Overview Of Back Pain
Back pain can range from a dull ache to sharp pain. Back pain is chronic if it lasts for more than three months. Acute back pain can come suddenly and last from days to weeks. In most cases, this pain can go away on it’s own with the help of over-the-counter pain relievers and some rest. However staying still for long periods of time by laying down for days can worsen the discomfort.
Pain in the lower back (lumbago) is particularly common, although it can be felt anywhere along the spine, from the neck down to the hips. In most cases, it is not caused by anything serious and will usually get better over time. There are things you can do to help relieve it. But sometimes the pain can last a long time or keep coming back. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.
Low back pain refers to discomfort that you feel in your lower back. You may also have back stiffness, decreased movement of the lower back, and difficulty standing straight.
Acute back pain can last for a few days to a few weeks.
Commonly Associated With
Backache; Low back pain; Lumbar pain;Back pain – short-term; Pain – back; Acute back pain; Back pain – new; Back strain – new
Causes Of Back Pain
Most people have at least one backache in their life. Although this discomfort can happen anywhere in your back, the most common area affected is your lower back. This is because the lower back supports most of your body’s weight.
Low back pain is the number two reason that Americans see their health care provider. It is second only to colds and flu.
You will usually first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an injury or accident.
Acute low back pain is most often caused by a sudden injury to the muscles and ligaments supporting the back. It may be caused by muscle spasms or a strain or tear in the muscles and ligaments.
Causes of sudden low back pain include:
- Compression fractures to the spine from osteoporosis
- Cancer involving the spine
- Fracture of the spinal cord
- Muscle spasm (very tense muscles)
- Ruptured or herniated disk
- Spinal stenosis (narrowing of the spinal canal)
- Spine curvatures (like scoliosis or kyphosis), which may be inherited and seen in children or teens
- Strain or tears to the muscles or ligaments supporting the back
Low back pain may also be due to:
- An abdominal aortic aneurysm that is leaking.
- Arthritis conditions, such as osteoarthritis, psoriatic arthritis, and rheumatoid arthritis.
- Infection of the spine (osteomyelitis, diskitis, abscess).
- Kidney infection or kidney stones.
- Problems related to pregnancy.
- Problems with your gall bladder or pancreas may cause back tenderness.
- Medical conditions that affect the female reproductive organs, including endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids.
- Discomfort around the back of your pelvis, or sacroiliac (SI) joint.
Symptoms Of Back Pain
You may feel a variety of symptoms if you have hurt your back. You may have a tingling or burning sensation, a dull achy feeling, or sharpness. The pain may be mild, or it can be so severe that you are unable to move.
Depending on the cause of your back pain, you may also have discomfort in your leg, hip, or the bottom of your foot. You may also have weakness in your legs and feet.
- Muscle ache.
- Shooting or stabbing sensations.
- Pain that radiates down the leg.
- Discomfort that worsens with bending, lifting, standing, or walking.
- Pain that improves with reclining.
Exams & Tests
When you first see your provider, you will be asked about your back pain, including how often it happens and how severe it is.
Your provider will try to determine the cause of your back issues and whether it is likely to quickly get better with simple measures such as ice, mild painkillers, physical therapy, and proper exercises. Most of the time, back pain will get better using these methods.
During the physical exam, your provider will try to pinpoint the location of the pain and figure out how it affects your movement.
Most people improve or recover within 4 to 6 weeks. Your provider may not order any tests during the first visit unless you have certain symptoms.
Tests that might be ordered include:
- CT scan of the lower spine
- MRI of the lower spine
Treatment Of Back Pain
To get better quickly, take the right measures when you first feel pain.
Here are some tips for how to handle discomfort:
- Stop normal physical activity for the first few days. This will help relieve your symptoms and reduce any swelling in the area.
- Apply heat or ice to the painful area. One good method is to use ice for the first 48 to 72 hours and then use heat.
- Take over-the-counter medications such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). Follow package instructions on how much to take. Do not take more than the recommended amount.
- While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.
- A common misbelief about this condition is that you need to rest and avoid activity for a long time. In fact, bed rest is not recommended. If you have no sign of a serious cause (such as loss of bowel or bladder control, weakness, weight loss, or fever), then you should stay as active as possible.
- You may want to reduce your activity only for the first couple of days. Then, slowly start your usual activities after that. Do not perform activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. After 2 to 3 weeks, you should gradually start exercising again.
- Begin with light aerobic activity. Walking, riding a stationary bicycle, and swimming are great examples. These activities can improve blood flow to your back and promote healing. They also strengthen muscles in your stomach and back.
- You may benefit from physical therapy. Your provider will determine whether you need to see a physical therapist and can refer you to one. The physical therapist will first use methods to reduce your pain. Then, the therapist will teach you ways to prevent getting back pain again.
- Stretching and strengthening exercises are important. But, starting these exercises too soon after an injury can make your pain worse. A physical therapist can tell you when to begin stretching and strengthening exercises and how to do them.
- If your pain lasts longer than 1 month, your primary provider may send you to see either an orthopedist (bone specialist) or neurologist (nerve specialist).
- If your pain has not improved after the use of medicines, physical therapy, and other treatments, your provider may recommend an epidural injection.
You may also see:
- A massage therapist
- Someone who performs acupuncture
- Someone who does spinal manipulation (a chiropractor, osteopathic doctor, or physical therapist)
- Sometimes, a few visits to these specialists will help.
How is back pain diagnosed?
Doctors use many tools to help figure out the possible cause for your back pain, which helps them know how best to treat it.
Your doctor may ask questions about your medical and family history to see if an injury or other medical condition is the source for back pain. The doctor may ask many questions about your pain, such as:
- When it started.
- Where it hurts most.
- If anything makes it worse or better.
Your doctor may also do a physical exam and have you bend or lift your legs to see how moving affects the pain, and test your reflexes and muscle strength.
Sometimes, you may need more tests such as:
- Other imaging tests.
- Bone scans.
- Blood tests.