Market Harborough Chiropractor Advises on Serious Causes of Back Pain
18 November 2013 | Admin
When back pain is a sign of serious illness. Infections, bladder problems, even cancer – those aches and twinges in your back could be trying to tell you something Sometimes organs send pain signals to other body parts – notably the back.
For instance, kidney and bladder problems are easily mistaken as back pain Here is a story from recent headlines. Michelle Law’s childhood was blighted by back pain. Her mother took her to the GP many times, only to be told that the constant gnawing ache in Michelle’s back was growing pains or a pulled muscle. (Of note few back problems are the result of a pulled muscle) She’d be sent home with painkillers or muscle relaxants – none of which helped. The pain between her lowest rib and pelvic bone on the right-hand side of her back dogged Michelle into adulthood. When she was 35 she was finally referred for investigations on her kidneys because of the site of the pain. ‘I had dozens of scans and tests over four years, but they couldn’t find anything wrong,’ says Michelle. ‘By that time I was relying on morphine for pain relief and had become house-bound.’ The breakthrough came 18 months ago when Michelle was referred to a specialist in female urology at Eastbourne Hospital, who ordered tests on her bladder. She was given a cystoscopy (where a tiny camera is inserted into the bladder) and biopsies under a general anaesthetic. These revealed that Michelle had been suffering from interstitial cystitis, which attacks the lining of the bladder. When she came around from the anaesthetic, Michelle was told there was nothing the specialists could do to save it. Her bladder was so badly scarred that it could not stretch or shrink as it should. Even a tiny amount of liquid – 20ml, or less than 4tsp – would cause it to empty (a healthy bladder should hold 700ml to 1,000ml). ‘I was told the tissue was so damaged it fell apart in the surgeon’s hands,’ she says. Michelle’s only option was to have a new bladder surgically formed out of her bowel tissue. Today, she suffers from frequent infections (the bowel tissue produces mucus that attracts bacteria) and, because the new bladder has no muscle control, Michelle has to empty it using a catheter, further raising the risk of infection. In the future she may need to have a permanent catheter, as well as a urostomy (an external bag). Though Michelle’s case is extreme, it is frighteningly common for back pain to mask the symptoms of other potentially serious health conditions. Kidney, bladder and gallbladder problems can easily be mistaken as back pain, particularly in women. Quite often patients will have gone back and forth, sometimes for months, with different diagnoses and treatments before they decide to visit a chiropractor as a last resort. Sometimes the organs can send pain signals to other parts of the body – notably the back – by a process called ‘referred pain’. Doctors cannot fully explain what happens, but believe strong pain messages running along nerves ‘leap’ or ‘overwhelm’ adjacent nerves, causing pain to be felt where that series of nerves originates. Back pain is a common symptom of pancreatic problems – pancreatitis (inflammation of the pancreas) and pancreatic cancer. Estimates of 20 to 30 per cent of pancreatitis sufferers see their GP about back pain before they are properly diagnosed. This condition, which causes inflammation of the pancreas, is believed to be triggered when a problem develops with some of the enzymes in the pancreas, which causes them to digest the organ. Pancreatitis is often linked to gallstones (in women) and sometimes to excessive alcohol consumption (usually in men) and typically affects middle-aged and elderly people. ‘Sometimes the organs can send pain signals to other parts of the body – notably the back – by a process called”referred pain”.’ More rarely, back pain is associated with other cancers such as lung, colon and very occasionally ovarian cancer if tumours grow large enough to press on nearby nerves or organs. Andy Whitfield, who starred in the TV series Spartacus: Blood And Sand, saw no reason to worry about the back pain he noticed when he began training for the series. The physical workload to build an authentic Spartan physique was intense and a certain amount of pain was to be expected. But when filming finished and the back pain became more severe and constant, he went to see his doctor. A scan revealed a large tumour pressing against his spine. He was diagnosed with non-Hodgkin’s lymphoma (which starts in the lymph nodes). He died 18 months later at the age of 39. For a small number of people, a dull ache in their back can be a symptom of some types of cancer, but it will usually be caused by something else If you have back pain that does not have an obvious cause, a good chiropractor will send you for other tests (such as a urine test) to screen for all possible causes, either direct pain or referred. ‘If you know you have done nothing to hurt your back, if your range of movement is unimpaired and yet painkillers are not helping, then it is important that you tell your chiropractor