According to the Back Association of Canada (BAG), a Toronto-based foundation established by a group of back pain sufferers and health care professionals, finding an effective program of back pain treatment in most cases calls only for knowledge of the general category (or categories) of problem to be known. "Narrowing the problem down further doesn't usually make a whole lot of difference since the conservative treatment for each category is more or less the same," according to BAG'S Web site, which lists the five main causes of pain as:
- Sprains and strains of the muscles, ligaments, and tendons
- Disk problems
- Facet joint problems
- Osteoarthritis (also called degenerative arthritis, or degenerative joint disease, because it's related to age-related changes in the bones and joints)
- Spinal stenosis, a narrowing of the spinal canal that can develop because of a congenital defect or as a result of osteoarthritis.
Chronic or Acute?
Not only can it be difficult to tell where the back pain is coming from - it can even be hard to tell whether the pain is acute or chronic, and that can affect treatment.
In general, acute pain is the initial pain people feel after an injury. In most cases, the body will begin healing itself, and the patient's job is simply to relieve the pain and keep the injured area safe until fully recovered. If the pain lasts longer than expected - which, for back pain, is usually considered to be about six weeks at most - or is due to an ongoing condition such as arthritis, it is considered chronic, and a different treatment plan comes into play.
Although chronic back pain is, in most cases, not directly caused by injury, the source of the pain can bring about an injury that then appears to be the culprit. For instance, poor muscle tone deprives the spine of necessary support, puts stress upon the joints, and leaves the back more susceptible to injury.
Some schools of thought hold that chronic pain is the end of a chain of nervous system events that starts in the brain and ends with pain in the back. In its most basic form, for instance, emotional stress can lead to physical muscle tension, which can lead to pain (and injury, which, in our stressed state, we're more likely to become victim to). Because the nervous system is connected to the mind and the emotions, the theory goes, healing is best directed there.
Categorizing your pain as acute or chronic can be a subjective call. Are those intermittent episodes of acute pain you're experiencing, or is it a series of recurrent episodes stemming from the same source? Does the pain never seem to leave, becoming only relatively better and worse?
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