It is common knowledge that the older we grow, the weaker our bodies become. Sometimes this comes with pain and difficulty in performing our day-to-day tasks. The back is no different as it serves as the major structural support of the body.
Our back comprises a complex network of bones, muscles, tendons, ligaments, and discs. These work hand in hand to provide a supporting structure for the body and aid movement. A problem could arise with any of these components, causing back pain.
Causes of Back Pain
About 80 percent of adults, at some point experience back pains. Most people develop their first back pain symptoms between the ages of 30 and 50. It gets worse as you get older. After age 50, you are more likely to develop the following conditions that precipitate back pain:
- l Spondylolisthesis: refers to a condition where one of your vertebrae slips out from its position, down to the bone below it.
- l Spinal Stenosis: here, the canal through which the spinal cord passes is narrowed.
- l Degenerative conditions of your joints and disc: this can result in little or lack of moisture and shock absorption. (1)
Other causes include:
- Structural problems such as sprain or strain.
- Inflammatory conditions such as Ankylosing Spondylitis.
- Infections of the bones.
- Other infections like pelvic inflammatory disease (PUD).
- Tumors that develop on the spine or other parts of the back.
- Sedentary lifestyle and bad posture: most back pain experienced by people is caused by this factor. Back pain occurs primarily at the back, sometimes you feel the pain down to your buttocks and leg. Depending on the nerves affected, you can feel it in other parts of your body. (2)
When To See a Neurologist?
Oftentimes, the pain can be managed without treatment, and just with lifestyle modifications. In severe cases, there might be a need to see a doctor, specifically a neurologist. A Neurologist is a specialist doctor who is responsible for the diagnosis and non-surgical treatment of conditions of the brain, nerves, and spinal cord. As nerve experts, they determine if your back pain is a result of nerve pain or nerve compression. See a neurologist if you experience the following:
- Low Back Pain: As the name suggests, it is depicted by pain in the lower part of the spine. It can be caused by a sprain i.e., injury to a ligament, or by a strain (muscle injury). This pain can be either sharp or dull, burning or aching, or a combination of pain. It can also be constant (you feel it all the time) or intermittent (it comes and goes) or comes up during physical activity). Women are more prone to developing lower back pain than men, possibly due to hormonal factors. The pain may sometimes require surgical treatment, but 50 percent of people who experience this pain have recurrent episodes within one year. It is regarded as chronic if it persists after 3 months. (3)
- The pain worsens or becomes persistent. (Especially when it is not relieved by rest). Pain that radiates to the lower limb for more than a few weeks. This could be a result of a neurological condition known as radiculopathy, a disease of the nerve root. It could be any of the following:
- Sciatica: refers to pain that radiates along the sciatic nerve to one or both legs.
- Thoracic radiculopathy: a rare condition where a pinched nerve or swelling compresses the nerve.
- Unexplainable weight loss.
- Inflammation of the back.
- Fever: points out a possible abscess (4).
If you are experiencing neurological symptoms like weakness and numbness in the legs, Numbness around the genitals and buttocks, seeing a neurologist is your best bet. This could be a result of a medical condition known as Cauda Equina Syndrome (CES). This is a condition where the bundle of nerves at the end of the spinal cord called the cauda equina is damaged. It is also characterized by back pain, tingling sensations, and changes in bladder or bowel function.
The neurologist makes a diagnosis based on the patient’s history, physical examination, and symptoms. In cases of chronic back pain where conventional medical treatment does not work, your neurologist could run some diagnostic tests to determine if you need to be referred to a spine surgeon.
Some of these tests include:
- Computed Tomography Scan: detects herniated disks or issues with any tissue, tendons, nerves, ligaments, muscles, and bones in the back.
- Electromyography: assesses the health of muscles and its controlling nerve cells by measuring the electrical impulses produced.
- Magnetic Resonance Imaging Scan: used in certain cases where a CT scan is not able to detect the issue at hand.
- X-rays: show the alignment of the bones. It also detects signs of broken bones and if the patient has arthritis.
- Myelography: detects the pathology of the spinal cord and the location of a spinal cord injury using a contrast medium.
- Selective nerve root block.
- Nerve Conduction Studies.
Treatment Of Back Pain
The neurologist could initiate medical treatments if the pain does not resolve with rest and home remedies like:
- Maintenance of good posture
- Stretching exercises like yoga
- Keeping physically fit by exercising and weight loss if obese
- Use of either heat or ice packs. The former is best used in cases of stiff or tight muscles. While the latter is used in cases of inflammation or swelling.
- Use of Over The Counter medications such as Ibuprofen and topical analgesics to relieve the pain.
The medical treatments include:
- Strong painkillers like Codeine and Hydrocodone can be prescribed to be taken for a short period.
- Muscle relaxants can be given at the neurologist’s discretion.
- Steroid injections: can be initiated if other options prove to be ineffective. Steroids are an anti-inflammatory drug that helps to reduce inflammation.
- Traction: Pulleys and weights are used to stretch the back and relieve pain.
- Transcutaneous electrical nerve stimulation (TENS): used in chronic back pain conditions. Here, electrodes are placed on the skin, and small electric pulses are delivered into the body with the aid of a TENS machine.
- Complementary therapies: may be used alone or with conventional medical treatments. They include Chiropractic, Osteopathy, Shiatsu, and Acupuncture.
- Surgery: this is usually the last resort for treatment
Why should you see a neurologist ?
Back pain can be caused by a variety of reasons for each patient which can sometimes be challenging to determine. Some patients may only need a general practitioner for their back pain management. When the pain is complicated, a neurologist needs to get involved.
A neurologist specializes in diagnosing disorders affecting your spine and peripheral nerves. He or she will have access to advanced diagnostic tools necessary to assess your back pain like an MRI and x-Ray, EMG, and nerve conduction studies, which will also uncover possible muscle weakness with amazing detail. This level of detail makes the neurologist the best resource to diagnose, test, and treat back issues and neck pain.
If the need arises, and you wish to visit a neurologist for an accurate diagnosis and treatment, the excellent team of top neurologists at https://superiorneurology.com will provide you with all the knowledge and care you need.
1.https://www.southeasttexasspine.com/blog/is-it-normal-to-develop-back-pain-as-you-get-older#:~:text=As%20you%20 age%2C%20your%20 spine,be%20attributed%20to%20general%20 degeneration.