Common Causes of Back Pain
My name is Stephen Levin. I'm a Johns Hopkins Pain Medicine specialistpracticing at Howard County General . There are multiple different origins of backpain. They can range from the very minor to thevery severe. Muscle strains or sprains can cause spasmand the most common cause of back pain.fortunately, they can be very selflimited and go awayby themselves. Patients can suffer inflammation or arthritis,which can affect the joints in the back including the sacroiliac joints and the facet jointswhich can cause pain with movement.
There can also be pain that is referred fromthe hip. Patients can also experience degenerativedisc disease which can cause what we call axial back pain, which is pain in the middleof the back and in some cases those discs can herniate and create what we call sciaticaor radiculopathy and this is a result of pressure from the disc on the nerves in the back. Posture or scoliosis, which is a curvatureof the back, can lead to biomechanical back pain, which is pain caused by abnormal movement. Some individuals can experience infectionswhich can lead to back pain.
Some of those are very unusual infectionsthat include tuberculosis or lyme disease or can be a more common from bacterial infectionsand that can infect the bone or the epidural space. Patients or individuals as they age can experiencethinning of their bone or experience osteoporosis and that can be so severe that the bones fractureand cause back pain. And in some cases patients with kidney, breast,lung, thyroid and prostate cancers can have their disease spread to the back and thatcan also cause back pain. The diagnosis of low back pain starts witha careful medical history along with a complete
physical examination. If those examinations suggest concerns, thenblood tests, xrays, CT scans, and MRIs are sometimes needed in aiding the diagnosis. In some cases, we use diagnostic injectionsthat are xray guided to help facilitate the diagnosis. Most people experience back pain in theirlives. The peak incidence of back pain can occurat two different times in life. One time that it occurs most often is in themid30s when people's discs start to dry out
and they can be susceptible to injuries fromlifting which can cause disc herniation. Later in life the incidence will go up againand will be associated with degenerative processes associated with aging so patients will experiencemore arthritic problems in the back or the thinning of their bones or osteoporosis. In general, it's good to avoid lifting injuries,poor body mechanics, and it's also good to maintain a good body weight and have a balancedexercise program. Doing these things can lessen the likelihoodthat you'll experience back pain in your life. Determining the best treatment for back paincan involve the thoughtful application of
interventional techniques, medication management,as well as rehabilitative and wellness programs. Our program offers a full spectrum of themost sophisticated medication management, highly specialized interventional pain managementtechniques, as well as rehabilitative and wellness programs. The mainstay of conservative treatment forpatients with back pain is the use of physical therapy. It can be also very helpful for individualsto use short courses of nonsteroidal antiinflammatory medications, muscle relaxants, oral steroids,or even in some cases a short course of opioid
Piriformis Syndrome versus Sciatica Animation
Piriformis syndrome is a neuromuscular conditionwhere the piriformis muscle one of the deep gluteal muscles presses on and compressesthe sciatic nerve causing pain, tingling and numbness in the buttock area and down thepath of sciatic nerve to the thigh and leg. Sciatic nerve runs UNDER the piriformis muscleand may be irritated when the muscle is too tight or shortened due to spasms. Piriformissyndrome is to be differentiated from sciatica which shows similar symptoms but has differentcauses. Diagnosis is commonly done by EXCLUSION ofsciatica. Because sciatica usually associates with compression of sciatic nerve roots bya herniated disc, sciatic symptoms in the
ABSENCE of spinal disc herniation are indicativeof piriformis syndrome. Causes and risk factors of piriformis syndromeinclude: Anatomical abnormality of the nervemusclerelation. Some people are more likely to get piriformis syndrome than others. Tightness or spasm of the piriformis muscle due to overuse injury. This commonly happensin sport activities that put pressure on the piriformis muscle such as bicycling, runningwithout proper stretching, or any activity that involves repeated movements of the legsperformed in sitting position. Treatment options include: Stretching exercises, massage, avoidance
of causative activities. Antiinflammatory drugs, muscle relaxants for relief of symptoms. Physical therapy that strengthens the gluteus maximus, gluteus medius, and biceps femorisis usually recommended to reduce strain on the piriformis muscle.