Back pain is a common problem, and most of us have experienced it (or will do so) at one point or another. Sometimes pain in your back comes and goes away easily, but in other instances it is persistent. Regardless of the duration, back pain has a major impact on your quality of life, but to manage it properly, it is necessary to get informed about this problem. Throughout this post, you’re going to learn about different causes and symptoms of back pain, and different treatment options to feel better*.
Table of Contents [Hide]
- How common is a back pain?
- Causes of back pain
- Everyday activities that cause back pain
- Back pain risk factors
- Symptoms of back pain
- How is back pain diagnosed?
- Treatment options
- Alternative treatments for back pain
- Things you can do to prevent/manage back pain
- Lifting technique
How Common is a Back Pain?
Back pain is a common problem, as mentioned above. Some estimates show that 8 out of 10 Americans will experience back problems at some point during their lifetime. In most cases, people feel pain in the lower back area. According to the American Chiropractic Association, about 31 million Americans experience low-back pain at any given time. The severity of this problem is best depicted by the fact that Americans spend at least $50 billion each year on back pain, and the sum only counts the identified costs!
In one survey, 2600 respondents shared the experiences about the impact of back pain on overall quality of life. About 39% of them said that back problems affect daily tasks, 38% experienced problems with exercise, while 37% reported interrupted sleep.
Causes of Back Pain
Human back is a complex structure of joints, tendons, disks, muscles, and ligaments. When any of these segments experiences some problems, you feel back pain. Therefore, it is impossible to pinpoint one specific cause of pain and discomfort in this area. In some cases, people know the cause of back pain while others don’t. In fact, only 1 in 10 patients finds out the primary cause of back pain. This has a lot to do with the fact that some people don’t see their doctor when back pain occurs thinking it will go away on its own and only seek medical assistance if the intensity of pain becomes unbearable.
We can divide causes of back pain into strains and structural problems. Strains are the most common cause of back pain and they involve strained muscles, ligaments, and muscle spasms. On the other hand, structural problems refer to different conditions such as arthritis that involve back pain, too. In order to learn more about the source of back pain you experience, here’s the basic rundown of potential causes.
A muscle strain occurs when the muscle is over-stretched or torn, thus leading to damage in the muscle fibers. This problem is also called a pulled muscle. A pulled back muscle is a common injury for athletes, but even if you’re not taking part in any sport, you can still develop this problem. How? You can strain back muscles by lifting a heavy item, throwing something while twisting, or falling unexpectedly.
This injury usually occurs in lower back area, and it is indicated by symptoms such as:
- Pain affects only lower back area; it doesn’t spread to the leg
- Lower back is sore upon touch
- Difficulty standing or walking
- Pain is often accompanied by muscle spasms
- Pain appears suddenly
When it comes to this injury, it is important to bear in mind that in some cases severe back pain can go away quickly, while the lower intensity of pain can be persistent and last for weeks or months.
Ligaments and tendons are defined as fibrous bands of connective tissue that attach to the bone. The purpose of ligaments is to connect two or more bones together and help stabilize the joints. The system of ligaments together with tendons and muscles creates a natural brace that protects* the spine from injury. Ligaments contribute to the stability of joints during movement and rest, and they prevent injury from hyperextension and excessive movements (hyperflexion). Due to this stabilizing role, ligaments are not overly flexible which is why injuries are quite common.
A torn or strained ligament in the back can be a minor or severe injury depending on the location and degree of damage. Strained ligament occurs when bones are subjected to massive force, thus leading to an injury in the connective tissue. You can develop this injury from an accident, sports or fitness activity.
Symptoms of strained ligaments include pain, decreased* range of motion, and tenderness in the affected area. It is not uncommon to experience swelling, bruising, and inflammation.
Muscle spasm is an involuntary or spontaneous contraction of a muscle. Although these spasms may seem like they pop up out of the blue, the movement that triggers this action is preceded by series of smaller strains to the structures of your spine. When these injuries occur, they cause inflammation which sensitizes the nerves. As a result, muscle spasms or contracts.
