Back Pain

Back pain is an extremely common problem affecting millions each year. Back pain can cause problems anywhere from the neck to the tailbone (coccyx). The back includes:

• The bones and joints of the spine (vertebrae).
• The discs that separate the vertebrae and absorb shock as you move.
• The muscles and ligaments that hold the spine together

Conditions that may cause back problems. Back pain or problems may not be related to an injury. Conditions that weaken the spine, such as ankylosing spondylitis, osteoarthritis, osteoporosis, spinal stenosis, or Paget’s disease, can cause back pain. These conditions are most common in older adults. In rare cases, tumours or infections can develop in or around the spine. Some medical conditions can cause pain to spread to the back from other parts of the body (referred pain). Many health problems that can cause back pain have nothing to do with the bones, joints, muscles, or ligaments of the back. Spinal deformities such as scoliosis, kyphosis (Scheuermann’s disease), and spondylolisthesis can cause back pain. Chronic pain syndrome caused by a previous injury or degenerative disease with aging can cause back pain.

Cancer Pain

The optimal management of cancer pain continues to be a challenge throughout the world despite nearly two decades of emphasis on the need for more aggressive and effective treatments.

Pain can be caused by the cancer itself. Pain could happen if the cancer grows into or destroys nearby tissue. As a tumor grows, it can press on nerves, bones or organs. The tumor can also release chemicals that can cause pain.

Treatment of the cancer can help the pain in these situations. However, cancer treatments, including surgery, radiation and chemotherapy, also can cause pain.

Complex Regional Pain Syndrome (RSD)

Complex Regional Pain Syndrome (CRPS) is a chronic pain syndrome with two forms. CRPS 1 currently replaces the term “reflex sympathetic dystrophy syndrome”. It is a chronic nerve disorder that occurs most often in the arms or legs after a minor or major injury.
CRPS 1  is associated with severe pain; changes in the nails, bone, and skin; and an increased sensitivity to touch in the affected limb.
CRPS 2 replaces the term Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems and results from an identified injury to the nerve.
CRPS/RSD is a chronic neuro-inflammatory disorder. It occurs when the nervous system and the immune system malfunction as they respond to tissue damage from trauma. The nerves misfire, sending constant pain signals to the brain. The level of pain is measured as one of the most severe on the McGill University Pain Scale. CRPS generally follows a musculoskeletal injury, a nerve injury, surgery or immobilization.

Diabetic Neuropathy

Diabetic Neuropathy is a complication of diabetes that affects the nerves and with proper pain treatment, pain management can be achieved. Nerve damage from diabetes is called diabetic neuropathy. About half of all people with diabetes have some form of nerve damage. It is more common in those who have had the disease for a number of years and can lead to many kinds of problems.

Peripheral neuropathy impairs proper functioning of these sensory and motor nerves. The most common symptoms of neuropathy include numbness and loss of feeling, usually in the feet and hands.

Disc Herniation

Each vertebral disc is composed of a tough outer layer of cartilage and a more elastic central area. As we age, these discs degenerate and become thinner and weaker. Extra pressure from a fall or from heavy lifting can cause cracks in the outer layers of the discs, allowing the central mass to squeeze out. This kind of rupture can put pressure on the spinal cord or the nerves that branch from it.

Herniated discs in the lumbar or sacral regions can put pressure on the sciatic nerve causing pain and discomfort.

Facet Syndrome

Facet joints are small joints, which attach adjacent vertebral bodies together and help with range of motion of the spine in the neck and back. Like any joint they have a fluid in them called synovial fluid. With Chronic pressure, degeneration or trauma, arthritis may develop in these joints, which can be a source of back pain.

Failed Back Surgery Syndrome

Failed back surgery syndrome, also known as postlaminectomy syndrome, refers to patients that undergo back surgery and still experience chronic pain. It can result from any type of back surgery and refers to patients with increase pain, new pain, and even patients who have less pain than prior to surgery.


Fibromyalgia is a condition that causes pain all over the body (also referred to as widespread pain).

The most common symptoms of fibromyalgia are:

  • Pain and stiffness all over the body
  • Fatigue and tiredness
  • Depression and anxiety
  • Sleep problems
  • Problems with thinking, memory, and concentration
  • Headaches, including migraines

POST COVID-19 Symptoms

Most people who have coronavirus disease 2019 (COVID-19) recover completely within a few weeks. But some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery.

