Reasons for chronic backache include poor posture and lack of exercise.

Back to backache – it never ends. Chronic backache is actually a mystery to medicine and there are so many different reasons for it occurring.

Some include poor posture, lack of exercise, a lifestyle of sitting rather than moving, leaning over computers, mobile phones and other technology, our nutrition because we are not replacing minerals in our bodies, and many more.

The reality of this condition is that it is responsible for millions of sick days off work, for some people giving up work altogether, for the consumption of countless painkillers and for, literally, ruining people’s lives. It affects 80 per cent of the population in most civilised countries.

I will be looking at four possible causes of back pain, to be considered along with a few others. The first cause is stress.

It is possible to have chronic back pain through a psychological cause rather than a physical one. Stressful life events and anxiety can cause pain by increasing muscle tension around the spine.

This eventually becomes painful because of the accumulation of waste products such as lactic acid in the muscles. There is no doubt it is difficult to prove that stress causes chronic back pain, especially in the way medicine would like to see it proved. However, the success of relaxation therapies easing the problem suggests a connection.

Meditation, hypnosis, biofeedback and cognitive behavioural therapy have all been successful in back pain management.

In fact, they have been endorsed by America’s National Institutes of Health. In one study, these non-conventional therapies reduced stress levels and resulted in a reduction in back pain of around 47 per cent. There was also a 47 per cent increase in activity levels within the group.

Chronic back pain could also be a symptom of bladder problems. Interstitial cystitis (bladder pain syndrome), which is chronic, recurring and doesn’t respond to treatment, can also cause long-term back pain.

Women seem to be especially vulnerable to bladder problems masked as back pain, says urologist Zaki Almallah at the Birmingham Bladder Clinic in the UK.

As the spine connects most parts of the body, it is often the target of referred pain from organs like the kidneys, bladder and gallbladder.

A survey of 629 interstitial cystitis sufferers, which required participants to describe their back pain, revealed that lower abdominal and lower back pain were among the most common areas where pain was experienced. Most said the pain was intermittent and moderate.

A bad back could also be a symptom of something far more serious. This leads me to recall that the year before my father was diagnosed with pancreatic cancer, he suffered severe back pain, something he had never suffered before. It took a year to link it to the cancer that eventually killed him.

Researchers in Finland stumbled upon an association between heart disease and a bad back 20 years ago when they tracked the lives of 8,816 farmers aged 30 to 66 for a total of 13 years.

At the start of the study, none of the farmers had a heart problem. However, those suffering from back pain, including sciatica, before starting the study, were more likely to have died of heart disease by the end of the study.

This was also the one association that persisted after the researchers had ruled out all the usual suspects for heart disease, including smoking, body weight and social status.

An association does not necessarily mean a cause. The muscles in our back play an important role in helping to pump blood back to the heart. As they contract, they squeeze blood out of the surrounding tissues, but in a back that has been injured, the muscles may remain in a continuous state of spasm with no symptoms.

Meditation, hypnosis, biofeedback and cognitive behavioural therapy have all been successful in back pain management

An inability to pump efficiently over years means that damage could build up and affect healthy heart function. It can work in the opposite direction. A poorly functioning heart could cause chronic back pain. If the veins that supply the blood and nutrients to the spine are not working properly, it can lead to degeneration of spinal tissue.

Researchers at the Institute of Public Health in Heidelberg, Germany, say that low back pain is sometimes a symptom of cancer and should always be considered a ‘red flag’, especially in people aged over 50.

They reviewed eight large-scale studies of back pain involving 6,622 patients. The chances of it being a spinal malignancy were small (0.66 per cent), but being aware of the possibility means the cancer can be caught early. Additionally, around half of patients with cancer in the head of the pancreas suffer abdominal or back pain. Anyone over 40 who suffers an unexplained weight loss together with this pain should be checked for pancreatic cancer, according to one of the studies.

Finally, back pain could be a symptom of an infection treatable by medication. About a year ago, this was big media news sparked off by two studies. In one, people who had suffered bulging of the spinal disc contents through a tear in the disc ring were most likely to develop an infection of the spinal disc which went on to cause long-term back pain.

kathryn@maltanet.net