Back Pain Overview

Back pain is a common complaint that affects more then 75% of Americans at some point in their lives. From lower back pain, neck pain, middle back pain, upper back pain to low back pain with sciatica this condition can be quite intrusive and interfere with your everyday living.

There are many causes of back pain including: nerve and muscular problems, degenerative disc disease, and arthritis. Fortunately there are things you can do to alleviate the symptoms and in many cases treat the underlining issue that is causing the pain.

Symptoms and Warning Signs of Back Pain

• An ongoing aching along the spine from the base of the neck to the where the lower back meets the hips.
• Sharp pains in the neck, mid back, and lower back. Often brought on by strenuous activity.
• Aching in the mid and lower back from long periods of still movement like sitting.
• Back pain can also “shoot” from the lower back down the leg all the way down to the feet and lower extremities.
• Spasms in the mid to lower back.

While these are largely common symptoms of back pain that may not be serious, you should call your doctor if any of these symptoms below occur as they may be stemming from a more serious issue.

• Numbness or tingling in any extremities.
• A sharp shooting pain down the leg.
• Back pain from bending or coughing when no strenuous activity has taken place that may have caused irritation of some kind.
• Lower back pain accompanied by strong smelling urine or a burning sensation while urinating may be a sign of a bacterial infection in the urinary tract or kidneys.
• A constant dull pain.

Causes of Back Pain

Your back is composed of bones, muscles, ligaments, tendons and disks when any of these components get strained, broken, or slip they can cause mild to extreme back pain. Determining the cause of the pain is generally an easy task consisting of various tests and x-rays.

Stains are the most common cause of back pain that can occur from various activities such as heavy or improper lifting. Awkward movement can cause muscles and ligaments to become stretched or torn, the effect being mild to extreme pain in the lower, middle, and upper back.

Bulging or ruptured disks can be a cause of the pain. The disks in your back act as cushioning between the vertebrae in your spine. If the material ruptures or bulges out of place it can press and irritate a nerve and cause pain.

• Sciatica can cause a shooting pain from your lower back down through the leg. This can happen when a bulging or herniated disk presses on the main nerve that travels down your leg.

• Arthritis can be a cause of your back pain, although not as common as other forms, arthritis may narrow the space around the spinal cord leading to spinal stenosis.

• Back irregularities such as scoliosis, which causes the spine to curve in an improper way, can cause back pain as well as many other complications.

• Osteoporosis is a bone disease that can cause your spine to weaken and compress together or fracture.

• Cancer in the spine A rare but serious form of cancer could be the cause of the back pain.

• Spinal infection could possibly, although rare, be the cause of the pain if accompanied by a fever.

• Referred pain is when there are symptoms in one part of the body but are caused by another condition. Referred pain in the back could be caused from any of the following intra-abdominal issues: appendicitis, aneurysms, kidney diseases, bladder infections, pelvic infections, and ovarian disorders.

This list is not exhaustive as there are many other factors that can be the cause of back pain. If your pain persists or becomes worse it may be necessary to consult your physician.

Exams Tests and Diagnosis for Back Pain

In many cases advanced tests are not necessary for the diagnosis of what may be causing your back pain. Your doctor will start with various questions to help them determine how severe the condition is and if there are any underlining issues that could be a factor for the cause of your symptoms. Questions may include:

• Questions about you past medical history
• When the pain started (was there an accident or reason for the pain or did it seem to appear out of no where).
• Does your back feel better or worse when you lay down or stand up?
• Do you have a family history of arthritis or other spinal or bone diseases?
• Do you have pain, numbness, or tingling down one or both legs?

You may also undergo a series of simple physical tests including:

• Watching you walk, sit, stand up, and bend.
• Check your reflexes to look for slowed or heightened reflexes, either of which might suggest nerve problems.
• Check for fibromyalgia by examining your back for tender points.
• Check for muscle strength and sensation.
• Check for signs of nerve root irritation.

In most cases these medical questions and physical tests are enough for diagnosis but if the root problem still cannot be found it may be necessary for further testing. Some tests that might be performed depending on the exact symptoms are:

• X Rays might be used to help determine if there is a fracture, arthritis, osteoarthritis, or an irregularity of the spine.
• Magnetic resonance imaging (MRI) or computerized tomography (CT) scans unlike X Rays, are used to see if there are possible issues with ligaments, tendons, nerves, spinal structures, and blood vessels. They may order these tests if they suspect a problem such as an infection, tumor, inflammation, or pressure on a nerve.
• Blood tests might be used to look for infections if your doctor thinks there might be a possibility from certain inflammations.
• Nerve studies (electromyography, or EMG) is a test that measures the electrical impulses produced by the nerves to look for nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).

Back Pain Treatment Options and Drugs

There are quite a few treatment options available such as medications that can alleviate the pain, exercises, stretches, and physical therapies to help with muscle tendon and spinal misplacement and surgeries in extreme cases. Treatment options include:

• Medications will be used as needed such as non-steroidal anti-inflammatory drugs to help with infection and inflammation, muscle relaxers such as carisoprodol (Soma®), or cyclobenzaprine (Flexeril®) work by calming down skeletal muscle tone which can help pain derived by spasms, or narcotics, such as codeine or hydrocodone, may be used for a short period of time to help alleviate the pain.
• Physical therapy and exercise is almost always beneficial in treating the core issue at hand by making your back muscles stronger, stretching ligaments, and aligning the spine. By following your physical therapists advice you can not only help alleviate pain but prevent it from returning.
• Injections for treating inflammation may be used if necessary such as cortisone. Cortisone will help decrease inflammation around the nerve roots which will dramatically reduce pain when inflammation is one of the root causes.
• Surgery can be an option if you have need to have either a disk replaced (they will insert an artificial disk), Have a disk removed or partially removed (taking the part of your disk that is pressing on a nerve), partial removal of vertebra, or fusion (connecting two parts of the vertebra to eliminate painful movement.

Back Pain Prevention and Home Remedies

Your back is a delicate intricate system that needs to be used carefully and treated with caution. Prevention and proper use is key in keeping it healthy throughout life. Prevention and things you can do at home that can help are:

• Exercising properly and often will strengthen your back muscles and in many cases prevent or even help with back pain. Good choices are low-impact aerobic activities such as swimming, walking, and some gym machines such as the elliptical.
• Maintaining a healthy weight will relieve excess strain on the back muscles and spine.
• Lifting correctly can prevent one of the most common strains on the back and spinal cord. Avoid twisting and lifting awkward objects and always keep your back strait and lift with the legs.
• Posture can be a cause of back problems so try and stand erect, sit strait, and try and keep the arch in your back at a proper curve.
• Acupuncture has worked for many people. This ancient art has been found to help with many forms of pain including chronic back pain.
• Hot baths help for temporary relief of back pain in many cases. Some people report that using various salts in the bath can help relax the muscles causing the problem.
• Massage Therapy has been found useful for temporary relief in many patients. Many doctors will suggest this if the condition permits it.

Everyone is different so it’s important to use common sense when it comes to your back and if the pain is chronic to see a specialist. When taking narcotic medications for the pain remember that they can be habit forming and should only be used for the short term relief of the pain and can in some cases cause damage to organs such as your liver.