Back Pain: Symptoms, Causes, Diagnosis, Treatment & Prevention

Muscle strains, disk injury, and certain medical diseases including osteoporosis and scoliosis are common causes of back pain. It can be treated with acupuncture, medicine, and applying of a warm or cold compress.

One of the most frequent reasons people leave work or seek medical help is back pain. One of the main causes of disability in the globe is back pain.

Fortunately, there are ways to avoid or lessen most back pain episodes, particularly those under 60. If prevention doesn't work, the back can heal in a few weeks with basic home treatments and proper body usage. Back pain is rarely treated with surgery.

Also Read: 15 Health Benefits of Exercise

What is Back pain?

Your back pain might range from an annoying ache to an excruciating pain. Just after colds, back pain is the second most common reason people see their doctors. It causes many people to miss work. In the US, between 80% and 90% of people will have back discomfort at some point in their life.

What types of back pain are there?

Medical doctors classify back pain in a variety of ways. If your back pain is on the left, center, or right side, you can categorize it as upper, middle, or lower back pain. You can also tell your healthcare professional what kinds of pain you experience. Are you experiencing mild, moderate, or severe pain? Is the pain a sharp stab or a wide ache? Additionally, the duration of back discomfort can be used to classify it. Acute episodes are abrupt, short, and frequently associated with an injury. If your back discomfort has persisted for longer than three to six months, it is considered chronic or persistent.

Back Pain Symptoms:

Back pain can vary from localized discomfort in one area to widespread pain throughout the entire back. Occasionally, the back discomfort can spread to other parts of your body, such as your legs, abdomen, or buttocks. Everybody has different levels of back discomfort. The following may occur, depending on the kind, origins, and location of your back pain:

• Increasing pain when bending and lifting.
• Increasing discomfort whether standing, sitting, or sleeping.
• Back ache that fluctuates.
• Stiffness upon waking in the morning and decreased back discomfort as a result of exercise.
• Pain that travels to the leg, hip, or buttocks from the back.
• Your legs or feet may feel weak or numb.

If your back pain does not go away after a few weeks or if you experience any of the following symptoms, you should consult a physician:

• Tingling and numbness.
• Severe back pain, that does not go away with medicine.
• Back pain following an injury or tumble.
• Back pain and difficulty urinating.
• Leg weakness, discomfort, or numbness.
• Fever.
• Loss of weight that was not your intention.

Causes:

Back pain frequently occurs without a known reason that can be identified by an imaging study or test. Back discomfort is frequently associated with the following conditions:

• Strain of a muscle or ligament. Back muscles and spinal ligaments can be strained by sudden awkward movements or by heavy lifting done repeatedly. Persistent back strain might result in excruciating muscular spasms for those who are physically unwell.

• Disks that are bulging or ruptured. In the spine, disks serve as cushions between the bones. A disk's soft substance may swell or burst, pressing against a nerve. Back discomfort, however, may not be caused by a bulging or ruptured disk. Spine X-rays, CT scans, and MRIs performed for various purposes frequently reveal disk disease.

• Arthritis. The lower back may be affected by osteoarthritis. Spinal stenosis, a narrowing of the space surrounding the spinal cord, can occasionally result from arthritis in the spine.

• Osteoporosis. If the bones become brittle and porous, the vertebrae in the spine may break painfully.

• Axial spondyloarthritis is another name for ankylosing spondylitis. Some of the spine's bones may merge as a result of this inflammatory condition. The spine becomes less flexible as a result.

Risk factors:

Back discomfort can strike anyone, even children and teenagers. The following variables may make back discomfort more likely to occur:

• Age. As people age, back pain becomes more common, typically beginning in their 30 or 40.

• Lack exercising. Back discomfort may be caused by weak, underused abdominal and back muscles.

• Overweight. An excessive amount of bodily weight strains the back.

• Illnesses. Back discomfort may be exacerbated by certain forms of cancer and arthritis.

• Improper lifting. Back pain might result from using the back rather than the legs.

• Psychological conditions. Back discomfort seems to be more common among people who are predisposed to anxiety and depression. Back pain may be exacerbated by muscle tension brought on by stress.

• Smoking. Smokers are more likely to experience back pain. This could happen because coughing from smoking can result in herniated disks. Additionally, smoking raises the risk of osteoporosis and reduces blood flow to the spine.

How is the diagnosis and evaluation of back pain made?

By asking you about your symptoms, medical history, and lifestyle, followed by an examination, your healthcare professional may be able to get all the information they require. But occasionally, imaging testing is required. These could consist of:

• X-rays

• CT and MRI scans

• bone scan

• EMGs

Treatment:

With home treatment, most back pain improves after a month, especially for those aged 60. Many people, though, experience pain that lasts for several months.