Causes of muscle spasms are numerous including a sudden fast movement, disc disorders, overstretching, neurological conditions, overuse, and fatigue of muscle due to poor posture, just to name a few. Although muscle spasms can have different characteristics, some common symptoms are severe pain, stress, inability to move the affected part of the back, forward-leaning posture, tension and tightness in the affected area. Muscle spasms can last for a few seconds, minutes, or longer. The pain intensity varies from mild and moderate to severe in a way that you have to seek medical assistance.
Now that we’ve covered strains, it is time to move on to causes of back pain due to structural problems.
A herniated disc is defined as a problem with discs or rubbery cushions between vertebrae or individual bones in your spine. Basically, spinal disc resembles a jelly donut with tougher exterior encasing a softer center. When one of these discs develops a crack in its hard outer wall, the inner disc material is pushed into the spinal canal. When this happens, the herniated disc irritates nearby nerves and causes pain, weakness, or numbness.
A herniated or ruptured disc is usually a result of age-related, gradual wear and tear i.e. disc degeneration. Aging brings all sorts of changes to your body and as you age discs in your spine are slowly losing their water content. In turn, their flexibility decreases* significantly. Above all, spinal discs become more prone to rupturing or tearing.
The truth is, most patients do not know the exact cause that led to a herniated disc situation. Other factors that play a role in developing this problem include overweight or obesity, genetics or family history of herniated disc, and certain occupations such as those involving repetitive lifting, pushing, pulling, twisting, bending sideways, among others.
In a vast majority of cases, herniated discs develop in the lower back area, but they can also occur in your neck. Symptoms associated with this problem usually include weakness of the affected muscles, tingling or numbness, and arm or leg pain. If herniated disc develops in the lower back, you may also experience leg pain, while arm pain or discomfort occur due to herniated disc in the neck.
Sciatica is pain radiating along the path of the sciatic nerve which extends from the lower back through hips and butt and down each leg. Generally, sciatica affects one side only; rare are the instances when people feel this pain in both sides of their body. In most cases, sciatica occurs when a herniated disc irritates the nerve.
According to some estimates, cases of sciatica have been reported in 1-10% of the population and primarily in people aged between 25 and 45. Of a total number of sciatica cases, about 90% of them are caused by herniated disc. Other causes of sciatica are tumors, but some diseases such as diabetes can also compress the nerve and induce pain. That’s why it is important to bear in mind that sciatica itself is not a medical diagnosis, it is just an indicator of some underlying medical problem.
A telltale sign of sciatica is pain ranging from mild to a sharp, burning*, and excruciating sensation. It is not uncommon for patients to experience tingling, numbness, and muscle weakness. While these symptoms are awfully similar to other conditions associated with back pain, sciatica is also indicated by the fact that pain becomes worse when you’re sitting.
Arthritis is a term used to describe disorders that affect joints. Millions of people have arthritis, but we usually associate it with our knees. Not only it can affect just about any joint in your body, but it is one of the most common causes of back pain. According to the Arthritis Foundation, various forms of arthritis can affect your back, and they are commonly referred to as spondyloarthropathies. They include:
- Ankylosing Spondylitis – An inflammatory disease that causes vertebrae in your spine to fuse. As a result, the spine becomes less* flexible, and an affected person develops a hunched-forward posture. While most arthritis types are more common in women, ankylosing spondylitis affects men primarily. There is no specific cause of this inflammatory disease, but scientists speculate genetic factors are involved. Symptoms associated with ankylosing spondylitis include pain and stiffness in lower back and hips, particularly in the morning or after prolonged inactivity
- Osteoarthritis – The most common type of arthritis both regarding prevalence and regarding back pain. Osteoarthritis (OA) involves the breakdown of cartilage that cushions the ends of bones where they meet to form joints. Although it can affect just about any joint in your body, OA usually occurs in joints in your hands, knees, hips, and spine. When it comes to spine, the breakdown takes part in the cartilage of facet joints where your vertebrae join. In turn, movements of bones can lead to the formation of spurs (bony outgrowths), further damage, and irritation. These spurs form pressure on nerves and cause pain. The most common cause of OA is age-related wear and tear and symptoms include pain, swelling, tenderness, and stiffness
