Fracture. Fractures of any of the vertebrae are difficult problems frequently following trauma such as automobile acci-
Fig. 134. Backache may be due to any combination of many joints, muscles and ligaments. Back trouble is very common in the upright human race because weight bearing is placed upon spine. Effective treatment gives relief for most back troubles.
dents or serious falls. Not all back fractures are serious, but after any severe trauma, examination of the back, possibly with the help of x-ray, will enable the physician to determine whether or not a fracture exists.
Backaches
The most common complaint of the back is backache, and the most frequent cause of backache after the age of forty-five or fifty is degenerative or wearing down type of arthritis. This very common difficulty is made worse by cold damp weather or unusual activity. It usually improves somewhat with rest, but gives rise to pain and limitation of motion after too much activity. Degenerative arthritis is most noticeable, in bending forward, backward or sideways, while in a sitting position. These motions bring out the fact that the backache is in the spine itself, and after fifty years of age, back trouble of this description is most often arthritis.
All during our lives, the wearing down processes are pitted against the reparative processes of the body, as nature constantly strives to rebuild anything damaged or worn. Youth can absorb considerable wear and tear, and expect to recuperate with ease, but in later life, we heal slower and cannot tolerate trauma as we did in the younger years. Following an accident backaches which might follow, are generally related to the severity and extent of the injury. For example, after a severe automobile accident, pain might be coming from bones, joints, cartilaginous disks, ligaments or muscles, any of which might be severely injured, but in less severe injury of the back, possibly from sleeping on a floor or very hard bed, the backache would most likely be due to temporary muscle spasm in the back.
Trauma, of course, can be imposed upon a spinal column which already has other diseases. Thus, the mild arthritic begins to have backache after the mildest trauma and after fifty years of age, it is painfully true that trauma of some sort usually precedes most backache. It is unfortunate that the back should be so singled out to suffer not only from arthritic disease, but also to suffer in so great a way from mild incidents.
Sometimes back pain radiates down into the back of the leg, and is called sciatica pain. It can be caused in the back by pressure on nerves to the legs, from an injury to a vertebral disk, the vertebrae itself, or to adjoining ligaments. This pain is greatly aggravated by coughing, sneezing or straining, and depending upon its cause, may be temporary or permanent. Anything resembling permanent sciatic leg difficulty should be presented to the physician if relief is desired.