ABSTRACT
Back pain may be caused by disease affecting a wide variety of anatomical structures covering the full spectrum of pathological processes, including degeneration, structural abnormalities, infection, inflammation, neoplasia, ischaemia and haemorrhage. Back pain is most conveniently classified according to the structure or organ that is the source of pain, as follows: spine and nervous system; retroperitoneal structures; thoracic structures; paraspinal muscles; diaphragm; and miscellaneous. Specific treatment will depend on the underlying cause. For example, cauda equina syndrome, spinal cord compression, leaking abdominal aortic aneurysm and type A aortic dissection require urgent surgical intervention to prevent neurological damage or death. A history of recent trauma or heavy lifting suggests a mechanical cause of the pain, such as a prolapsed intervertebral disc. Tachycardia or hypotension in association with back pain may indicate an aortic dissection or leaking abdominal aortic aneurysm. Serum electrophoresis, serum free light chains and urinary Bence Jones protein.
