What is Back Pain?

By Dr Ananya Mandal, MD

Back pain is a common symptom and affects most people at some point in their life. An estimated 75 to 85 percent of all Americans will experience some form of back pain during their lifetime. Most countries take a major blow to their productivity due to back pain through loss of workers on sick leave.

Some national governments, notably Australia and the United Kingdom, have launched campaigns of public health awareness to help combat the problem. One of these is the Health and Safety Executive's Better Backs campaign.

What does back pain feel like?

In most cases rather than an acute stabbing pain, it is a dull stiffness or tension in the back. The pain can be triggered by an awkward posture, bending or sitting awkwardly, or lifting incorrectly. 

Usually back pain is not a serious disease and usually gets better by 12 weeks. Exercises and pain relievers and advice of good posture maintenance is the treatment of choice.

Types of back pain

Back pain may occur at any part of the back but commonly affects the lower back. The pain may also be felt along the spine, neck or hips. Common types of back pain include:

  • Neck pain
  • Ankylosing spondylosis
  • Whiplash injury
  • Sprains and injuries
  • Frozen shoulder
  • Slipped or bulging disc (this lies like a cushion between two vertebrae)
  • Sciatica
  • Arthritis
  • Osteoporosis and vertebral fractures
  • Skeletal irregularities (e.g., scoliosis, kyphosis, lordosis, back extension, back flexion)
  • Other conditions include fibromyalgia, stress, pregnancy, kidney stones or infections, endometriosis etc.
  • More serious causes include cauda equine syndrome, bone cancers, spine infections

Causes of back pain

Risk factors for back pain:

  • Age – Back pain typically occurs between the ages of 30 and 40. It becomes more common with age.
  • Being overweight or obese – These individuals have too much stress on their spine that may lead to pain.
  • Level of fitness - Back pain is more common among people who are not physically fit, these individuals have weak back muscles.
  • Occupation – Persons who need to lift, push or pull and twist their backs at work, they may be at risk of back pain. Those working for long hours at their desks are also at risk of back pain.
  • Inherited - Some causes of back pain, such as disc disease may be inherited.
  • Ethnicity - African American women are found to be two to three times more likely than white women to develop spondylolisthesis. Caucasian women of northern European heritage, on the other hand, are at the highest risk of developing osteoporosis.
  • Smoking - Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.
  • Other diseases – Those with arthritis and cancers with spread to bones may also experience back pain.

Warning signs of back pain

In most cases a few days of rest and adequate mobility may help in recovery from back pain. However, some symptoms may indicate a deeper problem and mandates a visit to the doctor. These symptoms include:

  • Weight loss that is unexplained
  • Swelling and immobility of the back
  • Fever
  • Pain in the limbs
  • Numbness of the lower limbs or other parts of the body including genitals
  • Loss of bladder or bowel control
  • Worsening pain at night

Treatment of back pain

The primary modality of treatment is by remaining mobile and active. Earlier bed rest was advised for back pain. These days it is known that being inactive for long periods is actually bad for the back. Patient is advised moderate activities such as walking and doing their own daily tasks.

Pain relievers like Acetaminophen (Paracetamol) is commonly advised. Hot or cold compression packs may also help reduce the pain. There are other manual therapies including physiotherapy and osteopathy. These may also help relieve pain.

For back pain lasting for more than six weeks exercise classes or manual therapy along with pain relievers are advised. Acupuncture may provide relief in some individuals. Spinal surgery is usually only considered when all else has failed.

Prevention of back pain

  • Maintenance of good posture while sitting, standing, lifting, lying down.
  • Getting up from sitting or lying position is another important factor that needs to be improved to prevent strain to the back.
  • Individuals are advised not to place too much pressure on the back and ensure their back is strong and supple.
  • Regular exercise, such as walking and swimming, is an excellent way of preventing back pain. Yoga and pilates also improve the flexibility and strength of the back muscles.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Jan 1, 2014

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Comments
  1. Trevor C Trevor C United States says:

    Do you have any recommendations for back braces to wear to relieve back pain?

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