Back Pain

Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Chronic back pain is pain that lasts for more than 3 months.

Anyone can have back pain, but some things that increase your risk are:

• Older age. Back pain is more common the older you get. You may first experience back pain when you are 30 to 40 years old.
• Poor physical fitness. Back pain is more common in people who are not fit.
• Being overweight. Too much weight can stress the back and cause pain.
• Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
• Other diseases. Some types of arthritis and cancer can cause back pain.
• Your job. If you have to lift, push, or pull while twisting your spine, you may get back pain. If you work at a desk all day and do not sit up straight, you may also get back pain.
• Smoking. Your body may not be able to get enough nutrients to the disks in your back if you smoke. Smoker’s cough may also cause back pain. People who smoke also experience slow healing, so back pain may last longer.

Most back pain goes away on its own, though it may take a while. Pain relievers and resting can help.

If your back pain is severe or does not improve after 3 days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.

Treatment for back pain depends on what kind of pain you have and what is causing it. Treatments include hot or cold packs, exercise or stretching, medicines, injections, complementary treatments, and, sometimes, surgery.

Back pain can range from a dull, constant ache to a sudden, sharp sensation that leaves a person incapacitated. Pain can begin abruptly as a result of an accident or by lifting something heavy, or it can develop over time due to age-related changes of the spine.

There are many causes of back pain, but the majority of back pain is mechanical in nature. Examples of mechanical causes of back pain include:

• Disk breakdown
• Spasms
• Tense muscles
• Ruptured disks

Injuries from sprains, fractures, accidents, and falls can also result in back pain.

Back pain can occur with some conditions and diseases, such as:

• Scoliosis
• Spondylolisthesis
• Arthritis
• Spinal stenosis
• Pregnancy
• Kidney stones
• Infections
• Endometriosis
• Fibromyalgia

Other possible causes of back pain are infections, tumors, or stress.

To diagnose back pain, your doctor will review your medical history and perform a physical exam. Your doctor may order also order X-rays, magnetic resonance imaging (MRI), a computed tomography (CT) scan, or blood tests. These tests may help identify the cause of the pain, but many times, the cause of back pain is never known. Back pain can get better even if you do not know the cause.

Back pain can be painful and debilitating. It can negatively affect your job, your relationships, and your quality of life.

You can prevent pain by:

• Exercising often and keeping your back muscles strong
• Maintaining a healthy weight or losing weight if you weigh too much
• Getting enough calcium and vitamin D to keep your bones strong
• Standing up straight and avoiding heavy lifting
• Always stretching before exercise or other strenuous physical activity
• Making sure work surfaces are at a comfortable height
• Sitting in a chair with good lumbar support and proper position and height for the task
• Wearing comfortable, low-heeled shoes
• Sleeping on a firm surface. Sleeping on your side with the knees drawn up in a fetal position can help open up the joints in the spine and relieve pressure by reducing the curvature of the spine.
• Quitting smoking. Smoking reduces blood flow to the lower spine, which can contribute to spinal disc degeneration. Smoking also increases the risk of osteoporosis and impedes healing. Coughing due to heavy smoking also may cause back pain.

You should see a doctor if you have:

• Numbness or tingling in your back
• Severe pain that does not improve with rest
• Pain after a fall or an injury
• Pain plus any of these problems:
  • Trouble urinating
  • Weakness
  • Numbness in your legs
  • Fever
  • Weight loss when not on a diet

Treatment for back pain depends on the cause and severity of the pain. Acute back pain usually gets better without any treatment, but you can take a pain reliever such as acetaminophen (Tylenol) or an anti-inflammatory medication such as aspirin or ibuprofen (Motrin, Advil) to help ease the pain.

Chronic back pain requires treatment, which may include:

• Hot or cold packs (or both) to soothe sore, stiff backs. Heat reduces muscle spasms and pain; cold helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but they do not fix the cause of chronic back pain.
• Exercise can be used to ease chronic pain but should not be used for acute back pain. Your doctor or physical therapist can tell you the best types of exercise to do.
• Medications. Several mediactions are available to treat back pain back pain:
  • Analgesic (pain-relieving) medications such as acetaminophen (Tylenol) and aspirin or other non-steroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) and naproxen (Aleve)
  • Topical analgesics are creams and ointments that contain ingredients such as menthol, methylsalicylate, camphor, and capsaicin and are rubbed into the skin over the site of pain
  • Muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), metaxalone (Skelaxin), and methocarbamol (Robaxin), and some antidepressants, including amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor, Zonalon, Prudoxin), imipramine (Tofranil), and nortriptyline (Pamelor) may be prescribed for some types of chronic back pain, but these do not work for every type of back pain
  • Injections of steroids or local anesthetics can also relieve severe pain
• Behavior changes. Learn to lift, push, and pull with less stress on your back. Change how you exercise, relax, and sleep to help lessen back pain. Eating a healthy diet and not smoking also help prevent and eas back pain.

When back pain becomes chronic or when other treatments do not relieve it, complementary and alternative treatments may improve pain. However, many of these treatments have not been studied in back pain or have not been shown to be effective. The most common of these treatments are:

• Manipulation. Professionals use their hands to adjust or massage the spine or nearby tissues.
• Transcutaneous electrical nerve stimulation (TENS). A small box is placed over the painful area and sends mild electrical pulses to nerves.
• Acupuncture. This practice uses thin needles to relieve pain and restore health.
• Acupressure. A therapist applies pressure to certain places in the body to relieve pain.
• Surgery. Most people with chronic back pain do not need surgery. Rarely, when back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome, surgery is needed right away to ease the pain and prevent more problems. Surgery is usually used for chronic back pain only if other treatments do not work. You may need surgery if your back pain is caused by:
  • Herniated disk, a condition in which the disks that cushion the bones of the spine are damaged.
  • Spinal stenosis, a condition that causes the spinal canal to become narrow
  • Spondylolisthesis, a condition in which bones of the spine slip out of place
  • Vertebral fractures, which can be caused by a blow to the spine or by crumbling of the bone due to osteoporosis
  • Degenerative disk disease, which is a condition in which disks of the spine break down and cause severe pain as people age