Mechanical lower back pain is an emerging problem nowadays. Mechanical means that the vertebral column receives forces that destroy the soft tissues resulting in pain and uncomfortable sensations. The mobile parts of the vertebral column include muscles, tendons, ligaments, vertebral bodies, facet joints, and intervertebral discs. The motion of these mobile parts triggers mechanical pain. The lumbar region of the vertebral column is a common region for the occurrence of mechanical back pain because all the five lumbar vertebrae absorb and distribute a major portion of the body weight during movements and rest.
The neck is also a common region for mechanical back pain. The neck is the most mobile part of the vertebral column. It contains seven cervical vertebrae which support the head and much smaller than the lumbar vertebrae. A vast range of motion takes place at neck including bending forward, nodding, bending backward and side to side. A back or neck sprain or pain takes place when ligaments of the vertebral column are overstretched or torn. Neck or back sprain may also occur due to the involvement of muscles and tendons. Due to some injury or insult, muscles of affected part go into spasm which causes severe pain on movement. Movement is also difficult when muscles become stiffened.
Causes of Mechanical Back Pain
As we have already discussed, mechanical back pain happens due to injury or spasm of muscles and other soft tissues. Here we’ll discuss some other conditions which cause pain in your back while moving.
Intervertebral discs are present between each adjacent vertebrae. Each disc contains two parts. And outer ring-like structure called as annulus fibrosis and inner jelly-like material called as nucleus pulposus. When the inner jelly-like material comes out of the outer ring due to an injury or trauma, the condition is known as disc hernia. These discs allow a small range of movement at each segment of vertebrae. Due to disc hernia, the pressure is exerted to the adjacent nerve roots causing nerve irritation, impingement, compression, swelling, and pain. This pain is aggravated on movements because with each movement at back, the intervertebral disc also shows some motion.
Vertebral Compression Fracture
A vertebral compression fracture takes place when a vertebral body is collapsed due to some forces. Vertebral compression fracture may take place due to trauma or osteoporosis, a degenerative bone disease in which bones become weakened and prone to injury. In the patients of osteoporosis, vertebral compression fracture may happen spontaneously during routine movements like bending forward or lifting the weight. These fractures cause pain which is sudden in onset and severe in nature.
Lumbar Spinal Stenosis
Spinal stenosis is a condition when the spinal canal or the passageways of nerve roots become narrowed. Due to this narrowing, nerves are become compressed and pain is the first symptom to be felt. This pain can radiate to arms, legs, and feet. When it is radiated to buttocks and one or both legs, it is termed as sciatica. Lumbar spinal stenosis occurs due to degenerative disc disease and common in old age. One reason for this is, bony spurs usually grow in the old age patients of spinal canal stenosis, so nerves are pressed due to less available space.
It is also termed as spondylosis. It is also a degenerative disease of the vertebral column. Spondylosis can affect the facet joints of the vertebral column causing stiffness, swelling, and pain. It can occur in any area of back including neck, the middle part of the back (thoracic region) and lower back (lumbar region).
Risk Factors for Mechanical Back Pain
Following we’ll describe some of the risk factors for the development of mechanical back pain.
Wear and tear changes occur in the vertebral column with advancing age which leads to certain conditions that we have already discussed above like spinal osteoarthritis, spinal canal stenosis and bony spurs, etc. These conditions produce chronic neck and back pain. People between the age of thirty to sixty years are more prone to develop disc-related disorders while people above the age of sixty years have more chances of developing osteoarthritis.
It is proven from studies that certain kinds of vertebral column disorders have a genetic component. Its example can be given in terms of degenerative disc disease which has an inherited component.
3) Occupational hazards
Any type of job which demands repetitive bending movements and heavy weight lifting has a high prevalence of developing back pain. (for example nurses, surgeons, construction workers, laborers). Jobs that demand prolonged period of standing, e.g. a barber or sitting in an office chair, e.g. software developer also puts the person in the category of high-risk people. This is so because the back is not supported at all for prolonged periods of time.
4) Sedentary Lifestyle
Lack of physical activity and regular exercise enhances the likelihood of occurrence of lower back pain and also increases the severity of pain.
Extra weight puts extra pressure to the muscles of back and bones of the vertebral column which are thus strained. Being overweight also enhances the risk of knee and other joints pain.
6) Poor Posture
Any kind of poor posture for a prolonged period of time significantly enhances the risk for chronic backache. Examples can be given as driving while hunched over the steering wheel of the car and improper lifting techniques.
Treatment of Mechanical Back Pain
Mechanical back pain is treated in the same way as the other kinds of back pains. Treatment modalities include non-surgical approaches (bed rest, painkillers and supervised therapy programs) and surgical interventions if needed.
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Short time bed rest is suggested for the patients who suffer from back pain due to muscle spasm. Bed rest of greater than 45 to 48 hours is generally not recommended.
Ice and Heat Application
Applying hot or cold compressors is helpful for reducing inflammation and pain reduction. Cold fomentations also improve blood supply which is good for a spinal condition. It is usually recommended that you must apply a hot compressor for 20 minutes and then cold compressor for 20 minutes. You can apply each compressor individually. Apply each compressor 2 to 3 times a day.
If the mechanical back pain is due to muscle spasm, a muscle relaxant is prescribed. Painkillers are also prescribed to reduce pain. NSAIDs are the first line medicine in this regard. The famous drugs of this family are aspirin, ibuprofen, and naproxen but we DO NOT RECOMMEND to take any drug without consulting your doctor.