Back Pain: Causes, Symptoms, and Treatment

Last updated on September 1st, 2020 at 06:22 am

What is Back Pain?

Pain in the back of the body sometimes diffusing to the lower parts such as buttocks and legs is commonly termed as back pain.

What are the symptoms of back pain?

General symptoms for back pain may include:

• Muscle pain around the back which can be shooting or stabbing.
• Sometimes this pain may radiate downwards towards buttocks or legs.
• Pain that aggravates while bending, lifting, standing, or walking.
• Pain that soothes while lying back in a relaxed position.
  
  
  

Are you having these symptoms in Kathmandu?

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What risk factors contribute to back pain?

According to Doctor Stephen on Spine-health newsletter elucidates following risk factors: 

Aging

Older people are at more risk for back pain than the younger ones. This is because with time, wear and tear on the spine may result in various clinical conditions such as disc degeneration and spinal stenosis which commonly cause neck and back pain.

The age group of people ranging from (30-60) is more likely to have disc degeneration problems while people over 60 are more likely to have back pain related to osteoarthritis (degeneration of joint cartilage and underlying bone).

Genetics

Back problems are also sometimes associated with the genetics of the person and hence can be inherited from the family. For example, disc degeneration runs down the family and members of that lineage can likely back pain.

Occupational Hazards

Certain job types that involve heavy lifting and bending frequently for example, (construction workers), workers who need to stand for long hours without a break (barber), or those who sit in a chair for long hours (software developer) are likely to have back pain more than others.

Sedentary lifestyle

Lack of regular exercise decreases the strength of muscles and tendons supporting our back hence increasing the likelihood of back pain.

Over-weight

Risks of back problems also increase in peoples whose backs constantly have to bear the stress of being overweight.

Causes and Diagnosis of Back pain

Strain, tension, and injury are the frequent causes of back pain which can be diagnosed due to:

Muscle or Ligament Strain

When in a poor physical condition, activities like heavy lifting or abrupt awkward movement can strain back muscles and ligaments that can result in back pain. This can be acute or chronic depending on the type of injury.

Bulging or Ruptured disc

Discs are soft cushions between vertebrae (bones) of the back that act as shock absorbers. It can bulge or rupture depending on the injury pressing the spinal nerve which can lead to back pain.

Activities that can cause above-mentioned conditions involve:

• Twisting
• Overstretching
• Bending awkwardly
• Pushing
• Pulling
• Lifting or carrying something heavy
• Standing or sitting for long periods in front of a computer or driving

Arthritis

Arthritis is a disease associated with severe pain and stiffness of the joins that generally affects the lower back.

Additionally, it can also lead to a condition called spinal stenosis (narrowing of space around the spinal cord).

Skeletal Irregularities

This is seen especially after middle age where the spine curves to the side technically termed as (scoliosis) leading to back pain.

Osteoporosis

This is a condition where our vertebrae develop fractures because our bones are brittle and porous leading to back pain.

What should I do when my back hurts?

In general, acute back pain goes away within 6 weeks without any notification. But still, there are things that we can do to sped up the recovery process such as

Adopting an active lifestyle

It is very important to stay active and carry on with the regular lifestyle during a back pain while avoiding any extremities.

This helps build flexibility of the muscles and tendons that support our back and hence aid in the recovery process.

Moreover, it also aids in relieving pain by secreting natural pain killers called endorphins.

Using over the counter pain killers

While going about with life with natural ease may be easier said than done, during extreme back pain that one perceives, over the counter painkillers may be very helpful to use to relieve pain.

Heat or Ice Pack

We can also use heat or ice pack during back pain that loosens up the tight muscles and hence relieve pain.

Rest with ease

It’s a wise decision to rest in a comfortable position while sleeping or working to relieve pain and also recover faster.

When should I worry about my back pain and see a doctor?

Normally acute back pain gets better within 6 weeks’ even if unattained but it is advisable to seek medical attention if the pain lasts longer than that or is the result of some kind of mishap/accident and is accompanied by any of the symptoms below:

• Fever
• Unexplained loss of weight
• Swelling or deformity in the back
• Chest pain
• Started after meeting with an accident
• Loss of bowel control or difficulty peeing, coughing or sneezing
• Numbness or tingling around genitals, buttocks, legs or arms
• No improvement after resting or gets worse at night
• If the pain has its origin at the top of your back between shoulders rather than lower back

Moreover, having a history of a certain medical condition such as cancer or osteoporosis accompanied by back pain also requires immediate medical attention.

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Questions to prepare before visiting an orthopedic doctor?

