Back Pain

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Back Pain Relief

Back pain is among the most common medical conditions. Whether it is a sharp lower back pain or an ache in the muscles, most of us have experienced back pain at some point in our lives.

The good news is that most episodes of back pain will pass within a few weeks. Simple home treatment and over-the-counter medication can often ease symptoms with no further need for treatment.

On the other hand, back pain is sometimes difficult to treat. And a lot of times, the causes of back pain have developed over a long period of time. If you are experiencing pain in your back, understanding the cause is key to proper treatment.

This section provides an explanation of the several causes of back pain, the symptoms, and when it’s important for you to see a doctor. You can also find an overview of the different conditions that can cause back pain, as well as the types of back pain that typically accompanies them.

For specifics on how to improve your physical condition and avoid activities that lead to back injuries, see the prevention section. For those who are currently experiencing back pain, there is information on the various treatment options available and how you can achieve back pain relief. We also provide a detailed list of Chiropractors, Yoga Studios, Osteopaths and Acupuncturists that can help you manage back pain better. 

What Causes Back Pain?

It is important to understand that back pain can be a symptom of many different illnesses and conditions, not a diagnosis itself. In many cases, doctors can't find an exact cause for the pain. However, when a cause is found, common explanations include:

  • Stress or injury: Such injuries include sprains, strains and fractures, which can cause either short-lived or chronic back pain. Sprains and strains are often caused by repeated heavy lifting, a sudden awkward movement or a chronic overload of the back muscles caused by obesity. Fractured vertebrae are often the result of an accident or fall, or the disease osteoporosis, which can make your bones porous and brittle.
  • Acquired diseases or conditions: Many medical problems can cause or contribute to back pain. These include scoliosis, various forms of arthritis, as well as spinal stenosis. Other causes of back pain are pregnancy, kidney stones or a kidney infection, endometriosis and fibromyalgia.
  • Infections or tumors: Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae or the discs that cushion the vertebrae. Tumors, too, are relatively rare causes of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.

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Symptoms of back pain may include

  • Persistent aching or stiffness anywhere along your spine.
  • Sharp, shooting or stabbing pain in the neck, upper back, or lower back, especially after lifting heavy objects or engaging in other strenuous activity.
  • Chronic ache in the middle or lower back, particularly after sitting or standing for extended periods.
  • Back pain that radiates from the low back to the buttock, down the back of the thigh and into the calf and toes.
  • Inability to stand straight without having severe muscle spasms in the lower back.
  • Limited flexibility or range of motion of the back.

When should I see my doctor about back pain?

Back Pain DiagnosisMost back pain will gradually improve with home treatment and self-care. If you don’t see any signs of improvement within the first 72 hours, see your doctor. Otherwise, seek immediate care if you experience any of the below symptoms.

  • You feel numbness, tingling, or weakness in your arms or legs.
  • The pain in your back spreads down one or both legs, especially if it extends below the knees.
  • Your pain is accompanied by unexplained weight loss.
  • The pain increases when you cough or bend forward at the waist.
  • Your pain is accompanied by fever, burning during urination, or strong-smelling urine.
  • You begin to have problems controlling your bowels or bladder.
  • Your back pain is constant or intense, especially at night and when you lie down.

Back pain varies widely and is caused by many different conditions. Some of these include:

  • Back sprain or strain: A sprain is the stretching or tearing of a ligament and a strain is an injury to either a muscle or tendon. Back pain from sprains or strains typically begins on the day after heavy exertion. Muscles in the back, buttocks and thighs are often sore and stiff.
  • Bulging or ruptured disks. Disks act as cushions between the individual bones (vertebrae) in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve. This can cause severe pain in the lower back. If a disk compresses a nerve, the pain may spread down one leg.
  • Arthritis: Many different forms of arthritis, a degenerative joint disease, can cause back pain. This can include osteoarthritis of the spine or ankylosing spondylitis.
  • Osteoporosis: This common condition is characterised by thinned, weakened bones that fracture easily. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae.
  • Cancer: Cancer in the spinal bones or nearby structures can result in back pain. Back pain is usually consistent and may become worse when lying down.
  • Fibromyalgia: Fibromyalgia is a common musculoskeletal condition. Its characteristics include widespread muscle and joint pain and fatigue, as well as other symptoms. 
  • Scoliosis: Scoliosis is a condition in which your spine curves to the side. This may lead to back pain, but generally only if the scoliosis is quite severe.
  • Spinal stenosis: Spinal stenosis is the narrowing of the spinal column, which puts pressure on the spinal cord and nerves. This causes pain, numbness and weakness in the back and legs. Symptoms get worse when standing or walking, but are relieved by sitting or leaning forward.
  • Pyelonephritis: This is a kidney infection, in which people typically develop sudden, intense pain just beneath the ribs in the back that may travel around the side toward the lower abdomen or sometimes down to the groin.
  • Endometriosis: Endometriosis, which is the buildup of uterine tissue in places outside the uterus, can cause chronic pain in the lower back and pelvis.