- Psoriatic Arthritis – Type of arthritis that affects people with a skin condition called psoriasis which features red patches of skin covered with silvery scales. Although the connection between the two is relatively unknown, in most cases psoriasis comes first and it is followed by arthritis. The condition occurs when the body’s immune cells start attacking healthy cells and tissues. Psoriatic arthritis is indicated by swollen fingers and toes, foot pain, and lower back pain and discomfort
- Reactive Arthritis – Joint pain and swelling triggered by an infection in some other part of your body, usually in genitals, intestines, and urinary tract. Multiple bacteria can cause reactive arthritis including Clostridium difficile, Campylobacter, Yersinia, Shigella, Salmonella, and Chlamydia. It is important to bear in mind that reactive arthritis isn’t contagious, but bacteria can be transmitted to other people through contaminated food or sexual intercourse. Symptoms of this condition usually develop about 1-4 weeks after the exposure and they’re indicated by pain in low back or feet, knees, and ankles, urinary problems, eye inflammation, inflammation of muscles, tendons, ligaments, skin problems, and others
- Rheumatoid Arthritis – A chronic inflammatory disease of the joints i.e. the body starts attacking its own healthy cells and tissues. Rheumatoid arthritis (RA) usually affects elbows, wrists, hands, hips, knees, ankles, and feet, but it can also occur in the facet joints of your spine. The deterioration of joint in the spine leads to compression of the spinal cord and spinal nerve roots. Unlike OA which induces pain in lower back, RA primarily causes pain in the neck area. Rheumatoid arthritis is indicated, like other types of arthritis, by pain, tenderness, and swelling in an affected area. You may also experience loss of flexibility and have the crunching feeling when you move the joint, particularly noticeable in the neck. It is not uncommon for patients to also have a headache
Osteoporosis is defined as a condition where bones lose* their mass and become brittle and fragile. According to some statistics, osteoporosis affects 200 million women worldwide and about 75 million people in Europe, USA, and Japan. Women are more likely to develop osteoporosis than men, particularly after menopause. In fact, 1 in 3 women and 1 in 5 men over the age of 50 will experience osteoporotic fractures.
The primary cause of osteoporosis is a natural aging process itself. You see, your bones constantly renew themselves, when the old bone is broken down, the new one is made. As you’re getting older, bone mass is lost faster than it is created. At first, osteoporosis doesn’t have some distinctive signs and symptoms, but as your bones are getting weaker, you may experience back pain due to fractured or collapsed vertebra. Other symptoms include loss of height over time, bone fractures, and a stopped posture.
Spinal stenosis is a condition wherein the spinal canal starts narrowing. This puts pressure on the spinal cord and the nerves that run through your spine to extremities. Typically, spinal stenosis occurs in your lower back, but it can affect neck too. Although some people are born with congenital form, most patients develop this condition as a par to degenerative cascade.
The leading cause of spinal stenosis is arthritis, but other factors include herniated discs, thickened ligaments, spinal injuries, and tumors. Most patients do not even experience symptoms of spinal narrowing. When signs and symptoms do occur, they include pain and cramping in legs if spinal stenosis affects lower back. In instances, when spinal stenosis is in the neck, patients can experience numbness, weakness or tingling, in the arm, hand, leg, or foot.
Scoliosis refers to the sideways curvature of the spine. Basically, rather than running straight up the center of your back, scoliosis makes the spine “twist to one side”. In most cases, doctors don’t find the exact cause of scoliosis in a patient. When the cause of this condition is unknown, it is referred to as idiopathic scoliosis.
On the other hand, some types of scoliosis do have specific causes including congenital, structural, degenerative scoliosis. The condition is indicated by uneven shoulders, uneven waist, and it is usually painless. Although severe cases of scoliosis aren’t that common, they do cause pain and muscle spasms. Due to higher loads, facet joints and intervertebral discs can start to degenerate.
