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ASK DR. SPINE: All back pain is not created the same

ASK DR. SPINE: All back pain is not created the same


Back Pain is a common affliction. About 80% of the U.S. population will experience back pain at some point in their life.

That said, all back pain is not the same. In treating the back, it is important to note that there are many reasons for back pain. Additionally, certain types of back pain tend to occur within a certain age group.

Back pain is very rare in patients less than 10 years of age. When back pain occurs in this age group is caused by an infection, trauma or due to some form of skeletal deformity such as scoliosis.

Ages 10-20

Back pain in this age group is often due to physical activities such as sporting activities. Patients in this age group are often playing a sport such as baseball, football and gymnastics which places stress on the spine leading to back pain.

Since the body is still developing in this age group, this patients are prone to stress fractures in the spine or simply muscle overuse. Tumors are a rare cause of back pain in this group. Another source of back pain in this group is spine deformity such as scoliosis.

Ages 20-40

Overuse is the main cause of back pain in this group. This is often the result of occupation in patients who perform heavy work such as heavy construction or manual labor.

Tumors and deformity are less causes of back pain in this age group. Spine infection which spread from another part of the body is a rare cause of back pain in this age group. Abdominal disorders such as kidney stones, other gastrointestinal disorders or pelvic disorders such as ovarian cyst are rare causes of back pain.

Age 40 and older

As we age the incidence of back pain increases. As such, there are multiple causes for back pain in this age group.

These include overuse, degenerative changes, infection, GI disorders, pelvic pathology, vessel aneurysm and tumors. Degenerative conditions are by far the most common cause of back pain in this age group. Degenerative changes are caused by a combination of age and physical activities. As we age the disc in the spine become stiffer and also get smaller (this is the reason we lose height as we age). As a result of these changes arthritis will develop causing back pain. This type of back pain is worse with activities and often in the morning when we first get out of bed. Also as a result of these age related changes, there can be compression on the spine nerves leading to neurogenic or nerve related back pain. This type of back pain is different than the kind caused by arthritis in that it is worse with standing or walking but goes away with sitting.

Tumor is another rare cause of back pain in this age group. Most of these tumors originate in other parts of the body such as the breast, the prostate, the lungs and the kidneys. Tumors which start in the spine itself are a rare cause of back pain.

Another source in this age group of back pain is compression fractures. This is a result of age related changes called osteoporosis, which is weakening of the bone quality.

Finally, intra-abdominal or intra-pelvic pathologies can be causes of back pain in this age group. These causes are usually investigated when diagnostic studies of the spine fail to explain the patient’s back pain.

Dr. Dwight S. Tyndall, FAAOS, is a minimally invasive spine surgeon practicing in the Region at His column, which appears every other week, covers a wide range of health and medical issues.


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