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, ...
Spondylolisthesis (spaun-di-lo-lie-thee-sis) is a mouthful and is a common cause of low back pain (although it can exist anywhere in the spine, the lumbar spine is the most common area affected). The spinal column is a series of building blocks called vertebral bodies stacked on top of one another. Sometimes these blocks do not line up perfectly. This slight separation in the spinal column is called a spondylolisthesis .
"Doc says I have a spondy-something-or-other. Don't ask me what it is; all I know is that it hurts". Steve tries to explain his low back condition to his friend. But, he finds that he cannot explain what he does not understand. Steve has had back pain for a number of years. Every year the pain gets worse and has now become constant. His doctor sent him for x-rays recently. The x-rays showed a spondylolisthesis with disc degeneration at L5/S1. Steve could not understand his doctor's explanation of the condition. So, now he has pain and has confusion.
How can chronic pain be prevented? Oh that I and the insurance companies knew the answer to that question!
The key is to identify those patients at risk for the development of chronic pain .
Musculoskeletal pain is a significant problem in this country: 85% of the population suffers from this affliction at some point during the employment years. Fortunately, the majority recover rather quickly from acute back pain . It is the 3% to 10% that develop long-term disability due to their chronic pain, which is a deceptively small percentage if one considers that this minority consumes significantly more than 50% of the health care dollars for this problem.
If the chronic pain group could be identified, perhaps an intervention could occur which might avoid the suffering and costs associated with pain and loss of income. Unfortunately, musculoskeletal pain is such a frequent occurrence, it would be prohibitively costly to attempt psychological interventions upon every ...
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