Other Causes Of Back Pain
As you can see, causes of back pain are numerous. Besides conditions that affect ligaments and discs, many other problems are related to pain in your back. Along with potential causes of back pain that were named before, these can also lead to pain and discomfort:
- Different infections e.g. kidney infections
- Spine cancer
- Spine infection
- Cauda equina syndrome – the syndrome involves a bundle of spinal nerve roots that arise from the lower end of the spinal cord (cauda equina) and it is indicated by dull pain in the lower back
- Sleep disorders
- Bad mattress
Everyday Activities That Cause Back Pain
You already know that your lifestyle plays an important role in development or progress of health conditions, pains, and aches. Back pain is not the exception. For example, poor posture is a major contributor to back pain, and now you know why your mom and teachers constantly reminded you to sit up straight and stand “properly”.
In addition to causes of back pain that were mentioned above, other sources of pain and discomfort include:
- Lifting heavy objects
- Not lifting properly
- Bending awkwardly
- Muscle tension
- Coughing and sneezing
- Pushing/pulling something
- Carrying/lifting something
- Standing for prolonged periods
- Bending down for longer periods
- Long drive without taking a break
Back Pain Risk Factors
Although everyone can develop back pain, some people are at a higher risk of developing this problem. Risk factors of back pain include the following:
- Age – back pain is more common as you get older, it usually starts around the age of 30 or 40
- Depression – yes, psychological conditions such as anxiety and depression can, indeed, put you at a greater risk of back pain, according to a study that appeared in the Arthritis Care and Research
- Diseases – arthritis, cancer, and other health conditions can significantly increase* your risk of experiencing back pain
- Gender – women are more likely to develop back pain than man. For example, about a third of female adults suffer from lower back pain, but only a quarter of men deal with this problem
- The mentally stressful job is yet another risk factor for back pain, particularly if stress is left unresolved and leads to severe conditions such as anxiety and depression. Also, being hunched over your computer (in desk job positions) can set you up for back pain too
- Overweight/obesity – when you carry too much weight, it forms additional stress to your back, which is why the risk of pain increases*. A study published in the American Journal of Epidemiology found that compared to people whose weight is in a healthy range, overweight people have higher prevalence of low back pain, but obese individuals are at the highest risk
- Smoking – not only is smoking detrimental to lungs, brain, skin, heart, but it is a major risk factor for back pain. Why? That’s because this unhealthy habit prevents the back from getting much-needed nutrients for its discs. A study whose findings were published in the journal Human Brain Mapping found that smoking increases* risk of chronic back pain
- Sedentary lifestyle – if you don’t exercise regularly and your physical activity levels are down at the minimum, then you are at a higher risk of developing back pain. A sedentary lifestyle makes your muscles weak and makes you more susceptible to pain. It is important to add that along with physical inactivity, strenuous exercises (particularly if executed inadequately) can lead to back pain as well
Symptoms Of Back Pain
Signs and symptoms of back pain greatly depend on the condition that causes it. In most cases a person experiences:
- Decreased* range of motion
- Difficulty to stand up straight without pain
- Muscle ache
- Pain or discomfort in a certain area in the back e.g. lower, upper
- Pain that radiates down the leg
Besides these common symptoms, an affected individual can also experience:
- Bowel problems e.g. fecal incontinence
- Difficulty urinating
- Numbness around your genitals or anus
- Persistent pain i.e. it is not going away
- Sustaining injury to the back area
- Urinary incontinence
- Weight loss*
If symptoms associated with back pain, particularly the second group, are persistent and don’t go away regardless of what you do, then you should see your doctor.
How Is Back Pain Diagnosed?
A major mistake that most people repeat is that they don’t see their doctor when experiencing back pain. You have probably been there yourself and thought you don’t need a doctor because the pain will, simply, go away. Scheduling an appointment to see your doctor allows you to get diagnosed fast and receive a proper treatment to manage and reduce* pain that affects your quality of life.
The first thing your doctor will do is to do a physical exam of your back and assess your ability to walk, sit, lift your legs, and stand. It is crucial to mention all symptoms you’ve been experiencing, even if they seem meaningless to you. Your healthcare provider may also ask you to rate the intensity of pain on a 0-10 scale with 1 the lowest or nonexistent and 10 most severe.
