Low back pain - Joint pain and discogenic pain

Firstly, I would like to start out by stating that back pain that is constant, not relieved by rest, not aggravated by movement, associated with a fever, a result of significant trauma, or associated with weakness or numbness in the legs, should be seen by a health professional.

Many people, 15.7% of the population (in Australia) (Source: Back problems, Data - Australian Institute of Health and Welfare), have reported having a back problem. Of the people with back pain 15.9% reported experiencing severe or very severe pain versus 5.7% of people who do not have back problems (Source: Back problems, Data - Australian Institute of Health and Welfare). There are many causes of back pain.

The majority of low back pain is caused by vertebral dysfunction (problems associated with the spine including the disc, ligaments, muscles, facet (spinal) joints and sacroiliac joints (joint between the pelvis and tail bone) (source: Murtagh's General Practice 4th Edition).

Facet joint pain and discogenic (pain caused by injury to the disc between the spinal bones) pain can present with similar symptoms, depending on the severity of the disc injury. If the disc has not swollen enough to squash a nerve that exits from the spine (known as internal disc disruption or IDD), then there is typically no pain or weakness into the legs past the knee.

Facet pain and internal disc disruption (IDD) often present with the following signs and symptoms

• Can occur at any age

• History of lifting a heavy object, prolonged or repetitive bending or twisting

• The pain is usually central or one sided and can refer to the tail bone, buttocks or sacroiliac joint area.

• The pain is usually a diffuse, deep, aching, and episodic (comes and goes) type pain but can be a sharp "grabbing" pain with certain movements (this usually causes a spasm, where you are unable to move).

• There is often a sensation of a weak or unstable back (the back feels like it will give way).

• The pain is often aggravated by

  • activity

  • lifting

  • repetitive bending or twisting

• The pain is often relieved by

  • rest

  • warmth

If you suspect that you may be suffering from facet pain or IDD please see a musculoskeletal based chiropractor or physiotherapist, and/or a medical doctor.