By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)
80% of the population suffer from lower back pain at least once in a life time. Majority of back pain occurs sporadically as a result of back injury. Some are chronic and occurs very frequently and never go away completely.
- Back Muscle Strain – This is by far the most common cause of back pain. The muscles of the back got injured due to wrong activities such as lifting a heavy object, bending down, twisting or a sudden movement. Sometimes the reason is not clear.
- Slipped Disc – Back pain in slipped disc because of the injury and inflammation on the covering of the disc that allows the jelly to pop out. Typically the back pain is on one side and is accompanied by one sided leg pain. The leg pain is usually more than the back pain. Weakness, numbness, burning or tingling sensation may be present in the affected leg.
- Degenerative Disc Disease – This is wear and tear in the disc. It does not always cause back pain. If the disc is inflamed, the person can experience back pain that is worse when bending down.
- Spinal Instability (Spondylolisthesis) – The spine moves abnormally backward and forward sometimes sideway. The back pain typically occurs when changing posture from lying down to sitting and from sitting to standing. This type of pain is called start-up pain because the pain occurs at the start of changing posture and gradually subsides with time.
- Sacroiliac Joint Dysfunction – The sacroiliac joints either move to little or too much. This joint connect the lowest part of the spine and the pelvis bone. Patients with this problem complain of back pain and buttock pain.
- Facet Joint Osteoarthritis – People with this problem complain of back pain which is worse when extending the back. This problem typically occurs in elderly population.
- Vertebral Compression Fracture – This usually occurs in elderly due to osteoporosis. The bone is weak and brittle. Trivial fall may be big enough to cause a fracture. The back pain can be excruciating. The pain gradually improves as the fracture is healing and most stable.
- Spine Infection – People with urinary tract infection and diabetes are at risk of having spine infection. The back pain is usually more prominent when resting. It may be accompanied with fever.
- Spine Tumor – Spine tumor occurs more commonly in elderly population. Most of the time, the tumor comes from somewhere else spearing to the spinne (metastasis). The bone becomes weak and less stable causing back pain. The pain may be more prominent at rest. This may be accompanied by weight loss.
- Ankylosing Spondylitis – This is an inflammation of the spine causing stiffness. This disease starts at teen age. The back pain is more prominent at younger age. The pain decreases gradually as the spine becomes more stiff.
- Fibromyalgia – This is a chronic myofascial pain syndrome. The patient presents with generalised muscle pain in the back. The muscles are tender to touch. This is usually associated with severe fatique, sleeping problem and depression.
There are many causes of back pain. Most of them are not serious and do get better. Serious things like spine fracture, tumor and infection and ankylosing spondylitis do not get better so fast. If the back pain occurs more than 3 months, the best way is to see your doctor to get it checked.
Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.