Back pain is one of the most common reasons people go to the doctor or miss work and a leading cause of disability worldwide. Most people have back pain at least once. Fortunately, you can take measures to prevent or relieve most episodes. If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks.
Causes of back pain
The human back is composed of a complex structure of muscles, ligaments, tendons, disks and bones. The segments of our spine are cushioned with cartilage-like pads called disks. Problems with any of these components or with the spine such as osteoporosis can lead to back pain. In some cases, its cause is never found.
The most common causes of back pain are:
- Strained muscles
- Strained ligaments
- A muscle spasm
Things that can lead to strains or spasms include:
- Lifting something improperly
- Lifting something that is too heavy
- The result of an abrupt and awkward movement
The following structural problems may also result in back pain:
Ruptured disks – each vertebra in our spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
Bulging disks – in much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
Sciatica – a sharp and shooting pain that travels through the buttock and down the back of the leg, caused by a bulging disk pressing on a nerve.
Arthritis – patients with osteoarthritis commonly experience problems with the joints in the hips, lower back, knees and hands. In some cases spinal stenosis can develop, which is the term used to describe when the space around the spinal cord narrows.
Abnormal curvature of the spine – if the spine curves in an unusual way the patient is more likely to experience back pain.
Osteoporosis – bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
Cauda equina syndrome – the cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. People with cauda equine syndrome feel a dull pain in the lower back and upper buttocks, as well as analgesia (lack of feeling) in the buttocks, genitalia and thigh. There are sometimes bowel and bladder function disturbances.
Cancer of the spine – a tumor located on the spine may press against a nerve, resulting in back pain.
Infection of the spine – if the patient has an elevated body temperature as well as a tender warm area on the back, it could be caused by an infection of the spine.
Other infections – Pelvic Inflammatory d=Disease, bladder, or kidney infections may also lead to back pain.
Sleep disorders – individuals with sleep disorders are more likely to experience back pain, compared to others.
Shingles – an infection that can affect the nerves may lead to back pain, depending on the nerves affected.
Bad mattress – if a mattress does not support specific parts of the body and keep the spine straight, there is a greater risk of developing back pain.
Everyday activities or poor posture-Back pain can also be the result of some everyday activity or poor posture. Examples include;
- Bending awkwardly
- Pushing something
- Pulling something
- Carrying something
- Lifting something
- Standing for long periods
- Bending down for long periods
- Muscle tension
- Straining the neck forward, such as when driving or using a computer
- Long driving sessions without a break, even when not hunched
Who Gets Back Pain?
- Anyone can have back pain, but some things that increase your risk are:
- Getting older. Back pain is more common the older you get. You may first have back pain when you are 30 to 40 years old.
- Poor physical fitness. Back pain is more common in people who are not fit.
- Being overweight. A diet high in calories and fat can make you gain weight. Too much weight can stress the back and cause pain.
- Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
- Other diseases. Some types of arthritis and cancer can cause back pain.
- Your job. If you have to lift, push, or pull while twisting your spine, you may get back pain. If you work at a desk all day and do not sit up straight, you may also get back pain.
- Your body may not be able to get enough nutrients to the disks in your back if you smoke. Smoker’s cough may also cause back pain. People who smoke are slow to heal, so back pain may last longer.
- Another factor is race. For example, black women are two to three times more likely than white women to have part of the lower spine slip out of place.
Can Back Pain Be Prevented?
The best things you can do to prevent back pain are:
- Exercise often and keep your back muscles strong.
- Maintain a healthy weight or lose weight if you weigh too much.
- To have strong bones, you need to get enough calcium and vitamin D every day.
- Try to stand up straight and avoid heavy lifting when you can. If you do lift something heavy, bend your legs and keep your back straight.
- stay active – doing regular exercise can help keep your back strong
- avoid sitting for too long when driving or at work
- check your posture when sitting, using computers and watching television
- ensure the mattress on your bed supports you properly
Treatments and drugs
Most acute back pain gets better with a few weeks of home treatment. Over-the-counter pain relievers and the use of heat or ice might be all you need. Bed rest isn’t recommended.
Continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain, but don’t avoid activity out of fear of pain. If home treatments aren’t working after several weeks, your doctor might suggest stronger medications or other therapies.
Depending on the type of back pain you have, your doctor might recommend the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs); such as ibuprofen might relieve acute back pain.
Muscle relaxants; If mild to moderate back pain doesn’t improve with OTC pain relievers, your doctor may also prescribe a muscle relaxant. Muscle relaxants can make you dizzy and sleepy.
Topical pain relievers; These are creams, salves or ointments you rub into your skin at the site of your pain.
Narcotics; Certain drugs, such as codeine or hydrocodone, may be used for a short time with close supervision by your doctor.
Antidepressants; Low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline — have been shown to relieve some types of chronic back pain, independent of their effect on depression.
Injections; If other measures don’t relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone or numbing medication into the space around your spinal cord. A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
Physical therapy and exercise; Physical therapy is the cornerstone of back pain treatment. A physical therapist can apply a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain.
As pain improves, the therapist can teach you exercises that can increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.
Few people need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgery. Otherwise, surgery usually is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn’t responded to other therapy.