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Causes
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Ageing
As we grow older, the spine tends to degenerate. For
example, the bones in the spine may lose some of their mass (due to osteoporosis), and the joints that link the
vertebrae together can become painful due to arthritis.
As a result, back pain tends to be more common in older people.
For example, the following chart plots the age of back pain sufferers against the
percentage who reported chronic, or long term, back pain (chronic pain is defined as that
lasting for more than 28 days in any twelve month period): |
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Source: UK Department of Health – The
Prevalence of Back Pain in Great Britain in 1998.
For details on the spinal conditions that result from ageing, please visit our section on Problems with Ageing. |
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Hereditary Conditions
Back pain can be caused by a number of conditions –
some of them are due to ageing; others might be due to your sex (for example, 80% of
people who suffer from osteoporosis are women). However, some conditions are caused by
genetics – faulty genes that are passed on from one generation to the next. Problems
such as these are referred to as hereditary conditions (we inherit them from our parents
and, in turn, we might pass them on to our children).
The problems themselves might be congenital (that is, present at birth), or they might
develop over a period of time (as you grow older). The exact timing of the problem depends
on the genes that cause the condition, and when they’re turned on (or expressed).
Examples of hereditary conditions include: scoliosis
(idiopathic); Scheuermann’s
kyphosis; and short-leg syndrome. Please note, however, that some conditions may be
caused by more than one factor – they’re not always genetic. |
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Injury
Spinal injuries (including those to the muscles; ligaments;
intervertebral discs; and joints) are very common. The chances are, you’ll either
have suffered from an injury yourself, or you’ll know someone who has.
Some of the most common causes of back pain are listed below:
- Car accidents
- Sporting injuries
- Incorrect lifting
- Repetitive strain
- Osteoporotic fracture
Road traffic accidents – often a cause of serious spinal injuries – are
becoming more and more common. For example, according to the Bone and Joint Decade (an
international body supported by the UN, the World Health Organisation, and the World Bank)
they’ll account for up to 25% of all healthcare expenditure in developing nations
by the year 2010.
Even in developed nations, the problem continues to grow. For example, in 1994, the
medical cost of RTAs stood at $17bn in America; in 2000, the cost had grown to $32.6bn
– an increase of roughly 65% after inflation (source: National Highway Traffic Safety
Administration (NHTSA); US Dept. of Transportation).
Of the remaining causes, osteoporotic fracture and incorrect lifting are probably the most
common. Osteoporosis (a condition which leads to osteoporotic fracture) is generally
caused by ageing; nevertheless, it accounts for over 1.5 million fractures, or injuries,
in America every year.
Incorrect lifting is actually a result of bad posture (covered below); however, the number
of people who injure their backs in this way is very high. For details on how to prevent
back pain, please visit our section on Lifting.
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Obesity
It is widely recognised that people in developed countries
are becoming more sedentary and adopting poorer diets – factors that have led to an
increased incidence of obesity; lower muscle strength; and weaker bones.
For example, the number of adults in the UK who were clinically obese, defined by a
Body Mass Index (BMI) of greater than 30 kg/m2, has trebled, from approximately
7% in 1980, to 20% in 1999: |
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Sources: 1 Department of Health – Secular trends in sugar intake and obesity in
the UK. 2National Statistics – Obesity by social class of head of
household and gender.
Extreme excess weight is very bad for the back: the vertebral column is compressed and
subject to increased shearing forces, both of which can lead to dysfunction of, and injury
to, the spine. It should also be noted that lack of exercise, without weight gain,
can also result in back pain through atrophy and dysfunction.
For details on the anatomical effects of compression (and the implications for back pain),
please visit our section on the Anatomy of
Back Pain. |
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Posture
Over time, bad posture can lead to back pain and deformity.
For example, when we slouch:
- the joints in our spine are compressed;
- the intervertebral discs become squashed; and
- the wrong muscles are engaged.
However, the effects of bad posture aren’t immediately apparent – it may take
a number of years, or even decades, for pain, stiffness and other symptoms to develop. As
a result, people tend to focus on more pressing matters.
Modern life tends to compound this problem. For example, many environments are
ergonomically poor in the first place – they’re designed for maximum profit, not
for maximum comfort. As a result, they tend to encourage bad posture, and make correction
difficult.
But the good news is this – we are, to a large extent, in control of our
destiny. If we choose to, we can alter our posture. For more details on how to do
this (and how to change your individual activities), please visit our section on Posture. |
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