• Likely causes of your back pain.
• Do’s and don’ts during back pain.
• What are the self-help remedies that can help ease the pain?
• What lifestyle changes or home remedies can help it?
• What can make it worse?
• Is the medication required? If yes, then for how long? Side effects?
• The requirement of any diagnostic tests.
• What are the best treatment options given your condition?
• Length of treatment.
• Management of pre-existing medical conditions if any.
• Preventive measures to avoid future back pain problems.

What is the outlook for back pain?

In the majority of cases, back pain is acute and goes away within sometime unnoticed (within 6 weeks). But those that last more than that can be chronic and needs medical attention.

Much depends on the cause of the back pain and how it is handled. For example, while it may be wise to start with self-help remedies but if the pain persists one should not hesitate to contact medical professionals such as doctor or physio-therapist. 

How is your back structured?

Spine in our back starts from the neck region (cervical vertebrae) extending to the thoracic region (upper back) and finally ending in the lumbar region (lower back) as the figure below depicts.

Our spine consists of four major parts namely (vertebrae, joints, discs and, nerves) that in combination constitute our whole spine.

Vertebrae and joints

These are the bones that make up our spine. Altogether there are 24 bones fused which gives the structural framework to the back. And the flexibility of our back comes from the joints (spaces between two vertebrae).

Discs

These are the cushioning pads that sit between the joints and act as shock absorbers providing the flexibility to our back and minimizing friction.

Nerves

These are the most important part of our spine that extends from our brain up to our lower back.
These coordinate all the activities of our body such as movement and organ function by sending and receiving messages from the brain and decimating it to other necessary parts.

What tests are available for back pain? 

Elucidating a test starts with a physical examination by a doctor who will access you on your ability to sit, stand, walk, and lift your legs.

After the assessment, if there is a specific reason to suspect any condition, one of the following tests can be performed

X-Rays

Images from X-rays can reveal a broken bone or arthritis if a doctor suspects this being the cause of the pain. While it alone cannot pin-down on problems with spinal cord, muscles, nerves, or discs.

MRI or CT Scans

Scans such as these reveal the problem with herniated discs or the problems with bones, muscles, tissues, tendons, nerves, ligaments, and blood vessels.

Bone Scans

These are done in case your doctor suspects of bone tumors or compression fractures.

Nerve Studies

These are performed by performing EMG (Electromyography) which studies the signal produced by the nerves and its responses to the muscles. This study is done to confirm conditions such as nerve compression and spinal stenosis (narrowing of the spinal canal).

Why does back pain become chronic?

In most instances, back pain that lasts more than 6 weeks is due to unresolved pre-existing medical conditions such as herniated discs, spinal stenosis, or arthritis. 

But according to the report of the BMJ journal, it is still unclear in most cases to trace down the source of pain and thereby its reason.

What non-surgical options are available?

Physical therapies are the best non-surgical options to relieve the back pain and this may include:

Exercise and Yoga

These include the range of stretching postures as dictated by a trained professional. It will help improve the strength of muscles and tendons supporting our back.

Acupuncture

This is an ancient Chinese technique that involves inserting very fine needles to help relieve back pain.

Massage

It is a technique of rubbing the body with hands which can surely relieve back pains when done correctly by a well trained professional.

Pain-relieving injections

Range of pain-relieving anesthetics and steroids that are available can be applied to the joints, ligaments, muscles, or nerves. 

What are the treatment options available for back pain?

Choice of treatment options for back pain depends upon the nature of the problem involved but here is a list of some options that can be accessed

Medications

Use of over the counter medications/painkillers may be useful to relieve acute back pain that lasts for some days e.g. ibuprofen or narcotics such as oxycodone or hydrocodone

Pain relievers

Creams and ointments can also be rubbed in the back to relieve acute pain

Injections

Pain-relieving anti-inflammatory injections such as cortisone can be helpful if the medication does not work.

Physical therapies and self-help remedies (Non-surgical approach)

Exercise and physiotherapy routine and modality from a well trained professional is vital to start with for any kind of back pain.

The postures involved when performed regularly strengthens muscles and tendons and hence cure any future re-occurrence.

Other non-surgical models include self-help remedies such as the use of ice packs or heat treatments or ultrasound or electrical stimulation.

Surgery

If the pain is chronic and associated with structural problems or nerve compression, surgery might be essential.

Particularly if your back pain is the result of spinal stenosis (narrowing of the spinal cavity) or herniated discs (bulged, slipped or ruptured) disc.

But this is a decision to come to by a medical professional and not the patient.

Will the pain come back?

Even though there is no guaranteed answer to this question, keeping up with the active and healthy lifestyle, regular exercise of the back and general awareness of risk-factors, symptoms, causes and preventions can surely keep away future back pain problems.