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Pain Relief - Part II: Different types of back pain

Back pain will be classified as upper, middle and lower. It also important to identify or indicate whether the pain is on the left or the right. This can give a clue as to which of the many causes of back pain might be contributing to the issue.

The causes of back pain can be broadly classified as relating to:

  • Structure
  • Muscle pain
  • Nerve pain
  • Inflammation, such as is caused by arthritis

Three common classifications of back pain include:

Axial pain

This is also referred to as mechanical pain, and is usually the result of a muscle sprain or strain. It can be dull or sharp.

Referred pain

Referred pain moves around from location to location. It is associated with age-related changes to the spine and can be described as dull and achy.

Radicular pain

This is nerve pain that will often radiate outwards along the path of the affected nerve and can cause the arm or leg to become numb or weak. The pain is described as searing. This pain can result from a number of different causes, including:

  • Compression of the nerve
  • inflammation
  • Injury to a spinal nerve root.
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Sciatica(SIGH-attic-ah) is the most common form of radicular pain. The main causes of sciatica are:

a herniated disc-a disc that has rupture and might be pressing on the nervedegenerative disc disease, that is, the results of an aging spinespinal stenosis-that is, narrowing of the spinespondylolisthesis-one of the vertebrae slips forward onto the bone below it, causing the nerve to become compressed or pinched

Sciatic pain can generate from the back down to the hip and thigh. In some cases, it might even go as far down as the big toe. Diagnostic imaging will be important to determine the condition of the spine and the placement of the discs.

Certain sciatica symptoms can indicate an emergency and require immediate medical care. These include, but are not limited to:

  • progressive neurological symptoms such as leg weakness or numbness
  • bladder or bowel dysfunction, that is, the inability to control one’s urination or defecation.

These could be signs of cauda equina syndrome, a rare condition marked by extreme pressure and swelling of the nerves at the end of the spinal cord.

Infection or spinal tumors can also cause sciatic pain, so it is important not to suffer in silence thinking it’s a natural part of the aging process.


Another cause of lower back pain is lordosis, an abnormal inward curvature of the spine. It is commonly referred to as a sway back. It can be caused by age, or by poor posture. Treatment usually involves physical therapy, although in severe cases surgery, casting, and/or bracing may be required to restore the proper curve of the spine and ease any pain caused by it.

While it is true that the lower back is the most common area to experience pain, the upper back can be painful for musculoskeletal reasons, often connected with shoulder pain. This part of the spine is not as mobile and flexible as the lower part of the spine, but it can be injured in accidents.

Dowager's hump

Dowager’s hump, or kyphosis, is an abnormal outward curvature of the thoracic vertebrae of the upper back. Think of it as the opposite of lordosis. It is often the result of osteoporosis, or thinning of the bone. The spine bends and leads to a hump-like appearance. It is often seen in older women, who are much more prone to osteoporosis, hence the name. Osteoporosis is preventable, so the hump can be corrected in many cases.

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Scoliosis (SKOL-ee-OH-siss) can affect any part of the back. It causes an abnormal curve of the spine from side to side. People with scoliosis have a spine that can curve from one side or the other, to the point where their spine starts to resemble a letter C or a letter S.

Scoliosis is about two times more common in women than in men. It can start at any age, though it is usually most common in those over 10. It is hereditary, with it running in families.

The severity of the curve/s and their locations can produce a range of symptoms. Treatment can vary from spinal manipulation and bracing to surgery.

Upper and middle back pain

The 12 thoracic vertebrae that make up the upper and middle back are all very closely connected with one another, and with your ribs. That being the case, middle and upper back pain can be caused by a number of reasons, including:

  • Overuse of muscles
  • Muscle strain
  • Injury to the muscles, ligaments, and discs that support the spine
  • Poor posture
  • Pressure on the spinal nerves, such as due to a herniated disc
  • A fracture of one of the vertebrae.
  • Osteoarthritis, that is, wear and tear on the spine
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The spine shrinks and compresses with age, in part because the discs that cushion cushions the small facet joints in the spine start to break down. Taking care of your cartilage is key to maintaining your discs. Other than supplements and vitamins, proper hydration of the body is the easiest way to take care of your cartilage.


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