The pain we feel is actually a response to signals that are transmitted through the body. They arise from the source of the pain, say, for example, low back pain that travels up through the spinal cord to the brain, which then produces what is called the sensation of pain. Different types of pain Some pain is neurogenic and superficial, while others are deep. It is important to distinguish the type of pain, because different types of pain have different treatments. Neurogenic pain is caused by damage to nerve tissue and is usually severe or stabbing, such as “nerve root compression pain. Deep pain is caused by an injury or disease outside the nervous system. Unlike the severe trauma-like pain of neurogenic pain, this pain is a constant dull ache or pressure, such as “arthritis pain”. Chronic and acute low back pain Chronic low back pain is usually a deep, aching, dull, or sharp pain in an area of the low back that can also travel down the leg. Patients may feel weakness, tingling, burning, or pins and needles in the legs. Daily activities can sometimes be difficult or impossible for people with chronic low back pain. For example, they may not be able to work properly, even at non-manual tasks. Chronic low back pain lasts for a long time and is not relieved by common treatments. The cause of the pain may be a trauma that healed long ago, or it may be a persistent factor, such as nerve damage or arthritis. Acute low back pain is usually sharp or dull in the lower part of the back and is more severe in certain areas, such as the left and right sides of the back, the central region of the back, or the lower part of the back. Acute back pain is intermittent, but frequent and varies in severity. Acute low back pain can sometimes be caused by trauma or injury to the back, but most of the time there is no obvious cause. Patients with acute back pain, even in severe cases, usually improve significantly or recover completely within 6-8 weeks. About half of all low back pain is acute due to trauma. Contusions, muscle tears, and deformed joints caused by back trauma can cause acute pain. Patients with these injuries experience pain, muscle spasms, and decreased mobility. Short-term treatment is usually effective. With physical therapy, traction, and preventative exercises, these patients usually recover completely within a few weeks. Sometimes these patients may re-injure themselves, in which case they must undergo short-term treatment again. Patients with pain that occurs more than 3 times in a year, or with long-term persistent low back pain that interferes with daily activities (such as sleeping, sitting, standing, walking, bending, riding or driving), are prone to develop chronic pain. Mechanical low back pain is also considered acute low back pain, which can be exacerbated by exercise or coughing and relieved by rest. Typically, mechanical low back pain is caused by a herniated disc or stress fracture, and patients with this condition experience pain with forward motion of the spine. In addition, posture, coughing, sneezing and movement can all have an effect on pain originating in the spine. If the acute low back pain is severe and travels down both legs, the pain is most likely caused by lumbar disc disease, which is the most common cause of another type of acute pain, true sciatica. Diagnosis of acute low back pain X-ray: A painless and non-invasive imaging method that uses photographic negatives to absorb electromagnetic rays, which have extremely short wavelengths, less than 100 angstroms, and can penetrate solid materials of varying thicknesses and travel through the body. These images are commonly referred to as x-rays or photographs and are used for diagnosis and monitoring of various diseases. CAT Scan (Computerized Axial Tomography) (or CT scan): Another painless imaging technique that uses a computer to integrate X-rays from different axes to form a three-dimensional image of the body’s structure. Compared to all currently available imaging techniques, CT scan is the best for bone, blood and soft tissue. MRI (Magnetic Resonance Imaging): A non-invasive spine imaging technique in which a magnet is rotated around the body to excite hydrogen atoms in the body, and a scanner detects the energy produced by these excited atoms. MRI technology provides a better representation of the details of spinal structures because the main component of the body is water with two hydrogen atoms. This method of examination is most valuable for the diagnosis of spinal disorders. Spinal cord (X-ray) radiographs: For this test, an X-ray contrast medium is injected into the dural cavity that surrounds the spinal cord and nerves, and the spine is then visualized. This technique allows the radiologist to visualize the nerve roots and detect any abnormalities in the spinal canal, which can help in the diagnosis of spinal disorders such as nerve compression or disc rupture. Bone scan: This test involves injecting a small amount of contrast marker into the subject through an intravenous route and then scanning the area in question. The scanner will detect these markers that are concentrated in areas of high bone density. Bone scans should be used when tumors, infections, or minor fractures are suspected to cause increased bone density. Bone scans are not a substitute for the tests mentioned above, but they can provide a basis for ruling out some serious diseases.