Diagnosis of Back Pain

To diagnose back pain, your doctor will ask about your symptoms and take your medical history. In addition, your doctor will conduct a physical exam to check for pain, muscle tenderness or weakness, stiffness, numbness or abnormal reflexes.

If your doctor suspects a more serious problem involving your vertebrae or spinal nerves, you may need one or more of the following tests:

  • X-rays: X-rays are used to look for broken bones or an injured verterbra, and can also show the alignment of your bones. Injured muscles and ligaments or painful conditions such as a bulging disc are not visible on conventional x-rays.
  • Magnetic resonance imaging (MRI) or computerised tomography (CT) scans: These scans can generate images that may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
  • Bone scans: Your doctor may use a bone scan to diagnose and monitor infection, fracture, or disorders in the bone. They are often used to look for bone tumors or compression fractures caused by osteoporosis.
  • Nerve studies (electromyography or EMG). This test measures the electrical activity in a nerve and can detect if muscle weakness results from injury or a problem with the nerves that control the muscles. This test can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).

Treatment of Back Pain

Back Pain TreatmentMost episodes of back pain are not serious and improve with a few weeks of home treatment and care. Limited bed rest (no more than a few days) and over-the-counter pain relievers may be all that you need to feel better. Resume your daily activities as much as possible, but temporarily avoid any heavy lifting, prolonged sitting, or sudden bending or twisting. If your symptoms haven’t improved after a few weeks of home treatments, your doctor may suggest some of the treatments below:

  • Hot or cold compresses: Hot or cold packs can soothe sore, stiff backs. Heat reduces muscle spasms and pain, while cold helps reduce swelling and numbs deep pain.
  • Medications: Your doctor is likely to recommend pain relievers such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve). Both types of medications are effective at relieving back pain. It is important to take these medications as directed by your doctor, as overuse can cause serious side effects. Narcotics, such as codeine or hydrocodone, may be used for a short period of time with close supervision by your doctor. Muscle relaxants and some antidepressants may also be prescribed for certain types of chronic back pain, but these are not effective for every type of back pain.
  • Behaviour changes: Your doctor may recommend certain lifestyle changes to do with staying physically active, reducing stress and avoiding future injury. You can learn to lift, push, and pull with less stress on your back. Changing how you exercise, relax, and sleep can help lessen back pain.
  • Physical therapy: A physical therapist can apply a variety of treatments to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises that may help increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.
  • Injections: In some situations, your doctor may suggest a cortisone injection to decrease inflammation around the nerve roots and lessen pain. The pain relief usually lasts for only a few months.
  • Surgery: In rare cases, surgery may be required to treat back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgical intervention.
  • Alternative medicine: Some alternative treatments that may help ease back pain are massage, acupuncture, yoga and chiropractic care.

Back Pain Prevention 

You can prevent some forms of back pain by improving your physical condition and by avoiding activities that lead to back injury. Measures that may help prevent back pain include:

  • Maintain good posture: Always maintain a neutral pelvic position when standing. Good posture can reduce the amount of stress placed on back muscles. Avoiding sitting or standing for extended periods of time.
  • Exercise: Regular low-impact aerobic activities can increase strength and endurance in your back and allow your muscles to function better. It is important, however, to stretch before and after exercise. Walking or swimming regularly are good exercise choices to strengthen your lower back. Speak with your doctor about which activities are best for you.
  • Build muscle strength and flexibility: Practice abdominal crunches to strengthen abdominal muscles, which support your lower back. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Your doctor or physical therapist can let you know which exercises are right for you.
  • Maintain a healthy weight: Excess weight puts added stress on the structures of the lower back.
  • Lift correctly: Always lift objects from a squatting position, moving straight up and down.  Let your hips and your legs to do the heavy work. Avoid lifting, twisting and bending at the same time.
  • Sit well: Choose a seat with good lower back support, arm rests and a swivel base. When sitting, keep your knees bent and your feet flat on the floor. Change your position as often as possible, ideally at least once every half hour.
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