Back Pain and Injuries

Back pain is such a wide ranging topic. Firstly, pain can be located anywhere from the neck (cervical spine), down to the lower back and buttocks (lumbar and sacroiliac joint pain). As with many other injuries, pain can be acute i.e. occurring from a specific incident such as a car accident or lifting something heavy. Or it can be an overuse injury, which is usually associated with poor posture and muscle imbalances.

Here we have tried to list some of the most common causes of back pain, both upper, lower, acute and overuse.

Upper Back and Neck

Whiplash

Whiplash (also known as acceleration/deceleration injury) occurs following a rapid forwards and backwards motion of the neck and head. This is most commonly associated with car accidents. The injured involved tends to be a muscle strain of one of the muscles in the neck, most commonly the Sternocleidomastoid, Levator Scapulae or Longus Colli. More severe injuries may involve nerve or cervical fractures.

Symptoms may include:

Pain and stiffness in the neck which may not develop for 24 to 48 hours post injury.
Stiffness in the neck and reduced movement.
Headaches, dizziness, blurred vision.

More information on Whiplash Injuries.

Upper Back Postural Pain

Aching pain in the upper back and neck area which gradually develops with no specific point of injury is extremely common, especially in those with office jobs or who do lots of driving etc. This is usually related to poor posture, resulting in muscle imbalances and certain muscles overworking and becoming tight and painful. The most common scenario is tightness in the chest muscles which pulls the shoulders forwards (giving a rounded appearance). This is made worse by weakness in the muscles surrounding the shoulder blades which are not strong enough to counteract the pull of the chest muscles. Other muscle groups such as the Trapezius then become tight as they overwork to try to correct the situation.

Symptoms may include:

Pain in the upper back/neck area which develops gradually over a long period of time.
Upper back and neck muscles may be tender to touch.
A posture with the shoulders forwards, often the shoulder blades stick out and the head is forwards of the rest of the spine.

More information on Causes of Upper Back Pain.

Lower Back

Slipped Disc

A slipped disc refers to when one (or more) of the intevertebral discs protrude outwards. This can be symptom free, until the disc starts to impinge on the spinal cord. When this happens pain and other symptoms may be felt in the back and sometimes into the legs. Pain which radiates down the back of the legs is known as Sciatica as it is due to compression on the Sciatic nerve. This compression can occur from a slipped or prolapsed disc, but may also be impinged within the buttocks (especially by a muscle called Piriformis).

Pain from a slipped disc will usually occur from a particular incident, most commonly lifting a heavy object, especially if there is also some twisting involved. The pain is usually felt in the back and also sometimes radiating down the leg.

In piriformis syndrome, there is rarely any pain in the lower back and there is rarely a sudden incident which causes the pain.

More information on Herniated Discs and Piriformis Syndrome.

Sacroiliac Joint Pain

There are two sacroiliac joints, which are formed by the Sacrum of the spine (the wedge shaped part at the bottom) and the pelvic bones on either side. Pain in this area is usually due to either hypermobility (too much) or hypomobility (too little!) and so the condition is often referred to as sacroiliac joint dysfunction. Either way this can lead to problems with the surrounding structures such as ligaments and muscles. For this reason, SIJ problems can cause a wide range of symptoms, although the common complaint is pain at the very lower back, often located to one side, although can be both sides.

Find out more on Sacroiliac Joint Dysfunction.

Lumbar Lordosis

Lordosis is a curve in the spine, which is perfectly normal in the lower back. However, there can be too much Lordosis which results in an arched lower back and the appearance of the buttocks sticking out. This is accompanied by an anterior pelvic tilt. The cause of this is usually muscle related, with the hip flexors at the front of the hip and the lower back muscles being tight accompanied by weakness in the abdominal and gluteal (bum) muscles! Pain from this kind of problem is gradual in onset and may be worsened by standing and walking, whilst being eased by rest.