Back Pain

Overview

Approximately 80 percent of people experience back pain and this type of pain may last a few days or it can last weeks, months or even years.  This very common problem has many different causes and it can be difficult to treat.  Everyone should know the basics of back pain because this helps to avoid the causes and seek proper care if it does occur. 

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Generally, it is caused by poor posture, minor injury or lifting weight incorrectly.  Back pain can be a constant mild pain or a fast developing acute pain that may seriously limit patient’s movement.  Most back pain patients feel better in a couple of weeks.  Taking rest and over-the-counter (OTC) pain-killer medicines help in getting rid of the pain. 

 

 

 

Signs and Symptoms

The signs and symptoms depend on how severe the injury is. 

Common symptoms may include:

  • Muscular pain
    3D render of a medical image of a male figure with spine highlighted
  • Pain going down into the legs
  • Not being able to stand up straight
  • Sharp stabbing or shooting pain
  • Decreased range of motion and flexibility

If these symptoms persist or get worse over 48 to 72 hours, contact the doctor or nearest hospital.  The patient may require emergency medical treatment if the back pain is accompanied by:

  • Abdominal pain
  • Bladder or bowel problems
  • Fever
  • Happens after a severe injury
Causes and Risk Factors

There is often not a specific cause associated with back pain.  Following are the common causes that can lead to back pain, including:

  • Ligament or muscle strain: Sudden awkward movements or repeated heavy lifting can damage the ligaments (fibrous tissues that connect bones to the other bones) and muscles in the back.  This is even more common if the patient’s muscles and ligaments are not in good condition.
  •  Sciatic PainThis is due to compression of sciatic nerve, which runs from spinal cord through the legs.  Patient suffers pain, with numbness and tingling in legs. Most of the time sciatic pain goes away in a couple of weeks.
  • Slipped disc/ Ruptured or bulging discs: In between the bones of the spine are soft discs that act as a cushion.  In some cases, they can break open and the materials inside can leak out and press on a nerve.
  •  Frozen Shoulder: Pain and inflammation around the shoulder joint back muscles
  • Arthritis: Arthritis  or Osteoarthritis can affect the spine and is most common in the lower back.  It can narrow the area that surrounds the spinal cord.
  •  Osteoporosis: This is a condition where the bones in the spine are weakened.  They are more likely to become fractured.
  •  Ankylosing Spondylitis:  Pain and stiffness due to inflammation in spine and muscles around.

 Back pain can happen to anyone so everyone is at risk.  There are no specific risk factors, but it is known that being overweight, not exercising regularly and lifting improperly can result in back pain.  It is also thought that anxiety and depression can increase the risk, but doctors are not sure why.

Diagnosis and Testing

In some cases, the patient does not need any specific diagnostic tests to determine the cause.  The doctor will ask about when the symptoms started and if there was an injury that caused them.  Patient will be examined and the doctor will look at the range of motion and reflexes.  The doctor will ask about how severe the pain is and exactly where it is located to get an idea of what is causing it.  If the doctor thinks that there is a medical condition causing the pain, the following tests may be done:

  • X-ray: This type of imaging is done to look for broken bones or arthritis.  It also shows bone alignment.
  • Bone scan: This is not a common test, but it may be done if a doctor suspects compression fractures, bone tumors or osteoporosis.
  • MRI and CT scans: This is done to look for herniated discs.  It can also provide detailed information about the bones, tissues, nerves, blood vessels, muscles, tendons and ligaments.
  • Nerve studies: These tests are done to see if a disc is pressing on a nerve
Treatment

Treatment of back pain depends on the cause and severity. 

For mild pain, home treatment, such as ice, heat, rest and over-the-counter medications are often enough to treat minor back pain issues.  On average, the patient should rest for one to two days and then slowly return to full activity because spending too much time in bed can actually make the situation worse.  If any activities increase pain, slow down to avoid making the problem worse.  If these treatments are not helping after a few weeks, patient should consult the doctor.

Medicines

If OTC medications fail to provide relief your doctor may prescribe something stronger, such as a prescription pain medication or muscle relaxer.  If a narcotic pain killer is prescribed, these are meant to be used for a very short time.  Injections may help to reduce pain and inflammation.  In severe cases corticosteroids injections directly into the space surrounding the spinal cord is required.

Physiotherapy can help most people to strengthen their core and get relief from their symptoms.  This type of therapy may also include heat, electrical stimulation, ultrasound and muscle-release techniques.

In rare cases, surgery may be needed to improve back pain when the pain is disabling and all other treatments fail.  In cases where a nerve is being pressed and causing muscle weakness or consistent pain, surgery can remove the compression and lessen the symptoms.

Possible Complications

There is always the risk that it may not heal if treatment plan is not followed exactly.  There is also the chance for a a bulging or ruptured disc pressing on a nerve and causing additional symptoms, such as pain in the legs or arm, weakness, numbness and tingling.  If you experience back pain, not getting prompt diagnosis and treatment may lead to a significant worsening of the condition.

 

Living With Back Pain

It is important to keep your back healthy so regular exercise is important to increase strength and flexibility in your back.  Solid core strength (back and abdominal muscles) helps to keep your spine aligned which reduces the risk of injury.  You also want to lose any excess weight because being overweight increases the risk of back pain and injury.

Proper body mechanics are also a major part of a healthy back.  How you stand, sit and lift can result in injury when done improperly.  When you are standing, make sure to keep a neutral pelvic position and practice good posture. When you are lifting, make sure to lift with your legs.  When you are sitting, use a lumbar support pillow and make sure your hips and knees are level.

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