Since different conditions have similar symptoms, your doctor may order different tests to establish an accurate diagnosis and rule out other back-related problems. These tests include:
- Blood tests – They have the purpose to show whether you have an infection or some other health condition that causes pain and discomfort in the back
- Bone scan – Test performed to look for bone tumors or compression fractures that are caused by osteoporosis. Don’t despair, this isn’t one of the most common cases, it is performed in rare instances only
- MRI/CT – They may reveal herniated discs or problems with bones, tissues, tendons, muscles, ligaments, blood vessels, and nerves
- Nerve studies (EMG or electromyography) – measures electrical impulses that your nerves produce* as well as the response of your muscles. The test is used to confirm presence of spinal stenosis or herniated discs
- X-ray – Displays the alignment of the bones and presence of arthritis or fractures. That said, this test does not investigate the problems with muscles, nerves, discs, and spinal cord
When back pain is acute, it does not require some special therapy other than home treatment. For this purpose, use of over-the-counter medications combined with hot-cold therapies may be all you need to alleviate* the pain and move easily again. Bear in mind that even in this case, prolonged inactivity i.e. bed rest is not overly recommended because it may induce pain once you start moving again.
Also, if back pain occurs due to some underlying condition, then the doctor will recommend a treatment for that specific condition and it will help you relieve pain in back area as well. Chronic pain and ineffective home treatments usually require a more extensive approach to pain relief*. Your doctor may recommend:
- Medications – such as NSAIDs, muscle relaxants, topical pain relievers, antidepressants, narcotics, (codeine, hydrocodone), and injections
- Physical Therapy – The fundamental part of back pain treatment. During these therapy sessions, your physical therapist applies different treatments to ease* your pain and improve* flexibility. Some of the treatments include heat ultrasound, muscle-release techniques, and electrical stimulation
- Surgery – This isn’t such a common solution and it is recommended only in instances when other treatments prove to be ineffective
- Cognitive Behavioral Therapy (CBT) – It is not uncommon for doctors to recommend therapy to their patients. Why? That’s because it can help them cope with and manage their pain better*
Alternative Treatments For Back Pain
Doctor-recommended treatments for back pain revolve around medications and physical therapy, but alternative methods are popular as well. Complementary or alternative treatments are particularly popular among persons who prefer a holistic approach to good health and wellbeing and want to treat* pain that way as well. Even patients who adhere to doctor’s treatments try out one or two alternative options in order to relieve pain and discomfort faster and in a safe manner. Most popular alternative treatments for back pain are listed below.
Chiropractors are health care professionals who provide non-surgical treatments of disorders of the nervous and musculoskeletal system. A growing body of evidence confirms that chiropractic treatment can be an effective approach towards back pain relief*. Basically, chiropractors take the medical history first and perform a physical exam to identify the problem and determine the adequate treatment for your problem. Chiropractors usually do a spinal manipulation and manual manipulation to restore mobility to joints affected by tissue injury caused by a traumatic event such as falling, stress, or sitting without adequate support* to your back. To experience these benefits, it is important to seek advice or treatment from licensed chiropractors only.
You’ve probably heard about acupuncture; it is a technique wherein practitioners stimulate specific points on the body by inserting thin needles.
Acupuncture was an integral part of traditional Chinese medicine. In, traditional Chinese medicine explains we have about 2000 points on the body i.e. places where needles can be inserted. Scientists from Germany discovered that acupuncture works better* than modern treatments for management of back pain. They speculate acupuncture acts on pain generation or transmission of pain signals which help alleviate* the pain effectively. Just like with chiropractic, it is of huge importance to make sure a practitioner is certified.
Everybody loves a nice, relaxing massage and it turns out it has numerous benefits too. For instance, massage improves* blood flow, relieves* stress levels, and helps you improve* range of motion. At the same time, massage can help you if muscles in the back are overworked and tense. A study from the journal Pain Medicine found that massage has the tremendous potential to help treat* chronic low back pain. Scientists who worked on this research explain their findings give primary care providers more confidence to tell their patients with chronic low back pain to give massage a try.