The most common symptoms that can linger include:

  • Fatigue
  • Difficulty breathing
  • Joint pain
  • Chest pain
  • Brain fog, including an inability to concentrate and impaired memory
  • Loss of taste and/or smell
  • Sleep issues
  • Peripheral neuropathy

We don’t yet know why post-COVID syndrome occurs, but hypotheses range from hidden areas of infection to a prolonged inflammatory response.


There are more than 150 types of headache. They fall into two main categories: primary and secondary headaches.

Primary headaches are those that aren’t due to another medical condition. The category includes:

  • Cluster headaches
  • Migraine
  • New daily persistent headaches (NDPH)
  • Ten Secondary headaches

Secondary headaches are related to another medical condition, such as:

  • Disease of blood vessels in the brain
  • Head injury
  • High blood pressure (hypertension)
  • Infection
  • Medication overuse
  • Sinus congestion
  • Trauma
  • Tumor.sion headaches

Myofascial Pain Syndrome

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder caused by myofascial trigger points. This painful disorder can affect any of the skeletal muscles in the body.

Myofascial Pain Syndrome may be related to work when the identified active trigger point is present in the region injured in a direct traumatic incident or repetitive muscular strain and where there is continuous medical evidence and reporting.

Patients with MPS usually report regionalized aching, and diffuse, persistent pain in certain muscles and joints. The pain intensity can vary from mild to severe and is usually related to muscle activity.

Myofascial Pain Syndrome has been associated with a variety of factors which can occur at work or during leisure activities. Development of active trigger points can be associated with mechanical, physical, and psychological stressors, as well as socioeconomic factors. Psychological stressors include depression, tension from anxiety and secondary gain.

Occipital Neuralgia

Occipital Neuralgia is pain located in the cervical (neck) and posterior (back) regions of the head (these are the occipital areas). This pain may or may not extend or radiate into the sides of the head ultimately, into the facial and frontal regions. Occipital neuralgia is really two separate disorders with similar symptoms: lesser occipital nerve neuralgia and greater occipital neuralgia. This disorder often occurs after a whiplash injury, a blow to the back of the head, or an injury that produces a twisting of the head.


Osteoarthritis (OA) is the most common form of arthritis. Some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees. The level of pain may vary with each patient based on the amount of activity throughout one’s life.

With OA, the cartilage within a joint begins to break down and the underlying bone begins to change. These changes usually develop slowly and get worse over time. OA can cause pain, stiffness, and swelling. In some cases it also causes reduced function and disability; some people are no longer able to do daily tasks or work.

Post Herpetic Neuralgia

Shingles, or herpes zoster, is caused by the chickenpox virus that remains in the nerve roots of all persons who had chickenpox and can come out in your body again In post-herpetic neuralgia, the virus causes inflammation of the nerves under the skin of the affected area. Neuralgia is a medical term for pain resulting from nerve inflammation or damage.

The main symptom of post-herpetic neuralgia is intermittent or continuous nerve pain in an area of your skin previously affected by shingles.

The pain may come and go or be continuous. It can be described as burning, stabbing, shooting, aching, throbbing or like electric shocks.

It’s not clear why some people with shingles develop post-herpetic neuralgia, but increasing age, pain during the early stage of shingles and severe pain throughout an episode of shingles are all associated with an increased risk of the condition.

Shingles causes numbness, itching or severe pain followed by clusters of blister-like lesions in a strip-like pattern on one side of your body. The pain can persist for weeks, months or years after the rash heals and is then known as post-herpetic neuralgia.

Sacroiliac Joint Pain

The sacroiliac (SI) joint is a strong, weight bearing synovial joint between the ilium and sacrum bones of the pelvis. The bones are held in place and allowed limited movements by a system of sacroiliac ligaments. Relaxation of this and other joints and ligaments is important during pregnancy.

Like any other joint, the SI joint can develop inflammation by trauma or chronic asymmetric pressure on the joint. Pain from the SI joint can be in the low back/buttock area and may radiate into the legs as well.

Spinal Stenosis

Spinal stenosis is defined as a narrowing of the spinal canal. This can result in pain due to impingement of the spinal cord and associated nerves. The pain of spinal stenosis is generally experienced in the low back and legs.

Many will report cramping or weakness in their legs with prolonged walking or standing. The risk for spinal stenosis increases with advancing age.