What is Back Pain?
The most common cause of disability in the U.S. is back pain. Most back pain resolves quickly and is not serious.
Usually occurring in the lower back, back pain can occur in the upper back as well. The pain may be sharp and come with movement or it may be a constant dull ache (or a combination of the two).
What causes Back Pain?
Most back pain can be attributed to simple wear-and-tear, but a few cases may be genetic or may be due to a more serious illness. The most common causes of back pain include:
- Disc degeneration (e.g. osteoarthritis)
- Muscle strain
- Mechanical problems (e.g. a herniated disc)
- Vertebral fractures associated with osteoporosis
Some rare, more serious causes of back pain can include:
- Cancer
- Infection
- Vascular problems
- Damage to nervous tissues
Back pain affects men and women between the ages of 20 and 40 equally. There are some risk factors that may increase your chances of back injury or pain, as well as complications and delayed healing.
These risks include:
- Tobacco use
- Excessive consumption of alcohol and drugs
- Poor diet
- Lack of regular physical activity
- Repetitive, stressful motions and movements
- Overweight and obesity
What are the symptoms of Back Pain?
Pain can be sharp and come with movement or it may be a dull ache that is ever-present (or a combination of the two).
Patients may also have limited range of motion or tenderness upon touch. Symptoms may occur with excessive movement after long periods of inactivity. Each person’s back pain is as unique as they are.
Sometimes, sciatic pain can also occur, which results from the compression of the sciatic nerve and causes pain radiating across the buttocks and down your hip and leg.
There are some red flags that indicate a more serious condition that may require emergency evaluation or surgery. If you experience back pain accompanied by weakness, numbness, tingling, fever, weight loss, or problems with bowel or bladder control, head to your nearest emergency room.
Your doctor may order an X-ray, MRI, or CT, depending on your particular back pain symptoms, or if your doctor suspects a serious condition based on family or medical history.
A full neurological work-up may be ordered by your doctor to identify compressed nerves from a herniated disc.
What are my treatment options for Back Pain?
Relieving symptoms and improving your daily life are the goals of back pain treatments. Most patients find relief from back pain with conservative treatments, but for persistent back pain, there are also surgical options.
Some of the options include:
- Rest: Rest shouldn’t exceed the most acute phase of back pain, usually three days or fewer, as too much rest can make pain worse.
- Lifestyle changes: By making adjustments to diet and activity level, helps facilitate weight loss and helps maintain a healthy body-mass index (BMI).
- Exercise: Generally, back pain will improve within a few weeks, and exercise can help make this happen. Doing exercises to help strengthen the core and low-impact whole body workouts like swimming and yoga will help strengthen the body.
- Physical therapy: Physical therapists will use individualized exercises to help improve range of motion, increase flexibility, and speed recovery of both acute and chronic back pain. Physical therapy is great for moderate to severe cases of back pain.
- Acupuncture and chiropractic care: Acupuncture is becoming more common in treating back pain. Chiropractors can do spinal adjustments which can provide noticeable relief and improve function.
- Non-steroidal anti-inflammatory drugs (NSAIDs): Using over-the-counter pain medications such as acetaminophen or ibuprofen, is usually the first choice of treatment for acute back pain. Taking NSAIDs in conjunction with physical therapy or chiropractic care, can help you perform the therapies with less pain.
- Prescription medications: Your doctor may prescribe muscle relaxants to help ease back spasm and tension. Opioids are generally ineffective for long-term management of back pain, but may be prescribed initially, during the acute phase.
- Injections: There are some types of injections, such as epidural steroid injections, that can be helpful to manage back pain.
Surgery: If your back pain is caused by disc herniation, it may require surgical intervention, such as spinal fusion or discectomy (the removal of herniated tissue). Surgery is only recommended when other, more conservative, treatments have failed.
