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Back Pain

Back pain is the pain that all of us experienced it in our entire lifetime, and due to this, got uncomfortable and debilitating. People of any age can be affected by it but older age people have high chances of having it. This is very common among all of us and in fact, not just the older ones, but kids have also experienced it many times due to their sitting and standing position. Do you know why you have a backache every time? Well, the answer is the various elements through which your back is composed of such as bones, muscles, nerves, and joints. When you have the problem of any of these elements, causes back pain.

Although it is not a serious problem and can be reduced through various treatments, sometimes it has become so debilitating for some patients such that they even can’t stand or walk properly as well as many-a-times, it hinders the ability of the patient to participate in routine activities. The pain is felt in the back of your body. Being so common reason, it even let people go to the doctor or miss their work as well. Typically, it is divided into three distinct parts, which means you may have pain in lower back, middle back, or upper back.

What Causes Back Pain?

As there are many causes of back pain, but there are two main causes, which are common as well. These are:

-  Strain- Generally, people have a backache due to strained muscles and ligaments. When you lift a heavy object incorrectly, a strain commonly occurs. Sometimes sudden awkward movements also cause back pain. Strain also results when you did overactivity such as the stiffness in your body occur after continuous hours of work or playing a sport.

-  Structural problems - When you have disk injuries in your body, it causes a backache and sometimes they even rupture, bulge, or herniated. These herniated disks cause pain and the bulging disk, which travels from your back down the leg, can also cause sciatica. Pain, numbness, etc are some sciatica, can be felt in the leg. Skeleton abnormalities can also be the reason for your back pain.

-  Movement and poor postures : Back pain is the result of everyday activities and bad posture. This can if you happen to do following activities:

- Twisting

- Over-stretching

- Standing or sitting for long hours

- Bending in an awkward position for long hours

- Pushing or lifting some object

Other causes of back pain:

-  Cauda equina syndrome: This syndrome is a bundle of spinal nerve roots that starts from lower end of spinal cord. A person feels pain in the lower back and numbness in the buttocks and thighs. One also experience disturbance in bladder and bowel functions.

-  Cancer of the spine: A tumor in the spine may press against the nerve that causes back pain.

-  Sleep disorders: People who have sleep disorder tend to experience back pain more, than others.

-  Shingles: This is a type of infection that causes painful rashes. It may lead to back pain depending on the nerves that are affected.

Other causes of back pain are as follows:

-  Nonmalignant tumour in the spine or cancer

-  Spine bacterial infection or fungal

-  Displacement of one vertebral body onto another

-  Loss of nerve function at the lower spinal cord

-  Spinal stenosis. In other words, narrowing of the spinal canal

Read More: Fibroadenoma Causes | Hay Fever Causes

Back Pain Risk factors:

There are many risk factors for back pain but being so prevalent, it can strike even when you have no risk factors. Some specific risk factors can cause back pain and these are as follows:

- Ageing - Due to wear and tear on the spine over a longer period of time produces back pain. That means, it can be concluded that people over age 30 to 60 are at more risk to have a backache as compared to younger ones, and the reason behind it the spinal stenosis. Older people generally have disk-disorder, causing pain simultaneously.

- Occupational hazards - When a job of continuous bending and lifting (such as construction work) is done, then there are high chances of back injury or else you have work of continuous standing (such as barber) or sitting (such as accountant) position as doesn’t support the back causing huge pain.

- Sedentary lifestyle - When you are not physically fit, or you can say when you don’t go for regular exercise, increasing the risk of having back pain

- Excess weight - Your excess weight of body put stress on your back, thus becomes a risk factor. Not only on your back, but your extra weight affects the other joints of the body as well.

- Smoking- The fact is quite strange to hear that people who smoke are at higher risk for developing back pain than those who don’t.

- Pregnancy - Pregnant women carry excess weight in the front so that they develop back pain many times in short periods.

- Poor posture - When you have poor posture for a long time, you have a risk of having backache at the same time such as improper lifting.

Complications of back pain:

The complications of back pain are mostly psychological apart from physical.

Some of them are:

-  Limited mobility

-  Nerve damage

-  Depression caused with limited mobility

-  Weight gain

There is no definite reason for back pain. Numerous reasons together can cause back pain in adults and children.

A person is prone to back pain in the following conditions:

- Ageing: Back pain is very common among old people, especially those who are above 40 years.

- Sedentary lifestyle: Lack of physical efforts and sedentary lifestyle can weaken your muscles.

