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Back pain: where does back pain come from?
We talk about back pain as evil of the century, so widespread is this disorder.
However, back pain does not designate a particular disease, but a set of symptoms that can have multiple causes, serious or not, acute or chronic, inflammatory or mechanical, etc.
This sheet is not intended to list all the possible causes of back pain, but rather to offer a summary of the various possible disorders.
The term rachialgie, which means “spine pain”, is also used to refer to all back pain. Depending on the location of the pain along the spine, we talk about:
Pain in the lower back: low back pain
when the pain is localized in the lower back at the level of the lumbar vertebrae. Low back pain is the most common condition.
Pain in the upper back, it is surely neck pain
When the pain affects the neck and cervical vertebrae, see the fact sheet on Muscle Disorders of the Neck.
Pain in the middle of the back: back pain
When the pain affects the dorsal vertebrae, in the middle of the back, it is called back pain
The vast majority of back pain is “common”, meaning that it is not related to a serious underlying disease.
How many people experience back pain?
Back pain is extremely common. According to studies1-3 , it is estimated that 80 to 90% of people will have back pain at least once in their lifetime.
At any given time, about 12 to 33% of the population complains of back pain, and back pain in most cases. Over a period of one year, it is considered that 22 to 65% of the population suffers from low back pain. Neck pain is also very common.
In France, back pain is the second cause of consultation with the general practitioner. They are involved in 7% of work stoppages and are the leading cause of disability before age 454.
In Canada, they are the most common cause of workers’ compensation5.
It is a very crippling public health problem all over the world.
Causes of back pain
There are many factors that can cause back pain.
It can be trauma (shocks, fractures, sprains…), repeated movements (manual handling, vibrations…), osteoarthritis, but also cancerous, infectious or inflammatory diseases. It is therefore difficult to address all the possible causes, but note that:
- in 90 to 95% of cases, the origin of the pain is not identified and we speak of “common back pain” or nonspecific. The pain then comes, in most cases, from lesions at the level of the intervertebral discs or from vertebral osteoarthritis, that is to say from a wear of the cartilage of the joints. The cervicalgies, in particular, are very often linked to osteoarthritis.
- in 5 to 10% of cases, back pain is related to a potentially serious underlying disease, which must be diagnosed early, such as cancer, infection, ankylosing spondylitis, cardiovascular or pulmonary problem, etc. .
To determine the cause of back pain, doctors give importance to several criteria6 :
- the seat of pain
- the mode of onset of the pain (progressive or sudden, following a shock or not …) and its evolution
- the character inflammatory pain or not. Inflammatory pain is characterized by nocturnal pain, resting pains, nocturnal awakenings and a possible feeling of stiffness in the morning upon rising. In contrast, purely mechanical pain is worsened by movement and relieved by rest.
- medical history
Since back pain is “nonspecific” in the majority of cases, imaging tests such as x-rays, scans or MRIs are not always necessary.
Here are some other diseases or factors that can be responsible for back pain7:
- ankylosing spondylitis and other inflammatory rheumatic diseases
- vertebral fracture
- osteoporosis
- lymphome
- infection (spondylodiscite)
- “intraspinal” tumor (meningioma, neuroma), primary bone tumors or metastases …
- spine malformation
back pain8 : In addition to the causes listed below, mid-back pain can potentially be related to anything other than a spine problem, in particular a visceral disorder and should prompt consultation. They can thus be the result of a cardiovascular disease (infarction, aneurysm of the aorta, dissection of the aorta), of a pulmonary disease, digestive (gastric or duodenal ulcer, pancreatitis, cancer of the esophagus, stomach or pancreas). Low back pain : low back pain can also be linked to a renal, digestive, gynecological, vascular disorder, etc. |
Course and possible complications
Complications and progression obviously depend on the cause of the pain.
In the case of back pain without underlying disease, the pain may be acute (4 to 12 weeks), and subside within a few days or weeks, or be chronic (when it lasts more than 12 weeks). weeks).
There is a significant risk of “chronicization” of back pain. It is therefore important to consult your doctor quickly to prevent the pain from setting in permanently. However, several tips can help limit this risk (see the Low back pain and muscular disorders of the neck fact sheets).