What causes back pain?
Serious causes are rare and include tumors or infections involving the spine or the spinal canal. The most common causes of back pain are related to osteoporosis, disc disease, osteoarthritis, which by thickening the bones which surround the facet joints, can narrow the space through which nerves travel from the spinal cord to the rest of the body. Another cause is looseness of the ligaments and tendons which stabilize the many joints in the spine. This looseness can be the result of injuries such as whiplash injury where ligaments and tendons get overstretched so much they cannot regain their original elasticity, poor posture, or age. Ligaments and tendons are made up of collagen, the same substance that holds up your skin, and, just as your skin loses its tone as you get older, so do your ligaments and tendons. If one of your vertebrae collapses because of osteoporosis, or if a disk collapses, the space between vertebrae decreases the ligaments and tendons which tether these structures are automatically loosened. There can then be slippage of the vertebrae one on the other causing severe pain.
Whiplash injuryIt can also cause damage to the nerves that supply the skin of the back. These nerves have to cross the fascia, the fibrous sheath covering the muscles and bones of the back through tiny holes. Whiplash stretches the fascia and distorts these holes, which become slits. These squeeze the nerves and cause them to swell. Once swollen, the nerves are trapped in these holes and cannot slim down as they keep re-injuring themselves on the walls of these holes. As long as they remain swollen, these nerves will send pain messages to the brain. This pain can spread down the legs, and last for many years. Pain due to loose ligaments or tendons or arthritis only comes when you move the ligaments or tendons or the joints. Nerve pain, on the other hand, can be severe and happen at any time even when you are not moving at all. If you press lightly on an area with nerve pain, the pain gets much worse.
Back pain treatments
Belts which can provide support for your spine and also relieve your pain, when you’re wearing them. Unfortunately, like every girdle, they will prevent your own muscles from working and muscles which are not used tend to waste away, leaving your spine ever more unstable and likely to hurt.
Narcotics can be used to deaden the pain and do not interfere with inflammation, but they can be addictive and should be used very sparingly.
Chiropractors may realign your back, but if your vertebrae are not solidly stacked and held together one on top of the other by strong ligaments and tendons, it is likely your back pain will recur as they once again slip out of place.
References on prolotherapy for low back painRoss A. Hauser, MD, Marion A. Hauser MS RD Dextrose prolotherapy for Unresolved Low Back Pain: A Retrospective Case Series Study Journal of prolotherapy 2009; 3:145 – 155
http://drreeves.com/Low-back-pain.html an excellent review of all the literature on prolotherapy in low back pain.
Donna Alderman, DO prolotherapy for low back pain, reasonable and conservative approach to musculoskeletal low back pain,disc disease, and sciatica. Practical pain management, May 2007 58-63. A good review, easy to read and understand and four case reports.
Klein RG et al. A randomized double-blind trial of dextrose glycerin phenol injections for chronic low back pain J spinal disord 1993; 6:23 33. 77% of subjects (53% of controls) had greater than 50% pain control at six months.
Ongley MJ et al. a new approach to the treatment of chronic low back pain. Lancet 1987; 2:143 – 6. 88% of subjects (39% of controls) had >50% pain reduction at six months.