Your back hurts. Maybe a lot; it definitely has your attention. This may be a new kind of pain, or something you’ve had before, but now it’s blowing up, and you need to know what’s going on. When you make an appointment with your doctor, there’s a good chance that they’ll want some kind of imaging to help determine the cause of your pain. But what does that even mean?
Imaging may include X-Rays, a CT scan or an MRI. They’re tools used to get a better look at the internal structures of your body, however they’re different from one another, and it can be confusing to understand which one tells you what. They all use some kind of electromagnetic energy, but they’re different in the kind of energy used, the amount of detail they provide and the level of accessibility. Here’s a rundown:
X-Rays send a low level of radiation through your body to create an image. The structures that contain a high level of calcium, such as your bones or teeth, block the radiation. This makes those areas appear white on the X-Ray, while the radiation passes through the soft tissues of your body, making them appear gray, black or cloudy on the image. Because X-Rays show your bones in such detail, they’re commonly used to diagnose bone injuries, such as a fracture, dislocation, changes in the structure of a joint or misaligned bones.
X-Rays are quick to obtain, but don’t show issues like inflammation or a soft tissue injury, such as a muscle pull, sprain, strain or spasm. That said, sometimes your doctor will order an X-Ray just to rule out a fracture before treating an injury to a ligament or tendon.
An MRI, which stands for magnetic resonance imaging, obtains images through the use of a powerful magnet that sends radio waves through your body. Subatomic particles, called protons react to the radio waves, which creates incredibly detailed images of your body’s structures. Beyond bones, an MRI can provide clear images of blood vessels, nerves and other soft tissues. An MRI is different from an X-Ray because it doesn’t use radiation, and MRI’s can deliver images of body structures in better detail and resolution. When it comes to back pain, an MRI can diagnose conditions such as inflamed joints, compressed nerves, spinal injuries, disc compression, arthritis, tissue injury and loss of cartilage.
The downside of having an MRI is that it requires about 20-40 minutes in a tube-like structure, which can cause or aggravate feelings of claustrophobia in some people. At some facilities, there are newer machines available that are much quicker, or in which patients can stand up during the MRI. In addition, people who have metal in their body, such as a replaced joint, plates, pins, or a pacemaker cannot have an MRI, because of the powerful magnet in the MRI machine.
A CT scan may be a good option for patients who cannot have an MRI. A CT, or computed tomography scan, acquires images through radiation. However, it provides a computerized, 360-degree view of the structures being imaged, and in much higher detail than an X-Ray. CT scans are quick, deliver a great detail and are often used in diagnosing trauma. They can pick up conditions such as blood clots, subtle bone fractures that may not show up on an X-Ray, and injuries to internal organs. While an MRI is better at providing images of nuanced differences in your body’s tissues, the speed and ease of a CT scan is often a first choice in emergency conditions.
What About My Back Pain?
As for the pain in your back, your doctor may order one type of imaging over another. They may have checked with a radiologist to help choose the best option for you. Certainly, obtaining the right images can help uncover the source of your back problem, with one caveat: The results may show the likely cause of your pain, but in many cases, imaging may not find a visible cause of your pain. It’s also interesting to know that sometimes patients have imaging for another condition, only to find that they have some kind of back condition that should be causing them pain—but isn’t. This raises the question, why do people with similar injuries or conditions feel very different levels of pain, and some, no pain at all?
The simplest answer to this question is that you don’t feel pain unless and until your brain processes it. When you get injured, pain receptors from the injury release neurotransmitters that send chemical messages to your brain. The chemical “memo” gets to your brain through your nerves and spinal cord, ultimately telling it that something’s up. Your brain processes this information and acts accordingly, sending information back to your body telling it what to do. Different responses can include a muscle spasm to protect you from further movement, quickly moving away from a painful stimulus, ramping up your immune system to deal with inflammation or to begin healing, and even releasing different kinds of neurotransmitters that act as your body’s natural pain-killers.
What this means is that your brain has a say in how much pain you may or may not feel, even if it’s different from someone with a similar condition. How you experience pain is impacted by a number of factors including:
- Your genetic make-up
- Your past experiences of pain
- Emotions; stress and anxiety can aggravate your pain
- Your unique level of pain tolerance
- How your nervous system responds to painful stimuli
- Your overall condition, including the strength and flexibility of the muscles near your injury
- The specifics of your injury. Even with a similar condition as someone else, the specific location, affected structures and the severity are not exactly the same.
A Word About Acupuncture and Pain
Acupuncture is well-known for its ability to reduce pain, including and especially back pain. That’s because it works by causing physiological changes, not only at the site of your injury or condition, but also in your brain. Locally, acupuncture increases the circulation of blood and nutrients to help speed the healing process. It also increases the circulation of anti-inflammatory cells to help reduce painful inflammation. A type of acupuncture, called trigger point therapy, can help relax tight muscles and reduce muscle spasms, which is a common cause or side-effect of a back injury. And scientists have found that acupuncture triggers an increase in the circulation of pain-relieving neurotransmitters in your brain and ramps up your body’s own opioid system.
No one likes to hear that their pain is all in their head, because it makes light of the very real pain they are feeling. However, the reality is that your brain has a say in how you may experience that pain. You are a combination of history, genes, emotions and matter—your physical body. All of these factors play a role in how your back pain affects your life.
Treating pain is a major part of my practice, it is so prevalent, even patients who primarily see me to help with their digestion, fertility, or any other systemic imbalance, they often have a pain issue of one sort or another and back pain is by far the most common. If you’d like to talk more about your back pain and how acupuncture can help you, contact me at 604-733-2632
Click here for a free 15-minute consultation!
Dr. Jeda Boughton is a Doctor of Traditional Chinese Medicine and Registered Acupuncturist in Vancouver. She is also a Registered Herbologist and the founder of BodaHealth.
