Although they are much less common than the mechanical causes of back pain, certain diseases can contribute to back pain and are likely to need long-term treatment.
Arthritis is a disease that causes pain in the joints that is usually accompanied by swelling and sometimes changes in their structure. Although arthritis usually affects the knees, ankles and wrists, it can also affect the spine and hip joints, causing chronic back pain.
There are two major types of arthritis:
- osteoarthritis – caused by wear and tear of the joints
- rheumatoid arthritis – caused by inflammation in the joints
An extremely rare disease, (affecting about one person in every 1,000) the cause of which is largely unknown. Spondylitis means inflammation of the spine and ankylosing means fusing. The disease is characterised by low-back pain that may spread to the buttocks or thighs but never below the knee. It mainly affects people under the age of 30 and is more common in men than in women.
A muscle disease that cause pain all over the body, but mostly affects the neck, spine, shoulders and hips. It can occur as a result of stress, muscle injury or muscle overuse.
Fibromyalgia is more common than ankylosing spondylitis and affects between 4 and 20% of people in the UK. People with fibromyalgia often have trouble sleeping.
Although osteoporosis itself does not cause back pain, its long-term consequences can result in significant pain. Vertebral osteoporotic collapse, in which a vertebrae breaks down because of underlying osteoporosis, is an example of this.
Osteoporosis is a condition that affects bones and makes them more likely to fracture or break. Our bones are made of a thick outer shell and a strong inner mesh filled with collagen, calcium and other minerals.
Osteoporosis occurs when the holes in the mesh becomes bigger, making it more fragile and liable to break easily. Osteoporotic fractures occur most often in the hip, wrist and spine. Spinal fractures are also called vertebral fractures,
Women who have gone through the menopause are particularly susceptible to osteoporosis because they have lower levels of the hormone, oestrogen, which normally slows down the deterioration of bone.
Vertebral fractures can cause back pain, immobility and muscle spasm, to the extent that turning over, sitting up and getting dressed, for example, can become extremely difficult. Interestingly, however, many people with vertebral fractures do not complain of pain and may be unaware that they have a fracture in the first place.