What Is A Back Pain?
Back pain is a frequent cause of job absence and medical attention. It may be painful and debilitating.
It can be caused by trauma, physical exertion, and certain medical problems. Back pain may afflict individuals of any age for different causes. Age-related variables, such as prior profession and degenerative disc disease, raise the likelihood of acquiring lower back pain.
Friends, lower back pain may be associated with the discs between the vertebrae, the bony lumbar spine, the spinal cord and nerves, the ligaments surrounding the spine and discs, the abdominal and pelvic internal organs, the lower back muscles, and the skin surrounding the lumbar region.
And pain in the upper back may be caused by the chest tumors, aortic disorders, or inflammation of the thoracic spine.
Back pain can range from mild to severe. In some individuals working, walking, sleeping, or doing everyday activities may become difficult or impossible.
Generally, individuals get relief from back pain with rest, pain relievers and physical therapy (PT). Hands-on treatments (such as chiropractic manipulation) and cortisone injections can also give relieve from back pain and help the healing process. But in some cases surgery may be required.
What Are The Causes Of Back Pain?
The human back is a complex structure, which is made up of muscles, tendons, ligaments, discs, and bones, all of these works together to balance the body and help us to move.
Back pain can result from problems with any of these components. The underlying cause remains unclear in some cases of back pain.
Among other reasons, medical conditions, strain, and poor posture can also cause harm.
1) Strain
Generally, back pain is caused by strain, injury, or stress. Common reasons for back pain include:
- Muscle strain or ligament sprain
- Muscle tension
- Fractures, injuries, or falls.
- A muscular spasm
The following activities can cause strains or muscle spasms:
- Lifting an object that is very heavy
- Making a sudden awkward movement
- Improperly lifting an object
2) Structural Problems
Various structural problems may also lead to back pain.
Ruptured Disks
Disks cushion each vertebra in the spine; but if the disc ruptures, a nerve between those vertebras will experience increased pressure, resulting in back pain.
Bulging Disks
In a manner similar to that of ruptured disks, a bulging disk can increase pressure on the nerve.
Arthritis
Spinal osteoarthritis is also a possible cause of back pain. In a few cases, the space surrounding the spinal cord is reduced (a condition called spinal stenosis).
Sciatica
A bulging disc or a herniated disk pressing on the sciatic nerve that travels from your back and down your leg can cause sciatica. In sciatica tingling, pain, and numbness can be experienced in your leg.
Kidney Problems
Stones in the kidney or an infection of the kidney can also cause back pain.
Osteoporosis
Your bones, including vertebrae of the spine, can develop compression fractures if your bones become porous and brittle.
Abnormal Curvature Of The Spine
Back pain may also be caused by an abnormally curved spine. Scoliosis, in which the spine bends to the side, is one example.
3) Movement and Posture
Over time, adopting a very slumped sitting position while using a computer can exacerbate back and shoulder problems.
Back pain can also be caused by some daily activities and bad posture. Examples of these daily activities and bad posture include:
- Awkward bending, or prolonged bending,
- Twisting,
- Muscular tension,
- Coughing, or sneezing,
- Overstretching,
- Pulling, pushing, carrying, or lifting anything,
- Driving for long periods without a break, even when not slumped
- Sleeping on a mattress that keep your spine straight and does not support your body
- Straining the neck forward, such as while using a computer or driving
- Sitting for long periods
4) Other Causes of Back Pain
Some medical conditions may also cause back pain.
Cauda Equina Syndrome
The cauda equina is a bundle of spinal nerve roots that emerge from the lower end of the spinal cord. In addition to a dull pain in the lower back and upper buttocks, symptoms of this syndrome include numbness in the genitalia, buttocks, and thighs. Sometimes bowel and bladder function disturbances may also occur in this syndrome.
Infection of the spine
A fever and a warm, sore area on the back may be indicative of a spine infection.
Cancer of the spine
A spinal tumour may cause back pain by pressing against a nerve.
Shingles
A viral infection affecting the nerves may also cause back pain, depending on the affected nerves.
Sleep Disorders
People with sleep disorders are more prone to have back pain, than others.
Other Infections
Other infections like pelvic inflammatory disease (PID), kidney, or bladder infections can also cause back pain.
What Are The Symptoms Of Back Pain?
