Sciatica
When you feel pain, it is really a reaction to signals transmitted
throughout your body. These signals are sent from the pain source
-- such as a sore back, through the nerves in the spinal cord, and
up to the brain, where they are perceived as pain.
Different Types of Pain
The origin of some pain is neuropathic, while other pain is nociceptive.
This is important to know because different treatments work better
for each type of pain.
Neuropathic pain is caused by damage to nerve tissue. It is often
felt as a burning or stabbing pain. One example of neuropathic
pain is a "pinched nerve."
Nociceptive pain is caused by an injury or disease outside the
nervous system. It is often an ongoing dull ache or pressure,
rather than the sharper, trauma-like pain that is characteristic
of neuropathic pain. One example of nociceptive pain is arthritis
pain.
Some people experience mixed pain, which is a combination of
neuropathic and nociceptive pain.
Chronic versus Acute Back Pain
Chronic back pain is commonly described as deep, aching, dull
or burning pain in one area of the back or traveling down the
legs. Patients may experience numbness, tingling, burning, or
a pins-and-needles type sensation in the legs. Regular daily activities
may prove difficult or impossible for the chronic back pain patient.
They may find it difficult or unbearable to work, for example,
even when the job does not require manual labor. Chronic back
pain tends to last a long time, and is not relieved by standard
types of medical management. It may result from a previous injury
long since healed, or it may have an ongoing cause, such as nerve
damage or arthritis.
Acute back pain is commonly described as a very sharp pain or
a dull ache, usually felt deep in the lower part of the back, and
can be more severe in one area, such as the right side, left side,
center, or the lower part of the back. Acute pain can be intermittent,
but is usually constant, only ranging in severity.
Sometimes, acute back pain can be caused by injury or trauma
to the back, but just as often has no known cause. Patients with
acute back pain, even when it's severe, will typically improve
or completely recover within six to eight weeks.
Approximately half of all back pain patients have acute pain
caused by trauma. A contusion, torn muscle, or strained joint
resulting from a back injury can cause acute pain. Patients with
any of these conditions typically exhibit pain, muscle spasms,
and decreased functional activities. Treatment is short-term and
usually successful. With physical therapy, follow-up treatment,
and prevention practices, these patients typically return to full
functionality in a few weeks. Occasionally, these patients will
re-injure themselves and have to return for a short course of
treatment. Patients with acute pain occurring more than three
times in one year or who experience longer-lasting episodes of
back pain that significantly interfere with functional activities
(e.g., sleeping, sitting, standing, walking, bending, riding in
or driving a car) tend to develop a chronic condition.
Mechanical back pain — a form of acute pain —
is aggravated by movement and worsened by coughing. This type
of pain is usually alleviated with rest. Mechanical back pain
is typical of a herniated disc or stress fracture. For patients
with this condition, forward movements of the spine usually cause
pain. In addition, posture, coughing, sneezing, and movement can
all influence pain coming from the spine.
When acute back pain is severe and travels down both legs, it
could be caused by lumbar disc disease — the most common
cause of true sciatica, another form of acute pain.
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