Sometimes back pain is not strictly related to spinal structures. Sometimes back pain comes from other places, specifically internal organs. In a process called referred pain, internal organs can send pain signals to other parts of the body. For example, when someone is experiencing a heart attack, the left arm may ache. Nothing is wrong with the arm, but this limb hurts because the heart is referring pain to it. The neck, mid-back and low back are also potential targets for referred pain. Here are two examples when "back pain" has nothing to do with spinal problems.
Gallbladder: The gallbladder is a small organ tucked up near the liver that helps with digestion. Within this internal organ problems can arise like a blockage from a stone, an infection, or just an inflamed gallbladder attack. Sometimes the symptoms clearly point to a problem with the gallbladder. These classic symptoms include right upper quadrant abdominal pain just underneath the right chest wall, nausea, gas, and pain with a deep breath. Many times these classic symptoms occur at night or just after a meal. At first, one may think that the problem is just indigestion until the symptoms progress. However, sometimes the symptoms are a little more elusive and give a murky picture of vague discomfort and pain.
Referred gallbladder pain can be especially tricky because it is felt in the mid-back, right shoulder, and between the shoulder blades. Because these symptoms are especially common in women, all women with pain in these areas should have the gallbladder evaluated and should also consider some dietary restrictions to prevent gallbladder attacks. Oftentimes, referred pain from a sick gallbladder will rear its ugly head as a serious problem requiring surgery. This scenario can be prevented if the patient and doctor have earlier suspicions of a potential gallbladder disease.
Bladder: The bladder is the all important organ in the pelvis that collects and hopefully empties urine at the right time. Many problems can arise here like infections, cancer, interstitial cystitis, and, arguably the worst problem, a "fallen bladder" (a.k.a. Prolapsed Bladder, Cystocele). Yikes! That's right; the bladder can literally fall out. Varying degrees of a prolapsed bladder exist starting with Grade 1, where just a little portion of the bladder pokes into the vagina, all the way to Grade 4, where the entire bladder is fallen out into and through the vagina. Now that condition can be as painful as it sounds and looks. Pain from the prolapsed bladder can be felt in the low back, sacrum, and pelvic region.
If a woman has low back pain with the "usual" urinary incontinence, a mild prolapsed bladder can be mistaken as just "low back pain." As the bladder falls further and the pain gets worse, the prolapsed bladder becomes more obvious. After a little "nip, tuck, and sling," the bladder can be put back into place and the back pain magically disappears. Other female organs can prolapse and cause back pain besides just the bladder. So, women with back pain might want to consider having a full pelvic exam especially if urinary incontinence is present. Back pain may not be all that it seems.