Numerous symptoms may be present in back pain, like:
- A dull, aching feeling in the lower back.
- A shooting or stabbing pain that can move down the leg to the foot.
- An inability to stand straight without experiencing pain
- Diminished flexibility and inability to stretch the back
If back pain is caused by strain or misuse, then it is often temporary but can continue for days or weeks.
Back pain is considered chronic when symptoms persist for more than three months.
Symptoms Of Back Pain That May Signal A Severe Condition
Consult a physician if your back pain does not improve within two weeks of its appearance. Back pain can sometimes be an indication of a serious medical condition.
The following symptoms may suggest a serious medical problem:
- Fever
- Tingling, numbness, or weakness in one or both legs
- Bowel or bladder dysfunction
- Back pain following injury, such as a fall or hit to the back.
- Unexplained weight loss
- Intense, continuous pain that worsens at night
- Back pain linked with a throbbing sensation in the abdomen
What Are The Risk factors For Back Pain?
Back pain may affect anybody, even children and adolescents.
Following factors may increase your risk of having back pain:
Lack of Exercise
Weak, underused muscles in the back and abdomen can cause back pain.
Age
Back pain is more prevalent as you get older, generally beginning from age 30 or 40.
Gender
Women are more likely to suffer from lower back pain than men; this may be possibly due to hormonal factors (1).
Inappropriate Lifting
Using your back to lift objects instead of your legs might result in back pain.
Diseases
Certain types of arthritis and cancer can cause back pain.
Increased Body Weight
Excess body weight puts additional stress on your spine.
Smoking
Those who smoke have a higher incidence of pain. This may occur because smoking induces increased coughing, which might cause disc herniation. Additionally, smoking can reduce spinal blood flow and raise the risk of osteoporosis.
Psychological Conditions
Anxiety and depression tend to increase the likelihood of developing back pain.
Diagnosis Of Back Pain
Your physician will examine your back and determine your ability to sit, walk, stand, and raise your legs. Your doctor may also ask you to rank your pain on a scale from zero to ten and inquire about how well you’re coping with it.
These evaluations assist in establishing the cause of the pain, the presence of muscle spasms, and the extent to which you can move before discomfort causes you to halt. Additionally, these can also help to rule out more serious reasons of back pain.
If your doctor suspects that a particular condition is the cause of your back pain, then he or she may suggest you one or more of the following tests:
X-Rays
X-rays reveal the position of your bones and whether or not you have broken bones, or osteoarthritis, but they may not reveal damage in the nerves, spinal cord, discs, or muscles.
Blood Tests
Blood tests can help to find out if an infection or other health condition is the reason of your pain.
MRI or CT Scans
These scans can detect problems with bones, tendons, muscles, ligaments, nerves, and blood vessels; and can also reveal herniated discs.
Electromyography (EMG)
Electromyography (EMG) is a test that examines the electrical impulses generated by your nerves and the reactions of your muscles. This test can help in confirming the nerve compression due to herniated discs or narrowing of the spinal canal (or spinal stenosis).
Bone Scan
In rare instances, your doctor may use a bone scan to detect osteoporosis-related compression fractures or bone tumors. A radioactive substance (or tracer) is injected into your vein; this tracer collects in the bones and helps to detect bone problems with the use of a special camera.
What Is The Treatment Of Back Pain?
The majority of back pain cases improve within a month of home therapy. However, each individual is unique, and back pain is a complicated issue. For many, the pain persists for a few months, but just a few have severe and persistent pain.
The use of over-the-counter (OTC) pain relievers and heat may be sufficient for most of the cases. Bed rest is not generally recommended.
Continue with as many activities as you can do or tolerate. Try mild activity, like walking and your daily routine activities.
Stop engaging in activities that exacerbate pain, but don’t avoid activities due to fear of pain. If home remedies are ineffective after many weeks, your doctor may recommend some stronger drugs or other treatments.
A) Medications For Back Pain
Depending on the type and severity of your back pain, your physician may prescribe the following medications:
Pain Relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, diclofenac, and naproxen sodium may help in relieving back pain. Take these drugs exactly as prescribed by your physician. Overuse of these might result in serious adverse effects.
Muscle Relaxants
If mild to moderate back pain does not respond to over-the-counter pain relievers, your doctor may prescribe a muscle relaxant. But dizziness and drowsiness are common side effects of these muscle relaxants.
