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Where Does Your Back Pain Come From?

backpainAt one time or another, we have suffered from or diagnosed with back pain, which always occurs after over doing physical tasks such as working on the car, fall yard work, cleaning the house, shoveling, winter snow, and more. But, sometimes it can be difficult to identify the cause of back pain. Let’s have a comprehensive look at where this complication comes from.

Despite activity-related back pain being common, in most cases, a direct link to over-use is unclear. Micro-traumatic events, after accumulating, can be painful when a certain threshold is surpassed; just like the old say goes “the straw that broke the camel’s back”.

There are several causes of back pain, and one of them is known as referred pain, which can be as a result of soft tissue or irritated joint not necessarily placed in the immediate area of perceived pain. For instance, pain felt in the leg may be as a result of an injured facet joint, sacroiliac joint, and/or a disk tear. This type of pain is called as sclertogenous pain.

Internal organs are also likely to lead to back pain, referred to as a VSR (viscerosomatic response). A good example of this type of pain is when the right shoulder blade appears to be the source of pain when there is an inflammation in the gall bladder. The VSR can be located below or at scapula beside the spine and muscles in the area in spasm, and always painful or sensitive to touch. Additionally, this pain is often not changed or worsened by bending in various directions (as opposed to MSK/musculoskeletal pain). If not tested further, you can easily confuse VSR with a typical back ache or MSK. Finally, a final diagnosis may need an abdominal ultrasound (MRI, CT scan are not used frequently).

Visceral pathology found in the back pain patient presenting to chiropractors is reportedly uncommon. And one survey notes that just 5.3-percent of patients with non-musculoskeletal complaints. Other frequent VSR pain patterns include: Appendix right lower abdomen, whose primary symptom is stomach pain; upper tailbone, kidney small of the back, and/or groin areas; Ovaries groin and/or umbilical area; Small intestine between it and the breast bone and/or either side of the umbilicus; Lower quadrants and/or colon mid-abdominal; Liver right upper shoulder (back and front), just below the sternum, and right middle – low back; and heart left chest – left chest, left jaw, and mid-upper back.

Another drawback to diagnosis is cancer in the spine, and this can either be metastatic, which is from a different location or primary. Fortunately, this is not common. Nighttime sleep interruptions, no response to normal back care, a past history of cancer, over age 50, and an unexplained history of weight loss may make a doctor recommend tests to help determine if cancer is in the spine.

The Bottom Line

When patients are diagnosed with back pain, doctors and chiropractors have been trained to look for these rare but crucial causes of back pain. They get suspicious when the normal orthopedic tests don’t convey the normal responses noted with mechanical pain. In such cases, chiropractors work with primary doctors, so they can coordinate care to obtain prompt treatment and diagnostic testing.

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