The spine divides into three regions: the cervical spine, which is the neck area; the thoracic spine, which includes the upper area of the back, before the inward curve; and the lumbar spine, which extends from the curved area to the base, or sacrum. Many conditions and injuries can cause chronic upper and lower back pain. Current Medical Diagnosis and Treatment, 2010 lists some of the most common ones.
Osteoarthritis
Osteoarthritis causes a narrowing of the space between the bones of the spine as the cartilage in those areas degenerates. When the neighboring nerves become compressed, pain results. Osteoarthritis in the spine can also lead to spondylosis. The arthritic changes in the spinal joints become permanent causing narrowing of the disk space and weakening of the vertebrae. Symptoms do not appear right away, but as the nerve becomes compressed, pain becomes evident.
Rheumatoid Arthritis
Rheumatoid arthritis affects the connective tissue around the joints. The structures swell with inflammation and cause stiffness. In some cases ankylosing spondylitis sets in. This condition causes vertebrae to fuse together, robbing the person of mobility at the affected site. The ligament that holds the spine in place becomes lax allowing a vertebra to slide out of place. When this happens, the danger of compressing the spinal cord exists. Early medical treatment helps avoid paralysis.
Thoracic Outlet Syndrome
Thoracic outlet syndrome happens when nerves and blood vessels get compressed between muscle groups that work the arms and shoulders. Besides pain in the back, the person feels numbness and tingling in his upper extremities, weakness, and swelling of the involved extremities. The cause of the nerve compression traces back to poor posture, perhaps due to heavy breasts, old age and overdevelopment of chest muscles or scar tissue.
Herniated Disk
The disk between each vertebra acts as a cushion to keep the bones from rubbing against each other and to keep the nerves in the vertebral space. If the disk shifts or bulges out to one side, it presses against the nerve that runs in that area and causes great discomfort.
Compression Fracture
The compression of two vertebrae together can cause one or both to fracture. Most common in people with brittle bones characteristic of osteoporosis, this phenomenon occurs when a person experiences a jolt from above or falls and lands feet first. The spine takes the brunt of the impact in these cases.
Referred Pain
A person in pain might at times perceive his back as the source of pain, when in fact another part of his body causes it. This type of pain is called "referred pain." This happens, for instance, with lower back pain when the aorta--the body's largest artery--bulges or tears. A penetrating peptic ulcer can also cause referred pain to the back.
References
- Current Medical Diagnosis and Treatment; Stephen J. McPhee and Maxine A. Papadakis; 2010
- Dorland's Illustrated Medical Dictionary, 31st ed.; Sanders Elsevier, publisher; 2007
