Mild or intense, persistent or transient, violent, stabbing, unbearable. back or neck pain acts as an alarm to indicate that something abnormal is happening in the body. Bad posture, pinching of a nerve between two vertebrae, arthrosis, sudden movements. We take stock of the situation according to the location of the back pain.
The back is composed of 24 vertebrae, mobile, stacked one on top of the other, and held together by discs, ligaments, and muscles. However, this ensemble is fragile and subject to multiple stresses. The cervical vertebrae are among the most vulnerable parts of the spine. Their function is to support the head while ensuring its mobility, so they are very much in demand and often poorly treated. Whether the pain is in the lower back (lumbago), in the neck (cervicalgia), or more rarely in the middle of the back (dorsalis), the mechanism is identical.
Mechanisms of pain
Initially, there is most often an anatomical lesion of the intervertebral disc, such as a tear or degeneration, caused or aggravated by carrying too heavy loads or repetitive movements.
The posterior part of the intervertebral disc can be damaged, and this injury stimulates small nerves that propagate painful impulses to muscles, ligaments, and nerves. Neck pain can radiate to the shoulder, elbow, hand or shoulder blades, and a lumbar disorder can cause pain in the calves.
When this pain persists for more than six weeks, it becomes chronic: it is often less severe but leaves the sufferer with little respite.
Abrupt movement or violent exertion
Intense pain, “like a stab,” followed by a blockage of the lower back, is characteristic of acute low back pain or lumbago, the most common form of back pain. Lumbago can be the result of sudden efforts (moving, gardening, earthwork) or too frequent forced movements (bending over a patient, lifting bedridden people, working with arms outstretched in the air) as found in the professions of care assistant, house painter or beautician.
Acute low back pain affects workers and craftspeople who perform repetitive actions and carry more heavy loads. However, the risk of this condition, developing into chronic low back pain, is the same for managers and workers. More often, a crack or sagging of the intervertebral discs is at the origin of this low back pain.
The pinching of a nerve between two vertebrae
Back or neck pain can also be caused by the pinching of a nerve between two vertebrae.
-In the neck, the pain may extend into the shoulder and arm.
-In the lower back, the pain radiates into the buttock or even the leg. Caused by irritation of one of the roots of the sciatic nerve, it is characteristic of sciatica. There’s a continuum between the three, over time. It starts with low back pain, until the day the disc herniation occurs, it occurs when a disc, crushed between two vertebrae, moves out of its original position and compresses the nerve root. Very painful, it causes an alteration in the sensitivity of the lower limbs and can even make it difficult to move around.
From the age of 40: Osteoarthritis
Another major cause of pain is osteoarthritis. This progressive wear of the articular cartilage of the vertebrae causes stiffness and pain that becomes chronic.
In case of low back pain
the most affected are people with a high degree of arching from the age of 40-50 years. Even more, if they are overweight, this excess fat leads to a melting of the abdominal muscles. Beyond the age of 60, low back pain is more frequent as disc problems, and osteoarthritis is often combined. The main consequence is a narrowing of the lumbar canal (which notably contains the nerves destined for the lower limbs, such as the sciatic nerves) and claudication, which causes pain in the sciatic nerve when walking, making prolonged walks impossible. Doctors refer to this as lumbar stenosis syndrome.
In the case of neck pain
Osteoarthritis is the leading cause of neck pain or cervicalgia. This degeneration in the joints reduces the mobility of the neck and causes pain that radiates into the arm. The person suffers from the neck and shoulder pain accompanied by stiffness and urge to urinate, followed by slight paralysis of the lower limbs.
Pain in the neck: Poor posture
When cervical pain is not due to osteoarthritis, it may be caused by a disc problem and is usually the result of a trauma such as a whiplash (cervical disc herniation). Similarly, persistent torticollis sometimes reflects an underlying mechanical pathology, in response to a flare-up of osteoarthritis or a malfunctioning disc.
Poor posture during sleep or at work is also identified as the cause of severe cervical pain. For example, back specialists strongly advise against sleeping on your stomach, tilting your head forward when working on a computer, or pinning the phone between your ear and shoulder to take notes while communicating.
More generally, any poor posture maintained for long periods while sleeping or in front of a computer (back rolled forward) compresses the discs and pulls on ligaments and muscles, causing muscle contractures. Consulting a post urologist can help correct these bad habits.
Middle back pain: less common
The dorsal concerns the middle of the back to the root of the neck. Unlike low back pain and neck pain, they are very rarely caused by osteoarthritis or disc problems.
It is necessary to look for something other than a mechanical problem and to make a complete and exact assessment. It can be the sign of a spondylarthritis (an inflammatory disease of the spine) that wakes up at night, or acute affections of other organs (pancreatic cancer, aneurysms of the aorta.) that cause back pain. It is rare, but it exists.
When a child has back pain
It’s not healthy for a child to have back pain. If he complains, you should consult his doctor. The pain may be related to intensive sports such as gymnastics, horse riding, judo, or rugby. The lower back is subjected to regular stress, which, over time, can crack the end of a vertebra. It can then slide forward (spondylolisthesis).
A very acute pain that persists, requiring immobilization to consolidate the vertebra. In pre-adolescents, depending on the location of the pain and the way it manifests itself, the doctor will be more likely to suspect spondylarthritis or Scheuermann’s disease, a frequent abnormality in the growth of vertebrae, which may require the wearing of a corset during adolescence.