What is Back Pain

The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way down to the buttocks and legs. Some back issues can cause pain in other parts of the body, depending on the nerves affected.
Dr. Karen Johnston

Dr. Karen Johnston

Neurosurgeon
Toronto, ON
Dr. Paul Kongkham

Dr. Paul Kongkham

MD PhD FRCSC
Neurosurgeon
Toronto, ON
Dr. Ramesh Sahjpaul

Dr. Ramesh Sahjpaul

MD, MSc, FRCSC
Neurosurgeon
Vancouver, BC

Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon, discusses what back pain is and how it is typically treated.

Quiz: Do You Understand Back Pain?

Test your knowledge by answering the following questions:

Questions
True
False
1

Lumbar back pain is the most common type of back pain.

Explanation:
Back pain symptoms can be mild or severe, and cervical (neck pain), thoracic (middle back pain), lumbar (lower back pain) or tailbone/sacral (coccydynia). Lumbar back pain is the most common type.
2

Back pain isn't caused by medical problems involving the gallbladder or kidneys.

Explanation:
Back pain can come from muscles, bones, joints or nerves. It can also be caused by medical problems involving the gallbladder, aorta, kidneys or pancreas.
3

Scoliosis is a back condition but it doesn't cause back pain.

Explanation:
Back pain causes include injury or activity, arthritis, back strain, sciatica, poor posture, aging and scoliosis.
4

Back pain symptoms include pain that radiates down your leg.

Explanation:
Back pain symptoms include shooting or stabbing pain, pain that radiates down the leg, muscle aches, pain that worsens when you walk, lift something, bend or stand, and pain that improves when you recline.
5

Most patients with back pain will require surgery.

Explanation:
In most cases, back pain will resolve on its own with treatment at home and over-the-counter medications. Some patients benefit from spinal traction, a physiotherapy technique that applies a longitudinal stretch to the reachable joints and soft tissues that is commonly used on the cervical, lumbar spine and thoracic spine. Surgery is not usually recommended.
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What Spinal Conditions May Be Helped By Surgery?

hen a patient’s symptoms correlate with the findings on the MRI scan, in that situation surgery actually can be very helpful.

And some of the typical symptoms that respond well to surgery are what is typically known as sciatica. So pain, numbness, tingling, sometimes weakness in the legs if it’s due to a herniated disc, then surgery in fact in those situations can be very helpful.

So this model demonstrates a lumbar disc, and discs are cushions. You can think of them as cushions between the vertebrae. Over time these discs degenerate, wear out, lose their water content, and this is actually a normal aging process, and the MRI reports will reflect that, so that’s not alarming.

And sometimes even with acute traumatic situations a disc can actually bulge out or herniate as we see here. When that happens, a portion of the disc can actually protrude and irritate or squeeze a nerve that’s traveling by the disc.

And these nerves travel down to the legs, and when that occurs, patients will experience pain, numbness, tingling radiating down their leg, and that’s called sciatica.

If that sciatica is not responding to conservative measures or nonsurgical measures, and if the pain is worsening over time, or if there’s significant weakness, that very well may be an indication for surgery.

And the good news is that surgery can be very helpful in those situations. Now there are many different types of surgery available for spinal conditions. Lumbar microdiscectomy is one of the most common surgical procedures done.

It’s associated with a very high success rate as long as it’s done for the right indications.  Lumbar laminectomy is another surgical procedure that’s done for spinal stenosis, which is essentially a crowding of the space available for the nerves going down to the legs.

There are also other surgical procedures available, such as endoscopic disc surgery, laser spine surgery. The important thing to recognize is that the exact type of surgery is probably not as important as what the surgery is trying to achieve, which is to relieve the pressure on the nerves. And standard microdiscectomy done for the right reasons is associated with a very high success rate.

Presenter: Dr. Ramesh Sahjpaul, Neurosurgeon, Vancouver, BC

Local Practitioners: Neurosurgeon

What Causes Back Pain and How Is It Typically Treated?

Back pain is a very common problem, and in fact, approximately nine out of ten people will at some point in their life experience an episode of back pain, and it’s one of the most common reasons that patients visit their family physician.

The good news is that most causes of back pain are fairly self-limited and benign and do not represent a more serious underlying problem. Causes of back pain include muscle spasm, muscle tension; sometimes back pain can occur because of inflammation of the joints in the back – the facet joints.

So these are generally called soft tissue causes of back pain, and again they’re very common and they’re usually self-limited. There is a misconception that back pain is treated surgically when in fact that’s actually not the case.

Very simple treatments such as rest, anti-inflammatory medications, physiotherapy, hot and cold packs, acupuncture, sometimes traction, these can be very effective and are usually almost always effective in relieving the back pain. It may take weeks or a few months, but again these are the typical and most effective treatments for most cases of back pain.
Presenter: Dr. Ramesh Sahjpaul, Neurosurgeon, Vancouver, BC

Local Practitioners: Neurosurgeon

Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon, discusses what an MRI can reveal about the back.

Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon, discusses what spinal conditions may be helped by surgery.

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