Common Causes of Backpain

Sprain/Strain

A sprain means an injury to a ligament, and ligaments support the spine, including its joints—the facet joints. A strain is a muscle and/or tendon injury. Tendons connect muscle to a bone. A spinal sprain or strain can happen if you fall, use poor body mechanics (eg, lifting and twisting simultaneously), during a car accident, and many other ways. These are usually quite painful and may temporarily limit movement.

Spinal Nerve Compression

When a spinal nerve root is compressed, entrapped, or pinched it becomes inflamed and starts to send messages the brain interprets as pain. In the illustration (below) of a cervical (neck) spine segment, many different disorders are causing nerve compression: a herniated disc, thickened ligament, and bone spurs (also called osteophytes).

Lumbar Herniated or Bulging Disc

A herniated disc is illustrated in the picture above. There the contents of the disc (nucleus pulposus) have spilled out through the disc’s tough protective outer layer (annulus fibrosus). The nucleus pulposus is compressing a spinal nerve root and may cause back pain, with or without leg pain. Depending on the severity of nerve compression or damage, and where in the lower back the disc herniation has occurred, the patient may develop buttock, thigh, and leg pain. The location of back pain is generally diffuse and not located in a specific area. However, leg pain typically follows specific dermatomal patterns consistent with specific nerve root irritation.

• The patient may be told they have sciatica. The term sciatica is used to describe a group of symptoms that develop when the sciatic nerve is compressed.
• True sciatica is represented by pain following a specific nerve root pattern.
• Typical lower back, buttock and proximal (nearby) thigh pain are commonly called sciatica but the sciatic nerve gives off no major braches above the knee.