Heat therapy and painkillers may be all that is required. Resting in bed is not recommended.

As much as possible, despite your back pain, continue your activities. Try doing something easy, like walking. Avoid doing things because you're afraid of getting hurt, but stop doing things that make you feel more pain. After a few weeks, if home remedies aren't working, your doctor may suggest strong medications or other therapy.


The type of back pain determines the medication. They could consist of:

• Pain relievers. Ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve) are examples of nonsteroidal anti-inflammatory medicines (NSAIDs) that may be helpful. Only use these medications as prescribed. Serious side effects might result from overuse. Your healthcare provider may recommend prescription NSAIDs if over-the-counter pain medications are inadequate.

• Relaxants for muscles. Muscle relaxants may help if painkillers are ineffective for mild to moderate back pain. Muscle relaxants may make you sleepy and dizzy.

• Topical pain relievers. These products, which include patches, ointments, salves, and creams, apply painkillers to the skin.

• Narcotics Short-term usage of opioid-containing medications, such as hydrocodone or oxycodone, is permitted under strict medical supervision.

• Antidepressants. Chronic back pain has been demonstrated to be alleviated by certain antidepressant types, especially tricyclic antidepressants like amitriptyline and duloxetine (Cymbalta).

Physical therapy:

Exercises to enhance posture, strengthen the back and abdominal muscles, and increase flexibility can be taught by a physical therapist. Using these methods on a regular basis can help prevent discomfort from coming again. In order to prevent back pain symptoms from worsening while remaining active, physical therapists often teach patients how to adjust their movements throughout an episode.

Procedures such as surgery:

Back pain can be treated with the following procedures:

• Injections, commonly known as cortisone shots. A cortisone injection combined with a numbing medication may be helpful if other treatments are ineffective for discomfort that travels down the leg. Although the pain alleviation from a cortisone injection into the area surrounding the spinal cord helps reduce inflammation around the nerve roots, it usually only lasts for a month or two.

• Ablation using radio frequency. A tiny needle is placed into the skin close to the painful location during this treatment. To harm the surrounding nerves, radio waves are transmitted through the needle. Damage to the nerves prevents the brain from receiving pain signals.

• Nerve stimulators that are implanted. Under-the-skin devices can inhibit pain signals by sending electrical impulses to certain nerves.

• Surgery. For those with increasing muscle weakness or back discomfort that radiates down a leg, surgery to increase the amount of space in the spine can occasionally be beneficial. Herniated disks or other disorders that constrict the openings through which nerves go through the spine may be the cause of these issues.

Prevention:

Back pain may be avoided by improving one's physical condition and learning and practicing how to use the body. To keep the back strong and healthy, do the following:

• Exercise: Regular low-impact aerobic activities can improve back strength and endurance and allow the muscles to work better; swimming, walking, and bicycling are good options because they don't strain or jolt the back; consult your healthcare team about which activities to try.

•  Build muscle strength and flexibility: and maintain a healthy weight because being overweight strains the back muscles.

• Quit smoking. Low back discomfort is more likely to occur among smokers. Quitting can help lower the risk because the risk increases with daily smoking.

Steer clear of back-straining or twisting motions. To make appropriate use of the body:

• Be smart. Avoid slouching. Keep your pelvis in a neutral position. To relieve some of the strain on the lower back when standing for extended periods, place one foot on a low footstool. Switch up your feet. The strain on the back muscles can be lessened with proper posture.

• Take a seat wisely. Select a seat with a swivel base, armrests, and decent lower back support. Its natural curve can be preserved by putting a pillow or rolled towel in the small of the back. Maintain level hips and knees. At least every 30 minutes, switch positions.

• Lift smartly. Steer clear of hard lifting if you can. Let your legs handle the lifting if you have to lift something heavy. Avoid twisting, bend only at the knees, and maintain a straight back. Keep the weight near your body. If the object is awkward or heavy, find someone to lift it with.

References:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases. What is Back Pain? (http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp) Accessed 1/31/2022.

• Back pain: In depth. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/back-pain/advanced. Accessed April 3, 2024.

• Wheeler SG, et al. Evaluation of low back pain in adults. https://www.uptodate.com/contents/search. Accessed April 3, 2024.

• Walls RM, et al., eds. Back pain. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed April 3, 2024.

• Low back pain. American Association of Neurological Surgeons. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Pain. Accessed April 3, 2024.

• Back pain. (2019) https://www.niams.nih.gov/health-topics/back-pain

• Knight CL, et al. Treatment of acute low back pain. https://www.uptodate.com/contents/search. Accessed April 3, 2024.

• Chou R. Subacute and chronic low back pain: Surgical treatment. https://www.uptodate.com/contents/search. Accessed April 4, 2024.