Back pain is one of the most common health complaints and one of the top reasons patients visit their physician.
Back pain overview
Nearly every person will experience back pain at some point during their lifetime, but not all back pain is the same. The pain may be dull, sharp, constant or intermittent. It may occur suddenly, after movement or lifting, or it may develop gradually.
Back pain frequently occurs in the lower back, but not always. Sometimes, pain presents in the upper or mid-back. The location of back pain typically depends on the cause.
Back pain causes
Anatomy plays a role in the occurrence of back pain. The spine is made up of a number of small bones stacked on top of one another. These bones are called vertebrae.
The spine extends from the base of the skull to the coccyx or tailbone. It acts as a support structure for the head, shoulders and upper body. It makes it possible for individuals to stand and move.
Back pain in itself is not a condition but rather a symptom of the actual problem. The demands placed on the back can sometimes lead to injury and pain. Causes of back pain include the following:
- Overactivity – muscle soreness or stiffness can occur as a result of a new activity. Overstretching can also lead to ligament strain
- Disk tear, bulge or herniation – intervertebral disks are flat, round cushions located between the vertebrae. The rubbery discs act as shock absorbers to protect the spine
- Degeneration – over time wear and tear on the disks can cause them to collapse. A degenerative condition known as degenerative spondylolisthesis can cause the vertebrae to slip and slide, putting pressure on the spinal nerves
- Spinal stenosis and bone spurs – spinal stenosis is a narrowing of the opening around the spinal cord resulting in pressure on the nerves and the cord itself. Bone spurs and osteoarthritis can also lead to narrowing
- Abnormal curvature of the spine – also known as scoliosis – arthritis and other conditions can cause the spine to curve leading to discomfort
- Osteoporosis – this condition occurs when bone tissue breaks down faster than new tissue is being produced, leading to weak and brittle bones, which can lead to compression fractures of the spine
Symptoms of back pain
Back pain may present in a variety of ways, including:
- Discomfort that occurs or worsens with bending, lifting, sitting, standing or other movement
- Decreased range of motion or mobility
- Intermittent pain that comes and goes
- Stabbing pain that travels down the leg
Diagnosing back pain
Determining the cause of back pain may require physical examination as well as medical tests, such as:
- X-ray to identify bone conditions
- MRI to evaluate soft tissues, muscles, nerves, and disks for sign of injury
- CT scan to detect certain bone issues
- Bone scan may be done to reveal bone cancer or compression fracture
- Nerve studies may be ordered if nerve compression is suspected due to spinal stenosis or herniated disk
- Bone density test can help confirm whether osteoporosis is responsible for spinal fractures
Treating back pain
Many cases of back pain resolve with heat, ice, non-prescription pain medications and light activity. Pain that doesn’t improve after a few weeks should be evaluated by a medical professional.
Medical treatment options include:
- Medications for the treatment of back pain include over-the-counter pain relievers, muscle relaxants, topical pain preparations, narcotic pain relievers and cortisone injections to reduce inflammation. Specific types of antidepressants can reduce pain associated with chronic back pain
- Physical therapy including ultrasound therapy, electrical stimulation, stretching, and controlled exercise
- Back support braces for stabilization
- Infrequently, surgery may be required in cases where there is nerve compression worsening muscle weakness, structural problems including spinal stenosis or herniated disk
Preventing back pain
Reduce the risk of injury and prevent back injury by
- Maintaining a regular exercise routine such as brisk walking
- Practicing good ergonomics
- Changing positions frequently
- Reducing stress
- Focusing on proper posture, including sitting straight and avoid neck strain by positioning computer monitor slightly below sight line
- Avoiding twisting, bending from the legs and keeping objects close to body when lifting