general educational purposes only. We recommend you book an appointment with your health practitioner to ensure you receive the correct diagnosis and treatment for your individual situation.


Resources

https://www.sira.nsw.gov.au/

https://www.healthdirect.gov.au/

https://www.mayoclinic.org/

https://emedicine.medscape.com

https://orthoinfo.aaos.org

https://www.aihw.gov.au

https://painhealth.csse.uwa.edu.au

https://americanmigrainefoundation.org

https://choose.physio

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Fairy Meadow, NSW 2519

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