There are loads of different kinds of back pain but, for the purposes of this short blog article, I will split them into two basic groups: 1) back pain caused by muscles; and 2) back pain caused by joint pathology.
As athletes, it's almost inevitable that we'll succumb to muscular back pain at some point, but we are also at a higher risk of spinal joint pathology — how do we tell the difference, and how should we treat them differently?
This is my guide of identifying and self-treating the different types of back pain.
1. Back pain caused by muscles
Muscular back pain is both the most common, and the least serious type of back pain. It is a very common part of DOMS (delayed-onset muscle soreness), and will often last 1-2 days longer than DOMS. If pain lasts longer than 3-4 days, you need to seriously look at your posture when you exercise.
The pain you feel due to muscular back pain is a result of the muscles of the back becoming tight and inflamed. Exactly where you feel the pain depends on exactly which muscle group is involved — either side of the spine is your erector spinae group; the flanks of lower back is quadratus lumborum, etc.
You can identify muscular back pain in the following ways:
- The pain is across a wide (1-3") plane - not a small, specific area.
- The pain will gradually get better or worse, but won't stay the same
- The pain is lateral to the spine i.e. the pain is NOT in or over the spine itself.
- The pain is made worse by gently poking the affected area with your thumb/finger.
- Movement does not make the pain any better or worse.
2. Back pain caused by joint pathology
There are 86 joints in the spine, and each one of them has the potential to develop any number of pathologies, from disc herniations to osteophytes, to subluxations, etc. Although it seems like developing a joint pathology is only a matter of time, our body is very good at protecting itself, so it doesn't happen as much as you'd think.
The back pain that you feel from a joint pathology is the result of one or more joint structures applying pressure to a spinal nerve. This causes pain, obviously, but can also cause other symptoms like numbness, tingling, poor bladder control, difficulty evacuating the bowels, etc. However, absence of these secondary symptoms does NOT mean that that your back pain is muscular.
Joint pathology back pain is characterised by the following:
- Onset of the pain is very sudden
- The pain is in a narrow area (<1"), sometimes with pain shooting outwards/downwards
- The pain will stay constant, regardless of how much time you give it to recover
- The pain is not made any better/worse by touching the effected area/s
- Movement can make the pain worse (often much worse!)
If this sounds like the type of back pain that you're experiencing, better to speak to a sports health professional (physician or allied health) ASAP — don't wait 48-72 hours for RICER.
If you would like any more information, email me dirctly via the contact page. For specific information or treatment on your own back pain, phone one of my clinics directly. Details of those clinics can be found here.
Dr Mitch Clark