- Overweight: People suffering with obesity can suffer with back pain in their lower back.

- Hereditary: If an individual has a hereditary of back pain and spinal disorders are easily prone to back pain.

- Bad posture: Sitting in a bad posture for prolonged hours can cause back pain as you strain your body physically.

- Pregnancy: During pregnancy, as a woman has extra weight in front of her body. It happens when pelvis meets your spine at sacroiliac joint.

- Smoking: The frequent habit of smoking constraints blood flow to your back by cutting off nutrition to your back, thus making your back weak.

Symptoms of Back Pain:

Symptoms are the characteristics of back pain. Generally, the common symptom is an ache that occurs anywhere in the back, and sometimes it increases such that causing pain down the legs as well as knees. When your other nerves got affected, then back issues can cause pain in various parts of the body.

The pain may be for a shorter period or the longer one depending on the cause of such pain:

-  Inability to stand up straight and sit properly.

-  A dull aching sensation in the lower back.

-  Pain reaches below the knees.

-  A stabbing pain, which radiates down the leg to the foot

-  A decreased range of motion in order to flex the back.

-  Swelling of the back

-  Fever

-  Weight loss

-  A recent injury

-  Numbness around the anus

-  Numbness around the buttocks

-  Difficulty urinating

-  Urinary incontinence

-  Numbness around the genitals

-  Loss of control over bowel movements

-  Muscle ache

-  Localized redness and tenderness

Read More: Diverticulitis Symptoms | Heartburn Symptoms

Diagnosis of Back Pain:

The physical examination is all need to be done in the diagnosis of a backache. When you visit a doctor for a check-up, firstly he will check your back along with the ability to sit, stand, walk, and lift as well. You may be also asked to rate your pain on a given scale from zero to 10 as well as will have a conversation with you about your pain and your functioning with the same.

All the given information and tests will help to discover whether you have muscle spasms, the reason behind your pain, and your actual ability to move before the pain strikes.

If a specific condition is suspected, which results in back pain, then your doctor may order these tests-

- X-ray- This test is done to check whether you have any broken bone. This also determines the alignment of bones.

- CT scans and MRI - These scans are asked by doctors to reveal herniated disks through images. The generated images also discover problems with bones, tissues, muscles, tendons, nerves, and blood vessels.

- Blood tests - To examine whether you have an infection or other condition due to which you are having pain in the back of your body.

- Bone scan - For any type of bone fractures and tumours, you can be asked to have a test for a bone scan by your doctors. The test is done in very rare cases.

- Nerve studies - The responses of your muscles and produced impulses by the nerves are measured by the following test. This test assures the narrowing of spinal canal and herniated disks.

Differential diagnosis

In differential diagnosis, doctors adopt various approaches such as-

- A chiropractor is a direct approach that diagnoses with the help of touch, visual examination, or through palpation. The following approach has a strong and accurate focus on adjusting the spinal joints. The blood and urine tests and various scans results, which a chiropractor may want to see.

- An osteopath involves mobilization which means slow and rhythmic stretching, pressure techniques, and manipulation of joints and muscles. With the help of visual inspection and palpation, an osteopath also diagnoses.

- A physical therapist identifies the problems in the joints and soft tissues of the body and focuses on diagnosis.

The differential diagnosis of back pain includes-

Musculoskeletal

-  Mechanical pain

-  Fracture

-  Vertebral

-  Arthritis

-  Hip disease

-  Sacroiliitis

-  Disc disease

Infectious

-  Osteomyelitis

-  Joint infection

Malignancy

-  Primary

-  Metastatic

Other

-  Abdominal disease

-  Sickle cell disease

-  Genetic

-  Psychiatric

Back Pain Treatment:

Home remedies

- Get enough sleep - When you didn’t get enough sleep, or unable to sleep, thus called insomnia, causing pain. Most of the people suffer from back pain due to a sleep disorder. Difficulty in falling asleep can lead to serious conditions. That is why you need a proper sleep of at least 8 hours a day.

- Exercise your core - For reducing the pain of the back, or in order to improve it, you should simply exercise your core for at least 30 mins every day, considering your daily routine. You can just sit upright on exercise ball for as long as 30 mins once every day, results in engaging your muscles.

