Back pain is becoming an increasingly common problem that affects a large percentage of people, regardless of age. However, an interesting question is how to determine exactly what type of pain it is. At Okto, we will introduce you to some of the most common types of pain that you may recognize in your symptoms.
Generally, we will introduce you to 5 types of pain that can affect your back.
Often, this type of back pain is associated with some kind of intervertebral disc damage (it should be noted that this is not necessarily the case in all cases). More important is the fact that the pain and symptoms follow a certain pattern:
The approach in terms of physiotherapy, in these cases of flexion-dominant back pain, involves the prescription and performance of certain exercises and stretching. These can also be performed at home during certain periods of the day. Their purpose is related to maintaining mobility in the spine as well as strengthening certain muscle groups to provide the necessary stabilization of the spine. The effect of these actions in turn also leads to a reduction in pain.
However, it is important to consult a physiotherapist who can guide you on which exercises to do and help you learn the technique. There are instances where an exercise needs to be modified to the patients individual complaints.
Extension-dominant pain is often associated with a problem in the joints connecting the vertebrae of the spine, called the zygopophyseal joints. Again, it should be noted that this cause is not necessary in all cases and is not always the underlying problem. Symptoms in this type of pain again follow a certain pattern:
Taking care of this type of back pain is about finding ways to reduce the load on the spine in the extended position. Gentle stabilizing exercises emphasizing the abdominal musculature as well as those aimed at improving movement in the hip joints can be effective. Application of other methods such as acupuncture and manual therapy would also have an effect.
Neurogenic claudication is a specific type of extension-dominant pain that tends to affect people who are over 60 years of age. The cause of this pain is related to compression of nerves and nerve roots when the patient is in an upright position and walking. This condition can significantly reduce the patient's ability to walk for significant distances.
Symptoms are related to:
When a patient with neurogenic claudication is in the acute phase of the condition, their ability to walk for prolonged periods of time is greatly reduced as they must take frequent breaks to relieve symptoms. The approach in these cases involves the incorporation of exercises that are aimed at maintaining a flexion (leaning forward) position of the body. This is done to reduce compression on the nerve structures and allow them to recover. Once the acute symptoms have been managed, efforts are directed at correcting the pelvic rotation to an upright position, which would relieve the pressure on the nerves.
It is important to note that in the acute phase patients should not try to "train themselves to walk more" , but should adopt postures that relieve symptoms.
This type of pain is not so common, more common are the types caused by mechanical damage. In cases of inflammatory pain, the cause is related to the presence of a significant inflammatory process involving the joints of the spine. It should be noted, however, that this occurs secondary to being triggered by an existing autoimmune disease, which causes the body's own protective cells to attack healthy ones. An example of such a disease is ankylosing spondylitis. The physiotherapist's task in these cases is to recognise the symptoms and refer the patient for consultation with a specialist doctor. Once the diagnosis is established and appropriate treatment is prescribed, the physiotherapist's role is concerned with relieving the symptoms present.
The symptoms are:
Patients should be given a plan with gentle exercises and postures to perform and guidelines to follow during an exacerbation.
Pain syndromes that affect the back are some of the more challenging conditions to treat. The nervous system of this type of patient interprets stimuli that do not normally cause pain as dangerous and threatening and responds to them accordingly with a sensation of pain. This condition requires a deep discrimination of what exactly is causing this pain to occur. It must be taken into account that this type of patient experiences pain without any apparent reason as to what is causing it. In these cases, patients need to work with a team of professionals that includes the physiotherapist.
The symptoms in these cases are:
Patients suffering from pain syndromes often try different painkillers and methods until they find the best combination for them. Physical therapists should help patients understand their condition and help them maintain good physical activity.
In conclusion, there is no definite "best" treatment approach for any of the listed pain types. Each patient's symptoms are individual, which necessitates an individual approach.
If you are suffering from any type of back pain it is a good idea to contact a physiotherapist who can help you manage it and give you the advice you need. The professionals at Okto have a wealth of experience with pain complaints and can help you come up with a solution to your problems.
