You and Your Health - When your back pain isn’t from your back

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Published on Tuesday, October 23, 2018

By Dr. Mark Perrett

BSCs DC Chiropractor

Back pain will affect 80 per cent of the population at some time in their life and is the leading cause of disability and absenteeism from work. The majority of back pain is due to mechanical causes including sprains, strains, instability or degeneration. However, there can be times when your back pain is caused from internal structures of your body rather than from joints and muscles.

How pain works

Pain is our signal to tell us that something is wrong with the body. We have many types of sensory nerves giving us information about temperature, vibration, touch, stretch, pain, smell, sound, taste, and sight. A common example of this can be found with back pain. When a joint is not properly stabilized by the surrounding muscles, the force going through the joint causes a strain of the surrounding tissues. There is an extra stretch to the muscles and ligaments, provoking a pain signal to the brain. This type of pain mechanism is easy for the brain to localize in the body.

Referred pain is a different type of signal and there are several theories of how this works. One theory is that many organs have sensory nerves that work through complex pathways, and these signals can converge at the same spot as sensory nerves from the skin, muscles and joints. The body reads sensory information from the periphery more often than the organs and therefore assumes the pain is from this area and referred pain occurs. A common example of this is the heart. Cardiac pain in is often felt in the chest, arm, jaw, mid-back and neck. A kidney infection may be felt as a mid-back ache. You may have shoulder tip pain after having laparoscopic surgery.

The most common organs of the body to cause spinal pain are the following:
Head - brain aneurysm, tumour or lesion. Neck and shoulder - heart, lung, diaphragm and thyroid gland. Mid back - stomach, pancreas, gall bladder, liver and heart. Lower back - kidney, bladder, colon, reproductive organs

How to determine the source of pain

When uncertain if your pain is coming from the back, there are four general rules to consider:

1. The mechanism of the injury is the most obvious tool to tell you if pain is from muscles and joints. If you have a trauma or repetitive strain injury, the pain is most likely from the muscles and joints.

2. If it hurts when you use the joints and muscles around the sore area, it is most likely joint or muscle pain as the cause. Pain when activating and/or stretching a muscle is a sign pain is not coming from the organs. (i.e. If the pain is originating from an internal structure, such as your kidney, you should be able to move about and not provoke or make the pain worse.)

Often, muscle and joint pain is characterized by being “sharp” and “pulling”. Referred pain is characterized by being a “deep and achy” pain.

3. If you are experiencing abnormal activities with one of your body systems along with back pain, it might not be the back causing your problems. (i.e. If you have low back pain and are noticing that the color of your urine is more red than normal and that it hurts to urinate, you might have kidney problems, not back problems.) You should think about your own medical history, and consider whether a previous issue is recurring, or possibly progressing.

4. If your pain does not subside with rest and lasts longer than usual, you need to consider a secondary source to your back pain. Most uncomplicated muscle and joint problems heal within six to eight weeks. Persistent pain is a sign that the pain can be more than just a nagging back. 

Conclusion

There are circumstances when your back pain may be coming from an internal structure. Listen to your body and use the information provided to determine if your pain is originating from the back or from the internal organs. Always consult a trained health care provider to help determine the cause of your pain.

Activity Fact: Women are three times more likely than men to experience throat and jaw symptoms when having a heart attack.