- Stretch your hamstrings - Hamstrings are the muscles, located in the back of your thighs. Do stretch your hamstrings twice a day. If these are too tight, will cause more pain. Therefore, these should be stretched carefully and gently

Surgery

This treatment opts when all other conservative treatments haven’t worked out and you have persistent as well as disabling pain. Back surgery includes:

- Discectomy - A herniated portion of a disk will be removed in this type of surgery, in order to relieve irritation of the nerve. In order to access the ruptured disk, full or partial removal of a back portion of a vertebra is done in the surgery.

- Laminectomy - The bone overlying the spinal canal will be removed in the following procedure. The spinal stenosis causes nerve pressure, which is relieved by this surgery as well as enlarges spinal canal.

- Fusion- This procedure adds stability to a spinal fracture to relieve pain as it connects various bones in your spine. If you are having pain due to an injured disk, then it is the suitable surgery as it eliminates painful motion between vertebrate.

- Artificial disks - This treatment is alternative to the previous one for painful movement due to injured disk. Being relatively new option, aren’t opted by many of the patients.

Medication

Sometimes, the medicines become your companion in treating your back pain. Various medicines are available that will reduce your back pain such as-

- Over-the-counter pain relievers - Many of you are thinking about the term over-the-counter, so let me tell me that the following term means that some pain relievers can be bought without a prescription.  Mostly recommended medicine by doctors is Tylenol as it has fewer side effects than others. But if your pain stays for a longer period, NSAIDs may be suggested by your doctors as well.

- Narcotic - These can be taken when the pain is severe as they will provide you short-term relief. When used carefully, they can be very much effective in reducing pain. Examples include codeine, Morphine, Tramadol etc.

Back pain glossary

Listed below are some of the terms related to back pain that you should know.

- Acute back pain: A back pain that lasts less than three to six months. It occurs all of a sudden and can result in the form of an injury or illness.

- Chronic back pain: A type of back pain that continues for more than 3 to 6 months.

- Osteoporosis: The weakening of bones that makes it delicate and likely to break.

- Slipped disk: It is also known as prolapsed disc. It happens when an intervertebral disc in the spine bulges and presses on a nerve.

- Spinal stenosis: It is the narrowing of spinal column that puts pressure on the spinal cord and nerves.

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Common Myths About Back Pain:

Myth #1: Back pain can result in Paralysis

Even in the most cases, having back pain doesn’t indicate a back problem that could result in paralysis. There are other and very rare cases where it might have the possibility of having paralysis such as spine tumours, spinal infection, etc.

Myth #2: Severe back pain is correlated to the level of back damage

With chronic pain, which lasts more than 6 weeks, the amount of pain is not correlated with the amount of damage but with acute pain, the level of pain correlates to the damage level. For Example-You will immediately feel pain when you touch a hot iron.

Myth #3: Back pain doesn’t strike physically active people

Well, it is quite true that well-conditioned people have fewer chances to have back pain, but it doesn’t mean that it will not strike them as it affects all people. For example, some sports results in back pain such as golf, volleyball, etc.

Read More: Pneumothorax Myths | Bradycardia Myths

Frequently Asked Questions (FAQs) about Back Pain:

1) When should I worry about my back pain?

Ans: As it is a very common problem but one should consult a doctor if you notice some of these symptoms such as

-  Fever

-  Pain in chest

-  Swelling of your back

-  Worse pain at night

-  Inability to pass urine

-  Loss of bladder

2) Will the pain come back?

Ans: Depending upon the cause, acute pain may have the possibility to come back. If you had a surgery as a treatment, then the pain should not return, which is specific to your back surgery. Also, with non-surgical treatment, you can reduce the level of pain, but doesn’t cure properly.

3) Does complete bad rest necessary for back pain?

Ans: You can be asked by your doctor to have short-term bed rest as it will reduce severe back pain, rest for more than 48 hours will reduce your muscle strength. You should get back to your normal routine after a short period of bed rest as it will avoid stiffness in your body.

4) When should I seek a doctor in back pain?

Ans: You should immediately seek a doctor if you are suffering with back pain along with issues like:

-  Numbness in overall body,

-  Trouble in urinating

-  Weight loss,

-  Pain in chest

-  Swelling in your back

-  Loss of bladder

5) Why back pain happens?

Ans: Back pain happens for no reason. It can happen due to interruption of normal functioning of muscles, ligaments or cartilage. This can happen due to minor strains, injuries and muscle overuse. Conditions that cause back pain include:

- Slip disc: The soft material inside the disc can rupture the nerve when compressed. This is called sciatica when sciatic nerve is compressed.

