Undiagnosed Back Pain?

World Wide Web | Undiagnosed Back Pain? | According to Uptodate.com, about 85% of lower back pain cases are classified as nonspecific; this means that no cause is identified. Since finding effective treatment requires insight into the cause of pain, this statistic is a gloomy one to those with recurrent or chronic back pain.When doctors seek out a cause of this common condition, they generally turn to the spine. Spinal pain often requires physical therapy and sometimes surgery. Muscular causes of pain are common and usually ignored unless pain becomes chronic, in which case physical and massage therapies may be considered. Pain killers are a hallmark of modern medicine and are prescribed for almost every pain condition. When there is no clear spinal problem causing your pain, it is difficult to 1) be taken seriously by medical professionals and 2) receive efficient treatment. Often, the cause of pain or the reason for its recurrence lies beyond the spine and lower back muscles.

Connective tissue such as ligaments and fascia are integral structures of the back and merit consideration in cases of chronic back pain. Ligaments connect bones together, providing stability and limiting range of motion. Fascia is connective tissue that surrounds and connects all structures of the body, providing structural integrity. It has been theorized that these connective tissues may be key players in chronic back pain, and the idea has been supported by case studies for years. In 2009, credibility was given to the idea by a study whose results quantitatively supported it.

The Study

Using ultrasound technology, researchers assessed connective tissue thickness of patients with and without lower back pain. They found that, on average, participants with pain had 25% greater thickness of connective tissue in the back than those without pain. The study can be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796643/.

Increased thickness of connective tissue is the result of the body's injury and repair process. When a tissue is injured, it experiences inflammation. The inflammatory response is characterized by a rush of fluids that help rebuild damaged fibers to the injured site. Excess inflammation causes an overabundance of tissue formation (fibrosis) that leads to scar tissue and stiffness.

The researchers theorize that tense fascia and ligaments lead to altered movement patterns both due to their rigidity and the modifications the body naturally makes to avoid pain. This change in body mechanics tends to cause a cycle of recurrent and worsening pain.

Treatment Options

If you have nonspecific chronic back pain, talk to your doctor about the need to consider connective tissue involvement. Imaging tests may be ordered to confirm this.

Myofascial release is a technique employed to restore elasticity to the connective tissue surrounding muscles. A trained practitioner uses hands-on techniques to identify areas of fascial tightness and to break down knots. Self-myofascial release (SMR) can also be pursued using a foam roller or other dense, round object to roll over the area of tension and hone in on tender knots.

Active release technique may help individuals with ligament fibrosis. This is another hands-on technique and is employed by practitioners trained to identify problem areas and break down scar tissue.

Movement therapies such as yoga and tai chi can supplement the above techniques in restoring flexibility to the structures of the back. These therapies also increase core strength, which helps to prevent back pain.

If you have chronic or recurrent back pain, it is likely that connective tissue is involved. Being aware of possible back pain causes will help you move toward an effective solution.