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What if your back pain is not coming from your Back?

What if your back pain is not coming from your Back?

This is what’s known as referred pain. Referred pain is pain that you feel in one area of your body but originates in another. Most people have heard that pain radiating down the left arm, is one of the warning signs for heart attack.That is perhaps one of the best-known examples of referred pain.

The exact cause of referred pain has not been precisely defined, but according to the latest hypotheses, when we are developing in the womb, many of our organ systems originate from a common point of fetal tissue that later begins to differentiate and through the weeks develop into separate organs. Overlap and some redundancy remain in some of the nervous pathways, which in part can lead to pain being felt somewhere else despite its point of origin.

Image From: https://www.pinterest.com/pin/650559108661874594/

Where is your Back Pain really coming from?

The spine can be affected by referred pain, let’s look at some of the most common causes of REFERRED BACK PAIN.

Image From: https://www.rosenbergchiropracticclinic.ca/post/referred-pain

Kidney Stones:

Or renal calculi as they are known in medical terminology are formed by mineral deposits building up in the urinary system and they can affect any part of it, from the kidney to the urethra. A patient can come into the ER with acute Thoraco-Lumbar pain, and after an evaluation find out that the pain, they are feeling in their back pain is caused by kidney stones.

Image From: https://www.hopkinsmedicine.org/health/conditions-and-diseases/kidney-stones

Other causes of referredpain of the spine such as the ones described below can signal more serious underlying disease. They can also indirectly cause referred pain by affecting adjacent organs or tissues thus causing these to originate the pain although they are not necessarily the primary source. For example, An enlarged prostate can impede proper urination causing distension of the bladder which then can include low back pain as one of its symptoms, however the real problem lies in the prostate and not the bladder.

Prostate Problems:

The prostate is another organ which may present back pain as a symptom. Several conditions may lead to this including

  • Advanced Prostate Cancer
  • Prostatitis
  • Enlarged Prostate*Back pain is not a direct symptom of an enlarged prostate; rather symptoms tend to relate to difficulty and pain in urination.
Image From: https://www.besturologistnyc.com/enlarged-prostate-doctor-nyc/

Abdominal Aortic Aneurysm:

Back pain that is acute, severe and tearing.

  • It is a true medical emergency.
  • Pain can radiate to the anterior chest.
  • Rest does not relieve it.
  • Palpation over the back and changes in position do not aggravate the pain. Palpation of the abdomen may increase pain.
  • Loss of lower extremity pulses may occur as the dissection progresses.
https://halifaxhealth.org/services-treatments/our-services/vascular-surgery/vascular-surgery-3/

Gall stones:

  • Patients can experience severe pain in the abdominal or back area when fatty meals are consumed.
  • Pain is colicky (sharp episodic pain occurring at intervals) with periods of improvement and relief.
Image from: https://www.mentalfloss.com/article/550397/facts-about-gallbladder

Urinary Tract Infections

  • Pain is often across the back and radiates to the groin.
  • Patients often report dysuria, urgency and frequency.
  • If the infection affects the renal system, the pain is often more severe and can radiate to the upper back.
  • Fever may also be present.
Image From: http://isuporg.org/urinary-system-diseases/

Ectopic Pregnancy

  • Missed menstrual period
  • Vaginal bleeding
  • Abdominal or lower back pain.
  • Patients may also be diaphoretic or in shock.
Image From: https://www.wnyurology.com/content.aspx?chunkiid=11887

Acute Pancreatitis

  • Can cause thoracolumbar back pain.
  • Often triggered by binge drinking or gallstone
Image From: https://tbrnewsmedia.com/medical-compass-pancreatitis-risks-treatments/

Duodenal Ulcers

  • Vague abdominal and back pain.
  • Pain often worsens with hunger or with high acid levels in the stomach.
  • Pain often lessens with use of antacids.
Image From: https://www.beverlyhillsmagazine.com/health-fitness/symptoms-treatment-and-causes-of-antral-gastritis/

Visceral Cancer

  • Vague low back pain can be the first sign of visceral cancer.
  • Pain is often not relieved by rest and may be most intense at night.
  • Pain progresses regardless of modification of activities and use of medication.
Image From: https://www.sunwaymedical.com/cancer-types

While there are plenty of causes for back pain most are of musculoskeletal origin. Referred back pain presents unique challenges to patients and physicians requiring a sharp focus and an awareness of issues outside their area of expertise.

Sources:

https://en.wikipedia.org/wiki/Referred_pain

https://www.physio-pedia.com/Spinal_Masqueraders

https://www.verywellhealth.com/causes-of-referred-back-pain-29672

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