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Solving the Perplexing Puzzle of Back Pain

Aug 17, 2007
An estimated eight out of ten people in the United States will injure their back at some point during their lives. Few of these problems will require extended treatment, but back problems are invariably painful.

Managing and relieving back pain is not a simple process. The experience of pain is subjective; it cannot be measured from the outside. Health providers who treat back pain find it challenging to obtain the objective or measurable signs that verify and diagnose a patient's painful back symptoms.

Additionally, everyone's experience of pain is different. Pain descriptors encompass numerous adjectives - dull, sharp, throbbing, pulsating, stabbing and shock-like, just to name a few.

People experience and describe pain so differently partly due to its varied and complex origins. In fact, pain originates from numerous places in the body, such as muscles, bones, nerves, organs or blood vessels.

Pain is also described as acute or chronic. The word "acute" derives from the Latin word for needles and is usually described as a severe, sharp sensation. The initial stage of an injury is called the acute phase.

The word "chronic", on the other hand, originated from the Greek word for time. Chronic pain is pain that persists after a length of time, often months to years. Many back injuries tend to become chronic, especially when not treated properly during the acute phase. Chronic pain is often experienced as a dull ache or constant nagging irritant.

Acute and chronic pain sensations also travel different nervous system pathways inside the body. When you injure muscles or ligaments in your back, nerve endings called pain receptors pick up the pain impulses and transmit them to the spinal cord. From here, the pain message ascends to the brain. This process takes place at varying rates of speed depending on the size of the nerve fiber involved.

Acute pain tends to travel on faster, larger diameter fibers, while chronic pain prefers smaller, slower pain fibers. Experts suggest that chronic pain affects the brain's limbic system, which is associated with emotional states. Anyone who has ever had a long-term painful injury knows that negative or distressing emotions may accompany or perpetuate the initial injury.

The best way to treat chronic back pain syndromes is to prevent them. Although proficient early treatment does not always prevent an acute injury from turning into a chronic problem, it is a good insurance policy. Early treatment is especially important with injuries to the soft tissues (muscles, tendons and ligaments) to prevent them from becoming weaker, less elastic and more pain-sensitive.

One of the best ways to treat both acute and chronic soft tissue injuries is a hands-on approach that works to repair the injured tissues. Some examples are joint and soft tissue manipulation and mobilization, typically performed by a doctor of chiropractic or osteopath. Other good options are massage and physical therapy. A formal rehabilitation program at a health club or therapy clinic may also help to strengthen weakened and damaged muscles, especially the core stabilizers of the back.
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