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Back Pain Categories

The questions we ask typically help to narrow down the type of back pain you have.  There are many causes grouped into categories such as:

  • mechanical
  • systemic (rheumatological)
  • infection
  • degeneration
  • trauma
  • sprains and strains
  • postural
  • central (ie, neurological)
  • sinister
  • referred pain

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What Causes Back Pain?

Osteopaths are well known for their effective and gentle approaches to helping people suffering with back pain.  There are many kinds of back pain and with many causes.  It is impossible to list every cause, however a lot of back pain problems can be put into categories and regions to help make them easier to understand.

When an osteopath asks you questions, they are trying to narrow down the possibilities of the TYPE of back pain you are having.  Not all back pain is pain that comes from the back.  All of the questions we ask help narrow down the options, because not all back pain is what it seems or is safe for an osteopath to treat without working alongside your medical team.

Mechanical Back Pain

Your twinge is very often ‘mechanical’ back pain – related to a change in the structures of the back.  These kinds of pain are often changeable – you will feel them sometimes, then they will go away. They may be worse after moving a lot, or after sitting for a long time. They can sometimes ‘move around’.  These pains are very amenable to treatment  and they respond very well to osteopathy and exercise.  There are about as many causes of this kind of pain as there are structures in the back – and there are a lot of those! In this case, our questions relate to narrowing down what structures could be affected and why.  Then we can set about testing and examining before working with you to create a treatment plan to rid you of your pain.

Non Mechanical Back Pain

But some kinds of back pain are not mechanical.  There are a range of things that an osteopath must consider.  These include arthritis – which partly falls into the mechanical ‘category’ – or possibly a fracture or an infection.  We also must consider the possibility of a vascular problem with the very large vessels in the abdomen or even a potential tumour.  This is why our questions are so important – we need to refer you to a more appropriate specialist in those cases so you can get the care you need before returning for help with some of your symptoms.

Some back pain crosses a line that osteopaths are very familiar with.  This pain can be caused by systemic problems such as rheumatological conditions – ankylosing spondylitis is just one.  Osteopathy cannot ‘cure’ the underlying inflammatory condition causing the pain – but medical advances have given doctors excellent medications that can help slow those conditions.  In those cases, osteopaths are often part of the care team because the work they do to reduce pain in and get joints moving again can have a dramatic impact upon someone’s quality of life.

Structures that can cause Back Pain

Here are a few examples of the kinds of the mechanical problems that can cause pain in different parts of the back.  This is not meant to be an exhaustive list but reflect the more common mechanical pains that are seen in practice every day.

Upper back pain

Muscle pain from spasms or trigger points

Irritated joints between vertebrae or ribs

Degenerative conditions such as arthritis

Referred pain from the neck or shoulder

Rotator cuff injury or shoulder problems

Neurological pain from entrapped nerves

Middle back pain

Muscle pain from spasms or trigger points

Postural pain, such as from scoliosis

Irritated joints between ribs or vertebrae

Gastrointestinal problems – reflux

Degenerative conditions such as arthritis

Lower back pain

Muscle spasms

Irritated joints

Muscle pain from trigger points, especially from the buttocks

Nerve root impingement – from degenerative conditions or disc prolapse

Arthritis of the joints in the spine

Luckily osteopathy has a lot of success in treating these very common problems, which is why osteopaths are so often asked ‘don’t you “do backs”?’  Anyone who knows me knows osteopaths do a lot more than backs, but we do get a lot of satisfaction from successfully helping people with back pain.


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