Back Pain

Pain can be defined as an unpleasant sensory and emotional response to tissue damage.

Back pain or backache is the pain felt in the back that may originate from muscles, nerves, bones, joints, or other structures in the spine. It is one of the most common medical problems experienced by most people at some point in their life. Back pain can be acute, usually lasting from a few days to a few weeks or chronic, lasting for more than three months.  Pain in the lumbosacral region (lower back) is the most common type of back pain.

Causes

The back comprises the muscles, ligaments, nerves, spine, and spinal cord. These structures work together to support the weight of the body and enable a wide range of movements. Back pain can result from damage to any of these structures.  Some of the common causes of back pain include:

• Injury, trauma, or fracture
• Poor posture
• Muscle tension/spasm
• Strains and sprains of the ligament, muscle or tendon
• Osteoarthritis of the spine
• Ruptured, bulging, or herniated disks
• Intervertebral disk degeneration
• Spinal nerve compression
• Osteoporosis of the spine

Risk Factors

Some of the factors that can put you at greater risk of developing back pain include:

• Obesity, which places increased pressure on your spine
• Age, back pain is more common as you grow older
• Smoking, smokers have increased risk of back pain
• Medical conditions, such as cancer and arthritis
• A sedentary lifestyle or poor physical fitness
• Psychological conditions, such as anxiety and depression
• Pregnancy, which can stretch ligaments and irritate the nerves

Signs and Symptoms

Back pain can occur as a dull, constant pain or a sudden, sharp pain. Back pain may be confined to one area or may radiate to other areas such as the arm and hand, the upper back, or the lower back and can radiate into the leg or foot. Aside from pain, you may also have weakness, numbness or tingling in your arms or legs, caused by damage to the spinal cord.

Diagnosis

Your physician will review your symptoms and medical history and perform a physical examination, during which range of motion, muscle strength and pain location are assessed, to determine the source of your back pain. You may also have to undergo X-rays for a detailed view of the affected area. If this is not sufficient to identify the cause, an MRI of the affected region may also be ordered to view soft tissues structures, such as tendons and ligaments, which can aid in the diagnosis of a tumor, infection, pressure on the nerve, or inflammation. Blood tests may be ordered to diagnose conditions such as arthritis.

Treatment

Treatment for back pain is usually non-surgical and includes:

• Medications such as over-the-counter (OTC) pain relievers or non-steroidal anti-inflammatory drugs (NSAIDs)
• Application of cold packs, heat packs, or both to help ease pain, discomfort, and stiffness
• Providing sufficient rest can help improve or resolve pain within a few weeks in many cases
• Topical pain relievers such as creams and ointments to deliver pain relief through the skin
• Use of steroid injections into the affected region for pain relief
• Physical therapy to strengthen your trunk and back muscles, as well as improve your sitting or standing posture

In general, these measures can help relieve your back pain. However, in certain conditions, the pain may not resolve and you may require surgical intervention. Your physician will decide on the appropriate surgery based on your specific condition and other factors.

Prevention

The back is subject to wear and tear from daily activities and stresses. Pain may vary in severity and duration. Although the natural degenerative processes that take place with aging cannot be avoided, precautions can be taken at home and in your workplace to minimize their impact. A healthy lifestyle with good habits such as regular exercise, adequate sleep, good posture, a diet rich in calcium and vitamin D, and avoiding weight gain, smoking and stress can go a long way in keeping the back healthy.

Summary

Back pain is common and can often be successfully treated by conservative measures. However, some cases can be serious and require further evaluation and treatment by a doctor. It is important to keep your back healthy by avoiding poor posture, taking frequent breaks to change your position, and participating in regular exercise to improve spine stability, which also prevents extra stress on your back.