Definition: Defining the Meaning of Back Pain
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine. The onset of back pain may be acute or chronic. It can be constant or intermittent, stay in one place or radiate to other areas. It may be characterized by a dull ache, or a sharp or piercing or burning sensation. Back pain may be classified by various methods to aid its diagnosis and management. The anatomic classification of back pain follows the segments of the spine: cervical, thoracic, lumbar or sacral.
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.
Back pain is a common complaint.
Most people will experience lower back pain at least once during their lives. Back pain is also one of the most common reasons people go to the doctor or miss work. Most back pain gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor.
Symptoms of Back Pain
Many people have experienced some form of back pain at some point in their lives. There are many causes of back pain, from self-inflicted causes due to bad habits, to back pain caused by muscle strains, accidents, or sports injuries. Despite the causes of the back pain a person experiences, the symptoms may be the same.
Symptoms people with back pain experience might include:
- A persistent stiffness or aching along their spine, from the base of their neck to their hips.
- Sharp, localized pains in their lower back, upper back, or neck, - particularly after lifting heavy objects or after other strenuous activity.
- Chronic aches in their lower or middle back, particularly after sitting or standing for lengthy periods of time.
- Back pains which radiate from their lower back to their buttocks, down their back of their thighs, and into their calves and toes.
- An inability to stand up straight without experiencing oftentimes severe muscle spasms in their low back.
If you experience back pain, it is important to contact a doctor if you:
- Experience numbness, tingling, or loss of control in your arms or legs. These may be signs of signal damage to your spinal cord.
- Experience pain in your back that extends downward along the back of the leg. You may be suffering from sciatica.
- Experience pain that increases whenever you bend forward at the waist, or cough. The reason this needs to be looked at by a doctor is because it could be a sign of a herniated disc.
- Experience pain that is accompanied by burning urination, strong-smelling urine, or fever. You could have a bacterial urinary tract infection.
- Experience urinary or fecal incontinence.
- Experience dull pain in one particular area of your spine whenever you lie down or get out of bed. People who are over the age of fifty may have osteoarthritis.
Diagnosis Back Pain
A doctor will test your range of motion in relation to the back pain you are experiencing, unless you are completely immobilized by a back injury, and test for both areas of discomfort and nerve function. The doctor will most likely do some tests such as urine and blood testing in order to determine whether the back pain is due to either an infection or a systemic problem. X-rays may be taken to determine if you have any broken bones or skeletal issues that are the cause of your back pain; they can also help to locate issues with connective tissues. Soft-tissue damages that may be the cause of back pain can be analyzed using Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans. Nerve and muscle damage can be determined through Electromygram (EMG) tests.
Treating Back Pain
Back pain can be caused by a variety of things, and treating back pain involves the goals of both pain relief and restoration of movement. The basic treatment for back pain that has been caused by either a strain or a minor injury is rest. Application of an ice pack to the affected area can be helpful, as well as either aspirin or use of a Non-Steroidal Anti-Inflammatory Drug (NSAID). Once the inflammation related to this kind of back pain has diminished, application of heat can help to soothe both muscles and connective tissues.
Long-term bed rest is something that is not considered to be necessary for the majority of people who are experiencing back pain; in fact - it may be harmful, as well as making the recovery process more lengthy and presenting the possibility for new problems. For most people who are experiencing back pain; normal, non-strenuous activities like walking are recommended within twenty-four to seventy-two hours. After this period of time, the person should pursue controlled physical therapy or exercise.
Physical therapy treatments may include:
- Controlled applications of heat
- Whirlpool baths
- Individually-tailored exercise programs
The process of strengthening your back and abdominal muscles through both physical therapy and exercise helps to stabilize your spine. Learning how to perform proper lifting techniques and do gentle stretching exercises, as well as how to maintain good posture, can help you to prevent further back injuries.
