What Is Back Pain?
Back pain is one of the most common medical issues in the United States and throughout the world. It has been estimated that eight out of 10 people will experience back pain at some point in their lives. Back pain is responsible for more lost work days than any other condition.
The spine has three main regions:
- Cervical spine (neck)
- Thoracic spine (mid and upper back)
- Lumbar spine (low back)
There are many possible sources of back pain, in terms of both acute injury and chronic conditions. Diagnosis, treatment and specific symptoms will depend largely on the root cause.
Causes and Risk Factors
People at a higher risk for back pain include:
- Manual laborers
- Older people
- Overweight or obese individuals
- People with mental health conditions like anxiety and depression
- People with sedentary jobs
Most causes of back pain are considered nonspecific, meaning the cause is unclear. However, there are many potential causes of back pain, as well as many conditions that list back pain among their symptoms. Some of these causes include:
- Cauda equina syndrome—severe compression of the lumbar spinal canal
- Degenerative disc disease—the breakdown of intervertebral discs
- Facet joint arthropathy—arthritis in the joints that connect vertebrae
- Herniated disc—a bulge in an intervertebral disc, causing the disc to press on the spinal cord or nerves
- Muscle strain—injury or damage to one or more muscles in the back.
- Occupational or psychological causes—when a job, fitness activity or mental condition affects the back
- Spinal tumors—cancerous growths on or near the spine
- Spondylolisthesis—a condition in which one of the vertebrae slips forward
- Stenosis—a narrowing of the spinal canal, usually in either the cervical or the lumbar spine
Back pain can have a number of different qualities, such as:
- Radiating down an arm or leg
- Shooting or stabbing
Back pain may also cause limited range of motion in certain movements like twisting, raising an arm or lifting a leg. If back pain is accompanied by urinary or bowel incontinence, fever or severe abdominal pain, individuals should seek medical attention immediately.
Because back pain has so many possible causes, most diagnostic tools are potentially helpful. A medical history and physical examination are usually the first steps in diagnosing back pain. Medical professionals will be looking for family history of certain diseases, when symptoms began, what symptoms accompany the back pain and if any particular event or trauma preceded the pain.
Lab tests and imaging studies may both be employed. Blood tests can look for chemical signals of inflammation and certain conditions. X-rays can show dense tissue like bone spurs and vertebral abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) scans can show soft tissue, such as herniated discs, cartilage damage, stenosis, fractures, tumors or infections.
Treatment may differ depending on the root cause of the back pain, but most people generally make a full recovery. Some techniques to ease the pain include:
- Anti-inflammatories and pain medication
- Heat therapy
- Low-impact exercise such as biking, swimming, walking or using an elliptical machine
- Spinal manipulation
- Steroid injections
- Stress reduction
- Work accommodations
If surgery is required, it is usually because of a herniated disc, spinal stenosis or spondylolisthesis. In these cases, a microdiscectomy or decompression laminectomy may alleviate back pain.
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