Overview
What Is Back Pain ?
Back pain is one of the most common physical complaints among adults - and a chief cause of misery for many. At some point in their lives, most people will experience some sort of back discomfort.
Back pain describes pain or discomfort felt in the upper, middle, or lower back. The pain may extend to the hips and legs. The back consists of a complex arrangement of bone, ligaments, joints, muscles, and nerves, and pain can result from a problem with any of these components.
The most common type of back pain is low back pain. That's because the lower portion of the back is under the most pressure when a person is sitting or lifting, and it can be easily damaged.
Back pain can be classified as either:
- Acute - Sudden pain that lasts for just a short while, usually a few days to a few weeks.
- Chronic - Pain that lasts for more than three month, or pain that recurs.
Who Is At Risk?
Certain people are at higher risk for back pain, including:
Those whose work includes heavy labor or long periods of sitting and standing. Those who are "out of shape," as they may have let the muscles in the abdomen and back become weak and easily fatigued, placing extra strain on the muscles and joints of the back.Those who have jobs that subject their backs to a lot of vibration.Those who do heavy lifting without having the proper education and training to lift correctly.Those who smoke (smokers are more likely than nonsmokers to suffer from back pain)
Causes of Back Pain
Strains
Despite their size and strength, muscles of the lumbar spine can rip or tear. This is called a muscle "strain." A strain is the result of a heavy load or sudden force applied to the muscles before they are ready for activity. The muscle essentially rips, along with the blood vessels within the muscle tissue. This may cause bleeding into the injured area.
Sprains
Sprains refer to an overstretching of one or more of the ligaments of the back. The ligaments can be stretched beyond their natural integrity and in some cases can completely tear.
Lumbar Muscle Strain
Muscle strains are the most common cause of low back pain. Patients may or may not remember the initial event that triggered their muscle spasm, but the good news is that most episodes of back pain from muscle strains resolve completely within a few weeks.
Ruptured Disc
A ruptured intervertebral disc, also called a herniated disc, is another common cause of back pain. How to treat the back pain from a herniated disc depends on the particular individual and situation.
Discogenic Back Pain
Discogenic back pain is thought to be a common cause of low back pain. Discogenic back pain cis the result of damage to the intervertabral disc, but without disc herniation. Diagnosis of discogenic back pain may require the use of a discogram.
Spinal Stenosis
Spinal stenosis causes back pain in the aging population. As we age, the spinal canal can become constricted, due in part to arthritis and other conditions. If the spinal canal becomes too tight, back pain can be the result.
Lumbar Spine Arthritis
Arthritis most commonly affects joints such as the knees and fingers. However, arthritis can affect any joint in the body, including the small joints of the spine. Arthritis of the spine can cause back pain with movement.
Spondylolisthesis
Spondylolisthesis causes back pain because adjacent vertebra become unstable and begin to "slip." The most common cause of spondylolisthesis is due to degenerative changes causing loss of the normal stabilizing structures of the spinal column. If the spine becomes unstable enough, back pain can become a problem.
Osteoporosis
Osteoporosis can cause a number of orthopedic problems and generalized discomfort. Back pain from osteoporosis is most commonly related to compression fractures of the vertebra. Osteoporosis causes weak bones and can lead to these fractures.
Back Pain Treatment
The most frustrating aspect in treatment of back pain is that there is no "magic bullet." Most individuals recover completely by simply avoiding strain to their spine. Patients often find help from ice, heat, and medications. If the basic steps do not alleviate back pain, the next step is to seek medical evaluation. Depending on the symptoms and the length of the problem, your physician can properly organize a treatment schedule.
There are some conditions that cause back pain and require immediate treatment. For most cases of back pain, the first treatments are as follows:
- Rest -
The first step in the treatment of low back pain is to rest the spine. Because most cases of back pain are due to muscle strain, it is important to avoid further irritation to the spine and the muscles that surroung the spinal column. Bed rest is fine, so long as this only lasts two to three days. Prolonged bed rest can actually lead to more persistent back pain. Once the acute back pain eases, avoid lifting, twisting, and physical exertion. - Anti-Inflammatory Medications -
Anti-inflammatory medications, or NSAIDs, are helpful in treatment of both back pain and the associated inflammation. There are both over-the-counter and prescription NSAIDs, and both work well in the treatment of back pain. Side-effects of NSAIDs include problems of GI bleeding, and these medications should be avoided in patients with stomach ulcers. - Heat Application -
Applications of heat packs help ease much of the discomfort associated with muscle spasm causing low back pain. Patients can use heating pad, hot water bottles, or even a hot bath to help ease the muscle discomfort that often causes low back pain. - Exercises -
Strengthening of back muscles is probably the most important step in treatment of most causes of back pain. By increasing strength and flexibility of back muscles, weight is better distributed, and less force is placed on the spine. - Narcotic Pain Medications -
Narcotic pain medications are excellent at relieving pain, but these can be dangerous, addictive medications. These medications include Percocet, Vicoden, Oxycontin, and others. Using narcotic medications must be under close supervision, and only for a limited period of time. prolonged use of narcotic medication can be dangerous. - Muscle Relaxers -
Muscle relaxing medications can be very helpful in the treatment of some types of back pain. Muscle relaxers are sold under the trade names of Flexeril, Soma, Valium, and others. These medications help to relieve muscle spasm, but may also make patients quite drowsy. Physical TherapyBack exercises, as listed above, are the focus of physical therapy. However, there are other modalities that can be used in the treatment of back pain if the exercises alone do not help. Modalities include aquatherapy, ultrasound, electrical stimulation, and others.
- Epidural Steroid Injections -
Epidural steroid injections are an option for back pain treatment and inflammation around the spinal nerves. An epidural steroid injection is performed using an x-ray to guide the medication to the area adjacent to the inflamed spinal nerve. - Spine Surgery -
Usually a step when extensive efforts at conservative back pain treatment fails to relieve symptoms. Read on to learn about different types of spine surgery and the types of back pain these treatments may help.
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