Back and Spine Pain

Back pain is one of the most common reasons people seek medical care. It’s also the second most common reason people miss work days worldwide. Short-term (acute) back pain is often caused by strain or improper lifting. It often comes on quickly and get better after a few weeks with rest and home care. Back pain that lasts longer than 3 months is called chronic pain, and may be related to another medical condition.

Back pain can occur anywhere in the upper, middle, or lower back. It can feel like a dull ache or a sharp pain.

Acute (short-term) back pain is identified as back pain that lasts less than six weeks. It often comes on suddenly as a result of strained or irritated muscles or ligaments in the back. First episodes with back pain are most common between the ages of 30-40. It often resolves on its own within four to six weeks without treatment.

To understand back pain, it helps to know the parts of your back that can be injured or strained.

• Vertebrae [ver-tuh-BRAY]. These are the bones of your spine. They are cushioned by discs that can rupture or become herniated [HUR-nee-eyt-uhd], placing pressure on the nerves.
• Muscles and ligaments. This is the most common source of back pain. Ligaments are bands of tissue that connect bones to each other. Muscles and ligaments can become injured by improper lifting or sudden movement.
• Nerves and blood vessels. One of the sources of back pain can be sciatica [sy-AH-tik-uh], where strain is being placed on the sciatic [sy-AH-tik] nerve. The sciatic nerve is the largest in the body and connects to a network of nerves in your back, buttocks, and legs.

Chronic back pain lasts three months or more and can be a symptom of a more serious health condition. These can include problems with the alignment and movement of the spine, or a disease that puts pressure on the nerves.

The symptoms of back pain can vary depending on the affected area, but most types of back pain share some symptoms such as the following:

• Muscle ache
• Shooting or stabbing pain
• Limited flexibility
• Decreased range of motion
• Pain when twisting or bending
• Chest pain
• Pain shooting into the buttocks or down the legs

Back pain will often improve gradually. See your doctor if the pain does not improve after two weeks.

Seek care right away if you have:

• Severe pain even after resting
• Severe pain after a fall or injury
• Radiating pain down both knees or legs
• Fainting
• Inability to stand
• Bowel or bladder control problems
• Weakness and tingling sensation
• Pain along with:
• Numbness in the groin
• Fever
• Unexplained weight loss
• Vomiting
• Blood in the urine

If you experience back pain for the first time after 50, or if you have a family history of cancer, osteoporosis [OS-tee-oh-puh-ROH-sis], or have a personal history of steroid, drug, or heavy alcohol use, you should consult with your doctor sooner after experiencing back pain, especially if it is severe.

There are many common causes of back pain. Problems with the back itself, such as:

• Muscle or ligament strain. This is the most common cause of back pain and is usually the result of improper lifting or awkward, sudden movements.
• Bulging or ruptured discs in the spine.
• Injuries from accidents, such as sprains or fractures.
• Muscles spasms or muscle tension.

Underlying health conditions that can strain the back, such as:

• Arthritis [ahr-THRAHY-tis]
• Scoliosis (skoh-lee-OH-sis), and other irregular spine structures
• Osteoporosis [OS-tee-oh-puh-ROH-sis]., porous or brittle bones
• Kidney stones
• Stress
• Tumors
• Infections
• Pregnancy

There appears to be a relationship between back pain and psychological factors like depression and anxiety. It’s not clear whether mental illness is a cause of back pain or just a related risk factor.

Your risk of back pain increases with:

• Age. Back pain becomes more common with age. This happens as bones and muscles begin to lose strength and muscles become less flexible. A first episode of back pain is often between the ages of 30 and 40.
• Low fitness level. Not getting enough physical activity can contribute to loss of muscle tone. This makes can lead to strain or injury.
• Being overweight. Too much weight, especially around the belly, can cause back strain.
• Smoking. Smoking can make your bones weaker. It also makes recovery take longer.
• Family history. Some conditions that cause chronic back pain run in families.

Your doctor will perform an exam to determine the location of your pain and to test your function and range of movement. Depending on the results of that exam, your doctor may take some of the following steps to identify a cause for your back pain.

• X-rays
• MRI or CT scan
• Bone scan
• Blood tests
• EMG (Electromyography [ee-LECK-tro-my-AH-graf-ee])

Depending on the results of these tests, your doctor will prescribe a treatment plan specific to the kind of back pain you are experiencing.

Acute (short-term) back pain will often resolve on its own within four to six weeks. Things that may help include:

• Over the counter medicines, like ibuprofen or acetaminophen.
• Keeping moving to prevent stiffness. Lying in bed for more than a day or two can make pain worse.

For chronic (long-term) back pain treatment, your healthcare provider may recommend some combination of:

• Heat and cold therapy
• Medicines such as:
• Over–the-counter pain medicines, like ibuprofen or acetaminophen
• Muscle relaxants
• Injections (cortisone [core-tih-zone], etc.)Topical pain medicines
• Physical therapy
• Surgery may be considered after other approaches have been tried and not worked

You can also consult with your doctor to determine if alternative therapies like chiropractic [KAHY-ruh-prak-tik], massage, acupuncture [AK-yoo-puhngk-cher], or yoga might be advised in your situation. There are some specific exercises you can do after a back injury to slowly rehabilitate your back and avoid future strain. Consult with your doctor to determine what the best course of action is for your injury.

There are many measures you can take to prevent back strain and injury. The following are steps doctors often advise for not just those who experience back pain, but for everyone as best practices for a healthy lifestyle.

• Exercise. Make exercise part of your daily routine.
• Build muscle. A healthy amount of muscle and increased strength can prevent strain from normal, daily activities.
• Maintain a healthy weight. Avoiding excessive weight, especially around the belly, can reduce the risk of back pain.
• Practice good posture. Standing and sitting correctly without slouching can prevent back pain.
• Lift smart. Know the proper techniques of lifting from your legs so you’re not placing strain on the muscles of the back.
• Sleep firm. Use a firm mattress and position yourself to avoid strain while sleeping.

A few basic lifestyle changes to promote health can reduce your risk of experiencing back pain and put you in a better position to avoid back injuries as you age.