- Spondylolisthesis: When a nerve vertebra slips and pinches the nerve.

- Spinal stenosis: The narrowing of spaces within the spine, which puts pressure on the nerve that can travel through the spine.

6) What steps should be taken when back hurts?

Ans: You need not necessarily consult a doctor for back pain. Sometimes, you can prefer home remedies as they can help you in recovering soon.

-  OTC painkillers like Paracetamol or Ibuprofen

- Proper rest: Changing your sleeping position may take off the strain

-  Exercising can strengthen and increase flexibility of the back.

-  Stay calm in order to relieve tension and recover faster.

7) What tests are available for back pain?

Ans: The doctor may ask you to determine the reasons for back pain. Some of the common tests are:

- X-ray: This test provides image that shows the alignment of bones and whether you have arthritis, displaced bones or tumor.

- CT scan: This test gives you a detailed and cross section images of bones in spine or problems with muscles, tendons and ligaments.

- MRI scan: This test gives detailed images of vertebrae and nerve roots. MRI’s are used to diagnose spinal disorder to rule out spinal infection.

8) Can back pain become chronic?

Ans: Acute pain triggers in the nervous system to alert that something might happen. Acute pain can cause or persist for several months and sometimes years. This happens if physiological condition is ongoing, if the patient is suffering with arthritis.

9) What types of surgery should be done for back pain?

Ans: There are numerous surgeries that are available for the treatment of back pain. These surgeries are performed to relieve pressure on a compressed nerve to improve the deformity like scoliosis.

- Spinal fusion: Joining of two or more vertebrae with a section to stabilize and strengthen the spine.

- Discectomy: The removal of prolapsed disc that pressed nerve to the spine. These days micro discectomy is more common.

- Artificial disks: An alternative to spinal fusion for painful movement between the two vertebrae.

- Laminectomy: In this surgery, a bone is removed from one of the vertebrae, that compresses a nerve into your spine.

10) What are the non-surgical options of back pain?

Ans: The non-surgical options for back pain are:

- Exercise: It can strengthen your muscles and improve your posture.

- Acupuncture: Fine needles are inserted at different parts of the body to reduce the back pain.

- Manual therapy: Massage and spine mobilization

- Pain relieving injections: Delivery of steroids into the joints, ligaments or around your nerves.

- Facet joint injections: Local anesthetic and steroid medication is inserted that relieves pain and inflammation.

-  N erve root blocks: It is an injection of local anesthetic and steroid under X-ray guidance into the area around the nerve root to reduce pain or inflamed nerve.

11) What are the various treatments available for back pain?

Ans: There are various treatments available for back pain. The treatment options available depend on how long the pain lasts. For acute episodes, self-help treatments like painkillers can eliminate the pain. And, in case the pain becomes chronic, then one should go for physiotherapy, acupuncture and pain injections. If all these treatments didn’t prove helpful, then one must go for a surgery.

12) How does exercising helps in back pain?

Ans: While experiencing back pain, it is very obvious that one would take bed rest for some hours. But too much of rest can deteriorate your health. Exercising will not only help in reducing your weight, but some exercises can strengthen your back muscles, increase blood flow to your back by providing enough support to your back.

Exercises like swimming, aerobics and cycling are beneficial for your back.

13) How can I take self-care at home?

Ans: Sleeping with a pillow in between the knees while lying on one side can make you feel better. Some doctors even recommend you to do this. Exercising mostly helps in case of chronic back pain. But, do not take a heating pad directly on your skin. Many experts agree bed rest for long hours is associated with recovery period.

14) Which medicines are suggested to take for back pain?

Ans: Nonprescription medicines like Ibuprofen, that is available as OTC product is the most advised medication for short-term treatment of the back pain. Other medicines like Acetaminophin and Celebrax are also effective in relieving the pain.

15) Should I take antidepressants for back pain?

Ans: Antidepressants are prescribed to relieve back pain that last for at least six months, i.e., in case of chronic back pain. These medicines can affect how your brain senses certain kinds of pain. If a person is suffering with depression or anxiety, then they can they can suppress those symptoms that helps in easing the pain.

16) How does acupuncture help in the treatment of back pain?

Ans: Acupuncture is the traditional therapy that began 2500 years ago. This therapy involves inserting of needles at certain points of the body. It is believed that inserting needles with correct combinations can bring the energy flow back with proper balance.

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Last updated on : 26-10-2018

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