Back Pain

What Is Back Pain

Back Pain

Back pain can range from dull, mild, annoying pain to severe, persistent, and disabling pain in the back. This pian can interfere in mobility and normal functioning.  The spine consists of the individual vertebra which is stacked on top of each other to form a support structure that can carry the weight of the body and give us sufficient flexibility.  Each vertebra is composed of solid bone which supports the bulk of the weight. The disc is the soft, flat circular structure that separates one vertebral body from the other. This disc acts as a shock absorber and has a relatively hard shell that is soft from the inside. With age the disc may experience degenerative changes: it may start to dry up, thin out, and cracks may develop in the shell or the annulus. Consequently, the soft material from inside the disc escapes or herniates another reason for back pain called a disc herniation.

What Causes Back Pain?

Disc herniation can be very painful and unbearable. A herniation of the disc toward one side may compress a spinal nerve against the bone of the intervertebral foramen. In this case, the pain will shoot down or radiate to the limb, specifically the arm in a case of a cervical or neck disc herniation or the leg in a case of a lumbar disc herniation. Continued pressure will damage the nerve and weakness of the limb will atrophy or decrease in the mass of the muscle making movement slower. The condition arises because of various reasons:

  • Injury
  • Repetitive heavy lifting
  • Infection
  • Degeneration of vertebrae
  • Poor muscle tone in the back
  • Sprain or strain
  • Disease (such as osteoarthritis, and spondylitis)
  • Protruding or herniated (slipped) disk
  • Abnormal growth (tumor)
  • Obesity

Symptoms Of Back Pain

The pain can be due to the powerful muscles in the back that get stiff and muscle fibers may be damaged due to strain, causing painful spasms. This pain may also radiate down into the leg. The pain can be described in the following sensations:

  • Burning
  • Stabbing
  • Aching
  • Sharp or dull


Confirming what is causing the back pain usually requires performing specific tests of nerve function. Testing are procedures that evaluate how well the nerves of the wrist carry electrical signals. This information can help determine the extent of nerve damage (if any) and how best to treat the condition.

  • Nerve Conduction Studies (NCS)
  • Electromyography (EMG)
  • Radionuclide bone scan
  • MRI
  • CT Scan
  • X-Ray

Treatments For Back Pain

Dr. Mir can review your MRI with you, take your history, and may be able to tell by examining you if a disc bulge or herniation is in fact the cause of the pain or is an incidental or chance finding. If the pain is from facet arthritis or back sprain, Dr. Mir can recommend what course of action is the most beneficial for you. A neurologist is the best equipped and trained to help you determine if you need a referral to neurosurgery. However, certain options for treatment which are enlisted below can be taken:

  • Medicine
  • Osteopathic manipulation
  • Physical rehabilitation, therapy, or both
  • Activity modification
  • Occupational therapy
  • Weight loss (if overweight)
  • Following a prevention program
  • No smoking
  • Surgery

In Case Of Surgery

A very small percentage of disc herniations may require surgery. Specifically, herniations that are causing constant pressure on the nerves going to the limbs cause progressive weakness. In some cases, large central cervical disc herniations, which are discs that herniate to the front instead of the sides, can compress the spinal cord in the neck area causing weakness of both the arms and the legs. Additionally, large central disc herniations in the lumbar spine may compress the entire bundle of nerves that goes to the legs and may cause weakness of both legs that may require surgical remedies.