Causes of Back Pain That Moves Around

Mechanical low back pain is a very common musculoskeletal problem. In the United States, it is the third most frequently reported symptom, and about 85% of the population will experience mechanical low back pain that moves at some point during their lifetime. The prevalence of low back which is associated with degenerative disc disease represents a major epidemiologic problem. The intervertebral disk is a complex structure that lies between the vertebrae ‘the spinal bones’.

The intervertebral disk, which is filled with a watery, gel-like substance in its center, undergoes the most serious age-related changes. By the third decade of life, this center ‘nucleus pulposus’ is replaced with fibrocartilage. Research literature showed that the prevalence of degenerative disc disease in men under 50 was 71%, and for women, it was 77% in the same age group. The normal function of the discs is to act as a cushion between the hard vertebrae.

However, when degenerative disc disease develops, the vertebral bony prominences and bone spurs press on nerves and cause pain. Although, for many people, degenerative disc disease may not cause any pain, the most common symptom associated with a disease is back pain that radiates ‘moves’ down to the legs or arms depending on the disease’s site. Other symptoms, such as numbness, tingling, and weakness in the lower or the upper limbs may also present. Since our brain cannot determine the specific source of the pain, a careful history and physical exam by an experienced specialist is mandatory. In addition, X-rays are used to show bone deterioration, while a magnetic resonance imaging (MRI) scan will depict damage to the discs and soft tissues. Several conservative modalities are considered when treating chronic pain of degenerative disc disease. Strengthening exercises, medications, epidural injections, and trigger point injections with lidocaine are among these modalities that can relieve the pain and reduce the inflammation in the spinal canal. Surgical treatment is reserved for refractory cases that do not respond to conservative methods, and approximately 5% of patients undergo surgery as a treatment of degenerative disc disease.

In addition, X-rays are used to show bone deterioration, while a magnetic resonance imaging (MRI) scan will depict damage to the discs and soft tissues. Several conservative modalities are considered when treating chronic pain of degenerative disc disease. Strengthening exercises, medications, epidural injections, and trigger point injections with lidocaine are among these modalities that can relieve the pain and reduce the inflammation in the spinal canal. Surgical treatment is reserved for refractory cases that do not respond to conservative methods, and approximately 5% of patients undergo surgery as a treatment of degenerative disc disease.

The coccyx, which is the most terminal bone of the spine, is often considered a vestigial remnant of a tail and is referred to as the tailbone. Coccyx pain is another common cause of low back pain. Tailbone pain causes include trauma, fractures, dislocations, and primary or metastatic malignancies. Aging is a risk factor for the development of tailbone pain.

Degenerative changes or even fusion of the segments of the tailbone seem to increase with age. Moreover, trauma related to giving birth is another female-specific risk factor. Patients usually complain of localized pain over the tailbone which is associated with prolonged sitting or sitting on hard surfaces. During a clinician’s examination, patients would not tolerate the palpation of the coccyx via an internal or external approach. Conservative treatment modalities, such as exercises to strengthen the muscles that support your tailbone, pain controlling medication, and avoidance of prolonged sitting always help relieve the pain in few weeks.

Local injection of an anesthetic to block the ganglion impar can effectively relieve the tailbone pain. Another option is injection with corticosteroids at the sacrococcygeal joint in cases of focal inflammation. Surgical treatment, in the form of partial or complete surgical removal of the coccyx, is reserved for resistant cases that failed all the previous treatment options.