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Causes, Symptoms, Prevention and Treatment of Back Pain

Back pain (also known as dorsalgia when the pain is chronic) is any kind of discomfort or pain felt in the back, which can begin anywhere from the neck to the pelvis region. It can be a dull pain or a sharp stinging sensation. Back pain is a generic term used for various conditions that are associated with herniated disc, ruptured disc, sciatica, spondylitis, etc.

Almost everyone complains about some kind of back pain that interferes with his or her life and work. Back pain happens to be the most common cause for disability. Among common neurological complaints, back pain is the second most common illness.

Fast Facts about Back Pain

  • Back pain affects the lower back due to trauma or a disorder
  • Types of back pain are: acute and chronic
  • Back pain is referred to as sciatica, spondylitis, etc.
  • Back pain can be caused by poor flexibility, strain, sprain, spasm, or degenerative disease
  • Back pain affects men and women equally, and sometimes even affects children
  • Back pain symptoms include dull ache, sharp pain, kyphosis, scoliosis, or muscle stiffness
  • Diagnosed with medical history, physical examination, and diagnostic testing
  • Treatments include exercise, medications, acupuncture, biofeedback, spinal manipulation
  • Back pain can be prevented by exercise, good posture, lifting heavy objects properly, and using ergonomic principles at work and home
  • Back pain can be managed by stretching before exercise, using lumbar support for the chair, maintaining a balanced diet, and quitting smoking

Biology of Back Pain

The back is comprised of bones, muscles, ligaments, discs, and tendons, extending from the neck to the pelvis and any of them can be the cause of pain. The spinal column or spine protects and surrounds the spinal cord comprising of a network of nerves carrying signals that control movements of the body. Nerves originating in the spine travel to the arms and legs and can cause pain in the extremities as well. The spinal column is made up of vertebrae, which are of four types:

  • Cervical vertebrae (C1-C7)
  • Thoracic vertebrae (T1-T12)
  • Lumbar vertebrae (L1-L5)
  • Sacrum and coccyx – a fused mass of bones

The back pain is usually felt in the lumbar region.

Types of Back Pain

  • Acute back pain is short-term pain that can be brief for a few days or sometimes last up to several weeks
  • Chronic back pain is progressive, and can last for longer than three months

Common Causes of Back Pain

The back is composed of several intricate structures including bones, muscles, ligaments, tendons, and discs. The discs function as cushions between the segments of the spine. Back pain can originate in any of the above parts, and sometimes it is impossible to find the specific origin of back pain. The most common causes of back pain are:

  • Muscle strain or spasm, often caused by lifting heavy objects incorrectly
  • Ruptured or herniated discs
  • Sciatica
  • Spondylitis
  • Arthritis
  • Skeletal deformities like scoliosis or kyphosis
  • Rare conditions of cancer or infection
  • Old age
  • Poor posture
  • Stress
  • Poor physical health

Risk Factors for Back Pain

Some risk factors for back pain are:

  • Aging
  • Previous back injury causing pain
  • Compression fractures of the spine
  • Back surgery
  • Congenital spinal problems
  • Sedentary lifestyle
  • Smoking
  • Obesity
  • Physically strenuous work
  • Stressful job
  • Anxiety
  • Depression
  • Medicinal side effects

Symptoms of Back Pain

Signs and symptoms of back pain depend on the condition that is causing the pain, i.e. bulging or herniated disc, sciatica, spinal degeneration, osteoporosis, fibromyalgia, and spondylitis. Some symptoms are:

  • Muscle spasms resulting in stiffness and cramping
  • Pain in the back and buttocks region
  • Pain through the buttocks and down one leg to below the knee
  • Back stiffness upon awakening or pain after standing or walking for long period of time
  • Fracture of brittle and porous bones as seen in osteoporosis
  • Scoliosis or kyphosis seen in skeletal irregularities
  • Widespread musculoskeletal pain and fatigue with fibromyalgia
  • Chronic back pain and stiffness due to severe infection and inflammation of the spinal joints

Diagnosing Back Pain

A medical history and thorough physical exam are necessary to diagnose back pain.  Questions asked during medical history and physical exam will include nature of physical activities, and kind of work. This will help rule out a work-related origin for back pain. Some diagnostic tests performed to diagnose back pain are:

  • X-ray imaging
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Electrodiagnostic procedures, e.g. electromyography (EMG), nerve conduction studies, etc.
  • Bone scans
  • Ultrasonography
  • Blood tests in order to rule out metabolic disorders

Treatment Options for Back Pain

Many treatment options are available for treating back pain. This depends on how long the pain lasts and what is the cause of back pain. Some of the treatment methods are:

  • Exercise
  • Medications
  1. OTC analgesics such as aspirin, naproxen and ibuprofen
  2. Anticonvulsants
  3. Opioids such as codeine, oxycodone, and morphine
  • Spinal manipulation
  • Acupuncture
  • Biofeedback
  • Physical therapy
  • Traction
  • Transcutaneous electrical nerve stimulation (TENS)
  • Chiropractic
  • Minimally invasive procedures such as discectomy, vertebroplasty, foraminotomy, nucleoplasty, spinal fusion, and spinal laminectomy

Prevention of Back Pain

Some lifestyle changes can help prevent low back pain:

  • Exercise regimen including aerobic exercise
  • Correct posture while sitting and standing
  • Sleeping positions to protect the back
  • Low-heeled shoes
  • Maintaining healthy weight
  • Avoiding smoking
  • Nutritious diet that includes calcium, phosphorus, and vitamin D
  • Manage stress

Coping with Back Pain

Back pain can be debilitating and restrict your activities. However, it is possible to manage your symptoms and reduce the pain with some simple tips:

  • Get moving – exercise, walking, swimming, dancing – all keep your back active
  • Avoid exercises that can hurt your back
  • Maintain an erect posture when working at your desk
  • Use ergonomically designed workspaces
  • Eat a nutritious diet

Where to Find More Information: Spine Health