Dynamics of Chronic Back Pain

Abstract

<h4 class="maintitle">Abstract</h4> <b>Introduction: </b>Chronic back pain is a major cause of physical disability, absenteeism from work, and legal claims. Its prevalence has increased from almost 4% to over 10% in recent decades, using substantial healthcare services. The persistence and chronic back pain after multiple operations and treatments is often called “failed back syndrome.” <b>Method: </b>This paper investigates how chronic back pain develops, why it may be associated with psychosocial change, and why it is important to evaluate and treat each patient as an individual based on evidence. It is based on literature review and personal experience. <b>Results: </b>The anatomical structure specific to the spine, the outcome of treatments, and the patient’s perception of pain are the most contributing factors for chronic back pain. The closely located facet joints, discs, ligaments, muscles, spinal cord, and nerve roots, each can be involved in causing back pain and each may need a specific treatment. Those increase the chance for difficulty in determining where the pain comes from, complication, inadequate treatment, and recurrence of the pain. Because of extension of the nerve roots away from the spine, erroneous operation can take place in other organs. <b>Conclusion: </b>Treatment of chronic back pain is difficult unless its source is clearly identified and its correlation with the neurological and radiological finding is clearly determined. Yet not every chronic back pain is a failed back syndrome. Each chronic back pain has a different cause, each needs a different solution, and each patient needs a new evaluation first, disregarding previous diagnosis. <h4 class="maintitle">Keywords</h4> Dynamics of chronic back pain; Failed back syndrome; Emotional change in chronic back pain; Evaluation of chronic back pain; Management of chronic back pain