Mechanical back pain is a common term that refers to any type of back pain that is caused by placing abnormal strain or stress on muscles, ligaments, nerves or the bony structures of the vertebral column. Mechanical back pain is also known as low back pain, idiopathic low back pain, lumbago, lumbar syndrome or lumbosacral sprain or strain.

Causes of Mechanical Back Pain

Back pain can develop without a cause which the physician can pinpoint. But there are some conditions that are linked to back pain and they include:

• Ligament or muscle strain: Incorrect lifting of heavy objects or awkward movement can strain the spinal ligaments and back muscles.
• Bulging or ruptured discs: Discs act like cushions between the bones in the spine. When the soft material inside the disc ruptures or bulges and presses on a nerve compressing it, then this leads to a lot of pain. However, this can sometimes not present any pain symptoms and can be incidentally found during a spine x-ray for some other reason.
• Arthritis: Spinal osteoarthritis can also cause back pain. It is usually caused by damage and deterioration in the cartilage of joints in the lower back. It can lead to the narrowing of the spinal column in a condition known as spinal stenosis.
• Osteoporosis: This is the thinning of the bone and loss of bone density and it can lead to small fractures in the vertebrae. The fractures are known to cause severe pain and are referred to as compression fractures.

Symptoms of Mechanical Back Pain

Most individuals with mechanical back pain primarily experience pain in the lower back. However back pain can have many symptoms including:

• A dull ache in the lower back
• Inability to stand up straight without pain
• A shooting or stabbing pain that can radiate down the leg to the foot
• Reduced range of motion and diminished ability to flex the back

Diagnosis of Mechanical Back Pain

Evaluation of the patient’s medical history and a physical examination will help the physician to determine if mechanical back pain is present, and where it is coming from. It also helps in knowing whether the patient has muscle spasms and how much he/she can move before the pain starts. The physical examination involves examining the patient’s back and assessing his/her ability to stand, sit, walk and lift the legs.

The doctor can follow up the physical examination with one or more of the following tests:

• X-ray to show the bone alignment and if there is arthritis or broken bones.
• CT or MRI scans to reveal herniated disks or problems with muscles, bones, tendons, tissue, nerves, ligaments and blood vessels.
• Bone scan can be used in very rare cases to look for bone tumours or compression fractures that are caused by osteoporosis.
• Blood tests to help determine if there is an infection or another condition that might be causing the pain.
• Nerve studies using Electromyography (ECG) to measure the electrical impulses that are produced by the nerves and the responses of the muscles. This test can confirm nerve compression caused by either the narrowing of the spinal canal (spinal stenosis) or by herniated discs.

Treatment of Mechanical Back Pain

Most individuals do not need extensive treatment for mechanical back pain. Over the counter pain management medication is usually enough. However, in severe cases, stronger treatments may be required.

Medication prescribed might include:

• Nonsteroidal anti-inflammatory medication (NSAIDs)
• Topical rubs and ointments
• Opioids
• Muscle relaxants
• Antidepressants
• Steroid injections

Surgery is usually the last resort and is usually reserved for abnormalities in the bone structure that may have not responded well to the conservative treatment approach or therapy.

Next Step

At King’s College Hospital Dubai, we focus on offering an exemplary service, from initial consultation through to final diagnosis and treatment and beyond. Our multidisciplinary team of expert doctors, nurses, physio therapists are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re only a phone-call away.

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