If the back pain you experience keeps you from your common daily activities, a doctor might help you by either recommending or prescribing some pain medications. There are a number of over-the-counter pain medications such as Aspirin, Ibuprofen, or Tylenol that can help with back pain. If the back pain you are experiencing is severe, a doctor may prescribe something like either Percocet or Vicodin instead; some doctors may prescribe muscle relaxers. The effects of medications such as Vicodin and Percocet are on the brain, not on the muscles, and can cause drowsiness; care is needed when taking these kinds of medications. If your doctor cannot help you to control your back pain, they may refer you to a back or pain specialist.
A back or pain specialist might use things such as steroids, injections, or anesthetics in order to help you control back pain. There are some newer treatments that have been developed, such as Radiofrequency Ablation, which involves delivery of electrical stimulation to specific nerves in order to make them less sensitive to pain or actually destroy nerves with the intention of preventing pain, that may help. There is another procedure that delivers heat to a herniated disc that can shrink the disc so it no longer bulges onto a nerve root and cause pain. Medications from the antidepressant and anti-convulsant families are sometimes prescribed to assist with pain relief in association with irritated nerves.
A Word About Sciatica
Sciatica is a common form of pain that affects the sciatic nerve. The sciatic nerve extends from the lower back down through the back of each leg. Sciatica is caused by irritation of the roots of the lower lumbar and lumosacral spine. There are other causes of sciatica, including Lumbar Spinal Stenosis, Degenerative Disc Disease, and Spondylolisthesis.
The symptoms of sciatica include:
- Pain in the buttocks or leg that worsens when sitting
- Tingling or burning down the leg
- Numbness, weakness, or difficulty moving the foot or leg
- Constant pain on one side of the buttocks
- Shooting pain making it difficult to stand up
Sciatica commonly affects only one side of a person's lower body. Many times the pain will extend from the person's lower back all the way through the back of their thigh and down through one of their legs. The pain the person experiences may also extend to one of their feet or into their toes, depending on where the sciatic nerve is affected. The pain some people experience in relation to sciatica can be both severe and debilitating. Other people who experience sciatica find the associated pain to be infrequent and irritating; the pain they experience has the potential to worsen. For people who have sciatica, it is important to contact a doctor if symptoms worsen, lower extremity weakness increases, or they experience loss of bladder or bowel control.
Other things that may make your back pain worse include being overweight, not exercising regularly, wearing high heels, or sleeping on a mattress that is too soft.
Quick Facts: Cauda Equina Syndrome
Cauda equina syndrome is a rare disorder that usually is a surgical emergency. In patients with cauda equina syndrome, something compresses on the spinal nerve roots. You may need fast treatment to prevent lasting damage leading to incontinence and possibly permanent paralysis of the legs. CES affects nerve roots called cauda equina. These nerves are located at the lower end of the spinal cord in the lumbosacral spine. They send and receive messages to and from your legs, feet, and pelvic organs. CES occurs more often in adults than in children. But it can occur in children who have a spinal birth defect or have had a spinal injury.
Statistics: U.S. Back Pain
- One-half of all working Americans admit to having back pain symptoms each year.
- Americans spend at least $50 billion each year on back pain - and that's just for the more easily identified costs.
- Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.
- Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
- Most cases of back pain are mechanical or non-organic - meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
- The largest proportion of direct medical costs for low back pain are physical therapy (17%) and inpatient services (17%), followed by pharmacy (13%) and primary care (13%).
- Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor's office, outnumbered only by upper-respiratory infections.
- The primary cause of disability for those under the age of 45 is back pain. The yearly cost of care for back pain has been estimated at 50 billion dollars, surpassed only by the cost of care for cancer and heart disease.
- Adults with low back pain are often in worse physical and mental health than people who do not have low back pain: 28% of adults with low back pain report limited activity due to a chronic condition, as compared to 10% of adults who do not have low back pain. Also, adults reporting low back pain were three times as likely to be in fair or poor health and more than four times as likely to experience serious psychological distress as people without low back pain.