Back pain does not qualify as an independent diagnosis per se, but must rather be understood as a complex combination of symptoms and individual factors with biological, social and psychological components:
- Biological
-
- Degenerative changes
- Advanced age
- Trauma
- Deficits and imbalances in trunk-stabilizing muscles
- Social
-
- Job requiring heavy physical labor or one-sided posture (e.g. long periods of sitting or standing, working bent over)
- Low level of professional qualification or dissatisfaction with job
- Lifestyle causes: smoking, excess weight, lack of exercise, poor physical condition and lack of activities to balance out work and everyday life.
- Psychological
-
- Anxiety, depression
- Overextension
- Stress, everyday conflicts
- Somatization disorder
- Posttraumatic stress disorders
Biological factors are now no longer considered to be the sole cause of spinal column symptoms. Although the radiological signs of spinal column wear increase with age, the number of back pain patients tends to decrease with age. Back pain is also frequently initiated at trigger points. Trigger points are areas in the tissue that react sensitively to pressure with pain. Myofascial trigger points are points in muscles, muscle fasciae, and tendons up to 1 cm in size that may cause pain. Pain can be ”projected” into other regions from these trigger points. This type of pain is frequently observed at the back of the head (occiput), the back, the nape of the neck and the shoulders. Tender trigger points may set off chain reactions, especially in muscle tissue. Overloading a muscle, or favoring it in response to muscle pain, causes the affected muscle to contract and tense up, resulting in a localized circulation deficiency in the muscle tissue. The patient may respond by favoring this
area to ease the pain, causing other muscle groups to tense up, producing more trigger points and further exacerbating the pain.
|
