Marcella Carlson, age 13, of Dodge City, Kan., for her question:
WHAT CAUSES BACK PAIN?
A great number of different conditions can cause pains in the back.
Low back pain can be caused by a variety of mechanisms. The most common are acute injury or degeneration of the joints, ligaments, muscles or intervertebrai disks.
Referred pain, which is pain that hurts where it does not originate, can be felt in the back as a result of nerve root irritation. Muscles that are in spasm because of attempts to protect some local injury can also become painful. Sometimes the entire back hurts as the victim hunches and stiffens to guard against painful movement.
Acute back sprain is usually produced by a sudden bending of the spine, as in a fall or a "snatch lifting" motion. The force tears ligaments or compresses disks, producing pain and protective muscle spasm. These injuries usually heal in three weeks if protected against further sprains. It is necessary for some patients to wear a corset like support during the healing period.
Chronic back strain, also called postural fatigue, is a condition in which there is no violent, sudden, precipating incident, but the structures are subjected to prolonged tension greater than they can withstand.
Symptoms of chronic back strain usually come on gradually and progressively get worse. The symptoms usually are aggravated if the person is fatigued. but they can be improved by lying down or by physiotherapy.
The intervertebral disks are "shock absorbers" between the bony vertebrae of the spine. After age 20, it is normal for disks gradually to degenerate. Less weight is borne on the pulpy central portion and added strain is placed on the sensitive outer casing, sometimes giving rise to aching pain. Because the greatest strain occurs in the lower back. the pain usually is confined to that region.
Sometimes back pain can be the result of a poor posture. Poor posture definitely imposes added burdens on bones, ligaments and joints.
Scheuermann's disease, which is sometimes called "adolescent round back," is a common cause of backache among teen agers. For unknown reasons, growth changes in the thoracic vertebrae give them a wedge shaped formation which increases the usual thoracic curve. In the active stages of this disorder, which lasts from two to five years, there may be some pain.
There can be pain with scoliosis, a term used to describe a lateral curvature of the spine. It may be associated with a variety of disorders but, basically, it is caused by either a faulty bone structure or inadequate supporting muscles.
Idiopathic scoliosis is by far the most common type, and is usually first recognized in the pre puberty period. It occurs predominantly in girls. A doctor should be consulted as soon as the deformity is recognized because close observation and treatment are necessary to prevent a potentially severe deformity.