Back pain is due to pain in the lower back. It can be due to a problem in the ligaments, muscles, nerves or bony structures of the back. It can be due to problems in the organs around the back. It can result from injury, activity and some medical conditions. Back pain can affect people of any age, it is however more common in older people due to previous occupation and degenerative disk disease.

The lower back is the most common site of back pain. According to WHO low back pain is among the top 10 causes of disability. The lifetime prevalence of non-specific (common) low back pain is estimated at 60% to 70% in industrialized countries (one-year prevalence 15% to 45%, adult incidence 5% per year). Back pain is most common between the ages of 35 and 55.

Causes

Common causes of back pain includes;

  • Poor posture;
  • Ruptured disc: Each vertebra in the spine is cushioned by disks. If the disk ruptures there will be more pressure on the nerve around the spine, resulting in back pain.
  • Bulging disc: If the vertebra disc is bulging beyond its normal limit it can compress on the nerves leading to pain.
  • Arthritis: This can lead to narrowing of the space around the spinal cord and can lead to back pain
  • Sciatica: This is due to compression of the sciatic nerve which is a major nerve in the back can lead to pain which radiates to the thighs.
  • Osteoporosis:  A medical condition in which the bones become brittle and fragile from loss of tissue. This makes compression fractures of the spine more likely
  • Kidney stones: This is a hard, crystalline mineral material formed within the kidney and urinary tract. It can lead to back pain.
  • Spinal cord structural defect: Abnormal curvature of the spinal cord such as scoliosis can predispose to back pain.
  • Pregnancy: Hormonal changes and weight gain can lead to stress on the pregnant woman’s spine and lead to back pain.
  • Non- specific back pain: It can be due to non- specific reasons such as weakness of the muscles.

Risk factors

The following factors are linked to a higher risk of developing low back pain:

  • Occupational activities
  • Pregnancy
  • A sedentary lifestyle
  • Poor physical fitness
  • Older age
  • Obesity and excess weight
  • Smoking
  • Strenuous physical exercise or work, especially if done incorrectly
  • Genetic factors
  • Medical conditions, such as arthritis and cancer

Symptoms

  • Back pain can be dull, sharp pain
  • The pain can radiate to the legs and arms
  • There can be associated symptoms such as;
  • Weakness
  • Inability to stand-up straight without pain.
  • Decreased range of movement

Other symptoms that require urgent medical check-up include;

  • Loss of bowel or bladder control
  • Numbness, tingling, or weakness in one or both legs
  • Onset following trauma, such as a fall or a blow to the back
  • Intense, constant pain that gets worse at night
  • Presence of unexplained weight loss
  • Pain associated with a throbbing sensation in the abdomen
  • Presence of fever

Diagnosis

A good history and examination should be done to review the underlying cause of the back pain. In more serious conditions the following testes are done;

  • Blood and urine tests to check for underlying conditions
  • X-rays of the spine to show alignment of your bones and check for breaks
  • Computed tomography (CT) scan or magnetic resonance imaging (MRI) to assess your disks, muscles, ligaments, nerves, and blood vessels
  • Bone scan to look for abnormalities in the bone tissue
  • Electromyography (EMG) to test nerve conduction

Treatment

  • Ice packs can relief discomfort and reduce inflammation in the acute phase of pain while warm compress can help reduce pain when the inflammation has subsided.
  • Regular exercise; its important you practise regular back strengthening exercises can help to strengthen the muscles of the back and aid in pain relieve.
  • Proper posturing; its important you practice proper posturing at all times so as not to put strain on the muscles of the back. Sit up in a chair, ensure you practice proper lifting techniques (stoop to lift up heavy loads), proper positioning in front of the computer should be practised at all times.
  • Pain relieving medication such as; acetaminophen, NSAIDS; such as aspirin, diclofenac
  • Surgery; this is one of last resorts in the management of back pain. It is done when the pain is persistent and severe and ther is associated structural defect such as; bulging disc,
  • Treat underlying disease; such as antibiotics for kidney inflammation.
  • Sleep on appropriate mattress that can support your weight