about your concerns. Here, we examine some of the other causes of back pain. PAIN ON ONE SIDE OF LOWER BACK OTHER SYMPTOMS: Fever (feeling shivery and sick), may have blood in the urine. POSSIBLE CAUSE: Kidney infections – these are six times more common in women than men. Bacteria (usually E.coli) travel up from the bladder into one or both kidneys, often as a complication of an untreated bladder infection. The more your back pain is localised to one side, the more likely it is to be kidney pain. If it is closer to the spine and becomes worse with movement, it is more likely to be musculoskeletal. In a kidney infection, the pain is just above the pelvic ‘saddle’ and can radiate to the hip and groin. TREATMENT: Antibiotics and painkillers usually work within two weeks. If left untreated, the condition can cause permanent kidney damage. PAIN IN MIDDLE OF BACK ON ONE SIDE OTHER SYMPTOMS: Severe pain in the abdomen or groin, pain urinating, blood in the urine. POSSIBLE CAUSE: Kidney stones – when waste products in the urine (such as calcium, oxalate and phosphorus) build up, they form crystals that collect inside the kidneys as hard, stone-like lumps. There can be a genetic link making some people more susceptible to stones. Not drinking enough water (which means urine is more concentrated) increases your risk. Three in 20 men and one in 20 women will suffer kidney stones. They are more likely if you are overweight and between the ages of 20 and 40. The back pain may be consistent or intermittent. TREATMENT: Some stones can be passed in the urine without the need for treatment (albeit with pain relief and extra fluids to help move the stone along). Larger stones can be crushed using shock waves or broken up with a laser. ABDOMINAL PAIN RADIATES TO BACK OTHER SYMPTOMS: Pain in the abdomen (just below the ribs), feeling sick, vomiting. The pain, which is often described as a ‘boring’ sensation, may be made worse by eating. POSSIBLE CAUSE: Pancreatitis – also known as inflammation of the pancreas. This can be acute (lasting a week, causing no serious problems) or chronic (persisting, sometimes for years). It’s characterised by pain just below the ribs that spreads to the back, which may be sudden and intense, or mild. Pancreatitis is caused by enzymes in the pancreas starting to digest the organ; 90 per cent of cases are linked to gallstones (if a stone gets stuck at the point where the bile duct and pancreatic duct meet) or excessive alcohol consumption. It usually strikes middle-aged and elderly people, and affects around 20,000 people a year. TREATMENT: The acute version is treated in hospital with intravenous fluids, pain relief and oxygen. Drinking alcohol should be avoided. PAIN IN RIGHT RIBS AND SHOULDER OTHER SYMPTOMS: Abdominal pain (under the rib on the right side), nausea, wind, pain when inhaling deeply, arm pain. POSSIBLE CAUSE: Infected or inflamed gallbladder or gallstones – the gallbladder is a small bag under the liver that stores bile, which is emptied into the stomach when we eat, but it can become infected, inflamed or blocked by tiny stones (made from cholesterol, bile salts and calcium). The gallbladder area will be tender to the touch, but sometimes pain radiates through to the shoulder blade. ‘It can be intermittent or constant, sharp or dull, but tends to occur in the evening (particularly after a meal). ‘The nerve supply to the gall-bladder travels through the abdominal nerves or up the spinal cord,’ says Dr Anton Emmanuel, gastroenterologist at University College London. ‘The most stereotypical gall-bladder pain is under the right rib and the tip of the right shoulder.’ Gallstones are common, particularly in women who have had children and are overweight. TREATMENT: An ultrasound scan will identify gallstones that may need to be surgically removed via keyhole surgery or endoscope. DULL PAIN IN THE PELVIS AND BACK OTHER SYMPTOMS: Urgent need to urinate often, pain or stinging on urination, pain in lower belly. POSSIBLE CAUSE: Cystitis – this is an inflammation of the bladder and is usually caused by an infection (when bacteria gets in the bladder) or irritation (from a tampon, diaphragm, tight clothing or chemical irritants). It is common, particularly in women, affecting 15 per cent each year. If no cause can be found and it doesn’t respond to antibiotic treatment, interstitial cystitis may be diagnosed. This affects 500,000 women each year, though doctors are still baffled as to its cause. It’s thought it could be some sort of immunological reaction, causing inflammation. TREATMENT: Bacterial cystitis clears up with antibiotics. Untreated cases can lead to kidney infections. Interstitial cystitis is complex and may require painkillers, antidepressants or surgery. So as we can see alot of back pain can be caused by many different diseases and it is important that you tell your chiropractor all the symptoms correctly so that appropriate treatment can be arranged. I f you would like to make an appointment to see a chiropractor in Market Harborough or Melton Mowbray call The Chiropractic Clinic in Market Harborough on 01858 414841 The Chiropractic Clinic in Melton Mowbray on 01664 561199