Why does our back hurt?

Back pain is one of the main causes of sick leave and disability. Depending on its degree, it can seriously affect the quality of life of the person who suffers from it. Currently, there are many known causes of back pain, some mild, such as muscle contractures, and others more serious, such as tumors, infections, fractures, loss of strength (or paralysis) and other neurological alterations related to a possible spinal cord or nerve injury.

What is back pain?

Back pain is pain located in some area of the cervical, dorsal or lumbar spine. Sometimes this discomfort is concentrated in the central part of the back and sometimes it extends to the lower extremities, in this case we call it sciatica, or to the upper extremities, which we call cervicobrachialgia. Its most common causes are hernias or protrusions of the intervertebral discs.

It is currently such a widespread health problem that it can be said that anyone who has never suffered back pain will suffer it at some time in his or her life. However, it is necessary to distinguish between banal back pain and non-banal back pain. The former is triggered by an effort or bad posture, lasts only a few days and goes away as soon as it appears, while the latter may be a sign of a serious health problem.

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How do doctors detect these serious health problems?

The main tool available to neurosurgery specialists in the detection of back pain is the patient’s clinical history and, specifically, the neurological examination together with the necessary additional studies. We must be trained to see the “red flags”, that is, those warning signs that help to identify if the back pain hides another more serious problem. For example, situations such as unexplained weight loss, night pain, personal history of cancer, osteoporosis or recent infections, among others.

What is the solution for patients who suffer disabling back pain without a serious cause?

First of all, it is essential to make the diagnosis as accurately as possible through a global evaluation of the spine and balance, in addition to a specific evaluation of the area affected. In these cases, the cause is usually wear and tear, osteoarthritis of the spine or a myofascial disorder, i.e., of the muscles and tendons of the back.

Determining the cause is not an easy task. Even today, with the great technical means available, it is sometimes not possible to specify a cause of back pain. Sometimes the pain is the whole disease and, since habitual aging is accompanied by degenerative structural changes in the spine, sometimes highly complex diagnostic dilemmas arise.

What are the results of surgery?

Surgery is usually part of the solution in the most severe diseases of the spine, as well as in a carefully selected group of patients with degenerative diseases of the spine.

What techniques are applied?

The most important part of the surgery is the indication and planning. The type of surgery performed by neurosurgeons is personalized, they could be compared to the old tailors, tailor-made suits are made for the patients, they are unique models.

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In recent years, the most advanced technology and all kinds of minimally invasive techniques have been incorporated, with the fundamental pillar of microsurgery, the technique par excellence in neurosurgery.

How effective is the treatment in other areas such as physiotherapy, rehabilitation, osteopathy, acupuncture, pilates or ozone therapy?

As in other aspects of life, one cannot generalize in this way. The work of rehabilitators and physiotherapists is often the most important point of treatment. With respect to other disciplines, there is a lot of variability and since it is not within the scientific field, it is difficult to establish its effectiveness. A reasonable and prudent recommendation is not to start any treatment without having previously undergone an evaluation or medical check-up by a neurosurgeon or specialist in spinal diseases.

Finally, it should be emphasized that the doctor-patient relationship must be close. Specialists should have the ability to detect these problems and patients should consult their physician if they have any doubts, otherwise the consequences may be irreparable.