Yoga is yet another ancient practice that survived centuries and is still popular in the modern age. The practice helps your back by allowing you to improve* posture, stretch and strengthen* your muscles at the same time. It also works to improve* your balance and relieve stress, both of which play a role in development or management of back pain. The Pain Research and Management featured a study which showed that yoga is an efficacious adjunctive treatment for back pain. In order to experience these benefits from yoga, it is important to choose adequate postures. To make it happen, meet up with a yoga teacher who will create a customized plan specific to your preferences and wishes.
Things You Can Do To Prevent/Manage Back Pain
A large number of back pain cases could be prevented with a healthy lifestyle. At the same time, you can put up with pain more easily just by making some lifestyle modifications, as well. What changes you should make? Here are some of them:
- Exercise – Lack of physical activity can either contribute to back pain (risk factor) or it can aggravate it. You don’t really want that, right? Trying to be physically active is an effective treatment strategy whose benefits are well-documented. Evidence shows that exercise is an important strategy for management of back pain regardless of whether it is chronic or acute. A study from the Spine Journal revealed that physical activity is safe for patients with back pain because it doesn’t increase* the risk of work absence or future injuries. Regular exercise also improves* back flexibility and strength. Although resistance training is most beneficial for back pain, aerobic exercises can help as well through improved* mood states, work status, and reduction* of needs for physical therapy referrals. As strenuous activities can induce more pain, you should focus on lower intensity exercises instead. Just like with yoga, it would be more practical to consult a fitness trainer who will create a personalized plan, based on your needs
- Lose* weight – being overweight or obese puts you at a higher risk of a wide array of health conditions, including back pain. In order to stay healthy, you should work to lose* weight and keep your weight in a healthy range. Although this is not the easiest thing in the world, it is still far from impossible. Some of the most common musculoskeletal and joint-related problems are affected by, you guessed it, overweight and obesity. If you are overweight or obese and experience back pain, then focusing on weight loss* is vital since every pound adds strain to the muscles and ligaments in your back. No, you don’t need to diet and adhere to unhealthy methods. The best way to lose* weight is start exercising more and consume a well-balanced diet
- Eat a healthy diet – your nutrition plays a major role as well. Limit intake (or avoid entirely) of foods with little to no nutritional value such as sugar-laden beverages and snacks. Ideally, you should increase* consumption of anti-inflammatory foods, vitamin- and mineral-rich food options, primarily fruits, and vegetables. Foods that can help you beat the pain include ginger, Omega-3 fatty acids, olive oil, turmeric, red grapes, thyme, cherries, edamame, and hot peppers
- Keep back muscles strong – as seen throughout the post, back pain occurs due to degeneration of the spine, particularly when it is working too hard such as during hard work or heavy lifting. To avoid these frustrations and improve* overall health and wellbeing, you should build enough muscle strength. This is yet another purpose of the regular exercise. Do abdominal and back muscle exercises regularly
- Stretch – besides exercising, stretching is also useful for staying flexible and avoiding back pain. Let’s not forget the fact that stretches are essential for people who are in the process of recovery due to injury. You shouldn’t stretch only before exercise, but before lifting some heavy objects
- Proper posture – poor posture is a major risk factor for back pain and it is needless to mention it makes it difficult for you to breathe and it just doesn’t look nice. Practice good posture by standing up straight and making sure you’re sitting up straight as well. If you don’t pay attention to posture, this may seem like an odd thing to do, but it helps
A major source of back pain is lifting heavy objects inadequately. We don’t put much thought into it, but the way you lift something off the ground can either protect* your back or induce more pain. Here are some tips that will help you out:
- Stand with feet shoulder-width apart with one foot slightly ahead of the other
- Bend and the hips, knees and squat
- Look straight ahead keeping shoulders back and chest out
- Straighten your hips and knees to lift the object off the ground, avoid twisting as you lift
- Hold the object as close to the body as possible
- Take small steps to change direction
- Keep shoulders in life with hips as you move
Back pain is a common occurrence affecting millions of people around the globe. Generally, women are more prone to back pain than men. Causes and symptoms of pain in the back are numerous, but fortunately, it is possible to relieve symptoms with healthy lifestyle and management techniques. Also, improve* your posture, and make sure you consult your doctor if you notice pain isn’t going away.
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In-Post Images: Shutterstock, Montvalehealth.com & Terrytalksnutrition.com