What is Back Pain?
Back pain is a condition associated with any type of pain felt in the back. The most common type of back pain is acute and lasts less than six weeks. Pain that lasts longer than three months is classed as chronic.
Back pain can start slowly over time or appear suddenly as a result of a fall or injury. It is one of the most prevalent medical issues in the US and a leading cause of disability worldwide. (1,2)
Having anything wrong with your back can be incapacitating and interfere with your mobility and ability to function normally. It’s important to know what the signs and symptoms are and when to seek medical advice.
There are many causes of back pain, they include:
Disc Breakdown or Rupture
Our spine is made up of nerves, bones, ligaments, joints, tendons and muscles. Between the bones are discs comprising of cartilage and tissue, these also act as shock absorbers for the spine and allows the spine to move.
If any of these discs are damaged through degeneration or injury they can rupture and pain will be felt. This pain can be in the disc or can radiate down the legs, through the shoulders or to the arms. Radiating pain indicates the disc is pressing on a nerve. (3,4,5)
Muscle and Ligaments
Damage to the ligaments in the backbone can cause the nearby muscles to contract to protect the spine. This causes pain in the lower back which can be chronic or acute. (6)
Injury to the back can happen for any number of reasons. Car accidents, sports participation and falls are just some of the culprits for trauma which damages tendons, ligaments or muscle. The resulting pain is generally in the lower back and can be acute or chronic. (7)
Sprains and Strains
These are some of the most common causes of acute back pain. They happen when we overstretch and tear ligaments or muscles. You might twist awkwardly, lift something that is heavy or in the wrong manner. This type of injury can also cause the muscles in your back to spasm which will also generate discomfort. (8)
There is a large nerve (sciatic) that travels from the spine through the buttocks down to the back of the legs. If this nerve is pinched or pressed by a tumor, cyst or injured disc it can cause pain, this is called sciatica.
This type of pain can be sharp, sudden and radiate through the lower back, down the length of the nerve to the feet. You could also experience numbness, tingling and weakness in the legs. (9)
Inflammatory diseases like arthritis, osteoarthritis, rheumatoid arthritis and spondylitis, can also cause low back pain. (10)
Narrowing of the spinal column called spinal stenosis is a condition which places pressure on the spinal cord and nerves. It causes numbness and pain when you walk and can eventually result in sensory loss and weakness in the legs.
Curvature of the spine (scoliosis) or other congenital factors which disfigure the spine also cause lower back pain. These conditions are usually chronic. (11)
Other Medical Conditions
There are other conditions which can cause back pain including pregnancy, infections, endometriosis, kidney stones, tumors and fibromyalgia. (12)
The symptoms of back pain are dependent on the cause. It can be described as acute or short lived, lasting for up to about six weeks. However, if you have symptoms for longer than three months then the pain is considered chronic.
The symptoms can be varied and include aching or pain in the lower back. You can experience a short shooting or stabbing pain in the back which travels down one or both legs to the feet.
It is also possible that you won’t be able to straighten your back or stand without feeling pain. Your movements can be limited and you will not be as flexible as usual.
There are other symptoms which indicate you should see your doctor straight away. These included: tingling, weakness or numbness in the legs, pain that follows a fall or severe and constant pain.
Further factors accompanying your pain that point towards immediate medical attention are unexplained weight loss, a fever, or chest pain.
Losing control of your bladder or bowel functions and throbbing pains in the abdomen are also causes for concern. (13,14)
When you see your doctor they will initially take your medical history and give you a physical examination. They will want to know information like, when the pain started, how bad it has been and exactly where it is.
The physical examination includes neurological tests, like sensitivity to hot and cold, and a thorough check of your back.
If the cause of your pain is not apparent further tests can be necessary. These entail things like: (15)
This imaging test can identify broken or injured bones in the spine. It will also highlight any vertebral misalignment.
Computerized Tomography (CT) Scan
The three dimensional image produced by a CT scan can show damage to discs, stenosis of the spine or tumors.
Myelograms and Discography
Myelograms involve a dye being injected which shows the spinal cord. Nerves that are compressed by a disc or fracture are visible on x-rays or CT scans.
Discography also involves the injection of dye, but into the actual disc thought to be responsible for the pain. Fluid pressure can either reproduce symptoms or show damaged areas on x-rays or CT scans.
Magnetic Resonance Imaging (MRI) Scan
This scan is non invasive and can produce images of all structures and tissue in the back.
Ultrasound imaging can identify damage such as tears in any soft tissues, muscles, tendons and ligaments.
What is back pain? Back pain is a condition associated with any type of pain felt in the back. The pain can be both acute or chronic.
What causes back pain? There are many reasons why your back might hurt. Some are minor like sprains and strains. It could also be as a result of an accident or injury and dependant on how bad the damage is. Certain medical conditions can also cause back pain like arthritis, pregnancy, infections or tumors.
How do doctors test for back pain? After a physical examination a doctor can do sensory tests to see if they can ascertain why your back hurts. If they are unable to identify a cause they may request various imaging tests.
When should you go to the doctors with back pain? You should see your doctor if your pain does not go away after a few weeks. Any pain that stops you carrying out your daily activities, is severe, getting worse or worries you needs investigating. (16)
Can you prevent back pain? There are a number of things you can do to prevent back pain. Exercise and stretching are key for keeping your back in motion. Make sure you lift things carefully and maintain good posture when sitting down at work or at home. Try and take frequent breaks if you sit or drive a lot. A mattress which is not supportive is not good for you therefore you should rotate it regularly and change it when necessary. Finally being overweight can predispose you to back pain so maintaining a healthy weight through a good diet will help. (17)
What can relieve back pain? There are over the counter medications that you can take to help relieve back pain. You could also use heat and ice packs. The heat increases blood supply and helps counteract muscle spasms whereas cold numbs pain and reduces inflammation. Exercise can also help relieve pain, just be sure to check with your doctor regarding which forms will be best for you. (18)
What are the risk factors associated with back pain? There are several things that can increase your risk of back pain. These include age, fitness levels, weight, and genetics. Your occupation can also contribute, especially if you do a lot of lifting, pulling, or sit in one position for most of the day. (19)
What are the treatments for back pain? Treatments for back pain will depend upon the cause and severity of it. Exercise and medication are the initial approach. There are other options as well such as manipulation, acupuncture or nerve blocking therapies. You could visit a physiotherapist or chiropractor who can advise you regarding exercises and other treatments. Surgery is factored in only when necessary. (20)
Back pain describes any form of pain felt in the back. It can be chronic or acute and can be sudden or develop slowly.
There are many causes of back pain from injury due to accidents through to other medical conditions. Whatever the cause it is apparent that it can be hard for medical professionals to diagnose.
Fortunately there are many treatments available that can manage or relieve your pain. There are also a number of things you can do yourself to prevent back pain.
One of the recurring messages is to try and maintain a healthy weight and keep yourself moving. Even by taking a short walk each day and performing stretching exercises will mean that your back will be stronger.