Narcotics
Drugs containing opioids, like hydrocodone or oxycodone, may be used for a limited duration under medical supervision. Opioids act on the brain cells and body to reduce pain. These drugs should be used with caution due to a risk of addiction. Therefore your prescription should contain less than seven days’ worth of tablets.
Antidepressants
Some antidepressants, mainly duloxetine and tricyclic antidepressants (such as amitriptyline), have been demonstrated to alleviate persistent back pain irrespective of their effect on depression.
Topical Pain Relievers
Topical pain relievers deliver pain-relieving ingredients through your skin by creams, ointments, salves, or patches.
B) Physical Therapy
A physical therapist may teach you exercises to
- Improve your posture,
- Increase your flexibility, and
- Strengthen your back and abdominal muscles.
Regular usage of these techniques helps to prevent the recurrence of pain. Physical therapists will also educate patients on how to modify their movements when they are suffering from back pain in order to prevent worsening of pain symptoms while remaining active.
C) Surgical And Other Procedures
The following procedures may be used for the treatment of back pain:
Cortisone Injections
If previous treatments fail to alleviate your pain and it spreads down your leg, your doctor may inject cortisone (a steroid and a potent anti-inflammatory drug) along with a numbing medicine into epidural space (the region around your spinal cord). This injection reduces inflammation around the nerve roots, but the pain alleviation is often only effective for one or two months.
Implanted Nerve Stimulators
Implanted nerve stimulators are the devices placed under the skin which give electrical impulses to specific nerves to block pain signals.
Radiofrequency Neurotomy
In radiofrequency neurotomy, a small needle is injected through the skin and positioned close to the area causing your pain. Radio waves are transmitted through the needle to damage the adjacent nerves, which interferes with the transmission of pain signals to the brain.
Surgery
Generally, surgical procedures are reserved for the treatment of structural pain that has not responded to nonsurgical treatment with medication and therapy.
Surgical procedures may be beneficial for people with:
- Unremitting pain and which is also radiating down your leg
- Constant and severe pain with identifiable structural abnormalities
- Gradual muscle weakening due to nerve compression
- A ruptured disk
- Narrowing of the spine (spinal stenosis)
Prevention Of Back Pain
One of the most effective methods to prevent back pain is to maintain strong back muscles.
Take precautions to prevent back pain because back pain is simpler to prevent than to treat.
Follow these methods to prevent back pain and protect your back:
A) Increase your back strength
Physical activity can strengthen your back and reduce your risk for back pain:
- Perform muscle-building and stretching activities at least twice each week.
- You can try a yoga class: Yoga may assist in stretching and strengthening muscles, as well as enhancing posture.
- Regular Exercise: Regular physical exercise can help maintain healthy back muscles. Aim for at least 150 minutes per week of aerobic activity of moderate intensity.
If you have an injury, a health condition, or a handicap, see your physician or nurse about the best sorts of exercise for you.
B) Prevent Injuries
1) Try To Maintain A Good Posture
A healthy posture helps avoid back problems. Thus,
- Avoid slouching while sitting and standing.
- If possible, maintain your knees slightly higher than your hips when you sit up straight with your back against the chair’s back and your feet flat on the floor.
- Pose with your head held high and shoulders back
If possible, alternate between standing and sitting to avoid being in one position for too long.
2) Lift Properly
Lift appropriately by utilising your legs and not your back. Maintain a straight back and bend at the knees or hips. If the object is too large for you to lift alone, get assistance.
3) Prevent Work-Related Back Injuries
Workplace safety practices can help prevent injuries.
C) Healthy Practices
1) Try To Maintain A Healthy Weight
Maintaining a healthy weight reduces the chance of developing back pain. Losing weight in a healthy manner may minimize the strain on your back if you are overweight.
2) Consume Adequate Calcium And Vitamin D
Consuming adequate calcium and vitamin D can help maintain bone health and avoid osteoporosis. Osteoporosis makes bones more fragile and prone to fractures (break).
3) Quit Smoking
Smoking can increase the risk of your low back pain. This risk increases with the number of cigarettes smoked daily, thus quitting smoking is helpful in reducing this risk.
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References:
1) Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858456/
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Disclaimer: This article is intended for informational purposes only. Any information associated with this article should not be considered as a substitute for prescriptions suggested by local health care professionals.
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