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Other causes of back pain

MagazineJune 2007 (Vol. 18 Issue 3)Other causes of back pain

Backache may occasionally involve organs that are not thought to bedirectly related to the neck and spine

Backache may occasionally involve organs that are not thought to be directly related to the neck and spine. For instance, low back pain can be caused by a duodenal ulcer or acute pancreatitis.

Back pain can also be linked to heart problems. The biggest study in this area was undertaken by a group of Finnish researchers. For 13 years, they followed 8,816 Finnish farmers via a postal study. The group comprised 3,842 women and 3,648 men aged 30 to 66 with no previous history of heart problems. Men who had reported back pain, including sciatica, before they took part in the study had a significantly increased risk of dying of ischaemic heart disease during the 13 year follow up. The association remained even after adjusting for age, smoking habits, body mass index and social status.

The link between heart and back isn't so farfetched. The muscles in the back have a vital role to play in helping to pump the blood back into the heart. As they contract, they squeeze blood out of the surrounding tissues. In a back that has been injured, for example, the muscles may stay in a continuous state of spasm even without symptoms. Unable to pump efficiently over a period of years, this damage can build up and adversely affect heart function.

The connection between the heart and the back, however, runs both ways. There is some evidence, for instance, that a poorly functioning vascular system is linked to chronic back pain. If the large veins that supply blood and nutrients to the spinal column and related joints are not functioning properly, degeneration can occur.

Muscles elsewhere that are either poorly toned or hyper-toned may also be a contributing factor. For instance, abdominal muscles are known to play a part in maintaining back health. In a small Australian study, those with lower back pain were the least able to contract their abdominal muscles effectively. The authors suggested that this type of neuromuscular dysfunction might have a role to play in back pain. When back muscles are weak, a series of back exercises has also been shown to be effective in relieving backache.

Tight, shortened hamstrings are also a contributory factor. In one study, men with low back pain had greater stiffness in the hamstrings and lower trunk flexibility than the control group, who did not have back pain.

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