What causes back pain? What does it mean to have pain on the right or left of the back? Which doctor should I go to for back pain? Is persistent back pain normal? How is back pain treated? What is good for back pain? You can find the answers to all these questions and much more below.

About back pain

Back pain in our 20s and 30s can often be attributed to everyday life factors such as sitting for too long, holding children on our laps, or overdoing it while exercising. Back pain from work injuries, arthritis and degenerative conditions is more common in our 40s and older.

Back pain is so common that many patients ignore symptoms that could indicate a medical emergency. About 80% of adults will experience back pain in their lifetime, so it’s important to be able to detect the severity of your symptoms and track how long the pain lasts.

If back pain can be associated with a particular activity, such as excessive heavy lifting or incorrect posture , and the pain resolves within 72 hours of resting and applying ice, it is usually nothing to worry about. However, if the pain develops gradually, comes on suddenly, or has back pain that doesn’t go away, you may have a more serious condition.

What is the most common cause of back pain?

Muscle tension and sprains can occur suddenly or develop gradually over time due to repeated movements. To distinguish between muscle strain and sprain, we can keep the following two pieces of information in mind.

  1. Strains occur when a muscle is stretched too much and torn, damaging the muscle itself.
  2. Sprains occur when excessive stretching and tearing affects the ligaments that connect bones.

Common causes of muscle tension and sprains include:

  • Lifting or bending the spine when lifting a heavy object
  • Sudden movements that put too much pressure on the lower back, such as falling
  • Constantly having bad posture
  • sports injuries

While muscle tension and sprains don’t sound serious and typically don’t cause long-term pain, acute pain can be quite severe . In both these cases, it does not matter whether the muscle or ligament is damaged in the treatment, as the symptoms and treatment are the same.

What are the causes of persistent back pain?

Pain is considered chronic when it lasts for more than three months and exceeds the body’s natural healing process , or back pain that does not go away. Chronic pain in the back often indicates a disc problem, a joint problem, or an irritated nerve root.

Common causes of persistent back pain include:

herniated disc

The spinal discs play a crucial role in the lower back, acting as shock absorbers between the vertebrae, supporting the upper body and allowing a wide range of motion in all directions. If a disc herniates and leaks some of its inner material, this can cause symptoms such as persistent back pain and possibly pain in the leg . Symptoms of herniated disc usually begin for no apparent reason, or may occur with movements that place additional stress on the discs when a person lifts something heavy or bends their lower back.

degenerative disc disease

Degenerative disc disease is a common cause of back pain that does not go away, especially with age. As you get older, the discs that cushion your vertebrae—the long pile of bone in your spine—start to dry out. Also, discs can be damaged by normal wear and tear or injury. Some symptoms of degenerative disc disease include neck pain , stiffness in the back, and pain that gets worse with prolonged sitting.

facet joint syndrome

Facet joints are small joints that connect the vertebrae at the back of the spine and play an important role in the movement of the spine. Facet joint syndrome is caused by degenerative changes in the joints between the bones of the spine. In this syndrome, the cartilage within the facet joint can break down and become inflamed, triggering pain signals in nearby nerve endings. Facet joint syndrome may also be described by those affected as joint pain and is an arthritis-like condition that can be a source of neck and back pain.

sacroiliac joint dysfunction

The sacroiliac joint is the joint that connects the sacrum at the bottom of the spine to either side of the pelvis. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and lower body. If the sacroiliac joint is inflamed (this is called sacroiliitis ) or there is too much or too little movement in the joint, it can become painful and cause back pain that does not go away.

spinal stenosis

Spinal stenosis occurs when one or more of the bony openings (foramina) in the spine begin to narrow and reduce space for nerves. This process can occur in the spinal canal (where the spinal cord runs down the center) or in the intervertebral foramen where the spinal nerves exit the spinal canal and can cause persistent back pain.

Spondylolisthesis

Spondylolisthesis is the displacement of one of the bones in your spine, known as the vertebra. It most commonly occurs in the lower back, but can also occur in the middle to upper back or the upper part of the spine, in the back of your neck and cause pain. This condition is also known as lower back pain and can cause lower back pain or upper back pain.

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Osteoarthritis (calcification)

Osteoarthritis is caused by wear and tear of the disc and facet joints. It causes varying degrees of pain, inflammation, instability, and stenosis and can occur at a single point or multiple points in the lower spine. Spinal osteoarthritis is associated with aging and progresses slowly. It is also called spondylosis or degenerative joint disease.

Deformite

Some conditions, such as scoliosis ( curvature of the spine ), are closely related to pain. If such conditions lead to deterioration of the discs, facet joints, sacroiliac joints or stenosis, they may be associated with persistent back pain.

Trauma

Acute fractures or dislocations of the spine can cause pain. Back pain that develops after a trauma such as a motor vehicle accident or fall should be evaluated medically. Because such accidents may require urgent medical attention.

compression fracture

A compression fracture is a type of broken bone that can cause your vertebrae to collapse and become shorter. A compression fracture causes you to lean forward and slouch over time A compression fracture can also cause back pain that does not go away.

NOT!

It is important to note that the presence of one or more of the above conditions does not necessarily mean that it is the cause of the pain. For example, an imaging test may show osteoarthritis or degenerative disc disease, but the person may not report any pain.

What are the rare causes of back pain?

Although rare, the cause of back pain can be any of the following:

Infection

A spinal infection, also called osteomyelitis , is rare but can cause severe back pain and is life-threatening if left untreated. It can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with weakened immune systems are more prone to develop infections in the spine.

Tumor

Most tumors that trigger back pain start in another part of the body and metastasize (spread) to the spine. The most common tumors that spread to the spine start from breast, prostate, kidney, thyroid or lung cancer . Any new back pain symptom in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastases.

autoimmune diseases

Autoimmune diseases are conditions in which the immune system interferes with healthy tissues as a result of a malfunction. Back pain; It is a possible symptom associated with autoimmune conditions such as ankylosing spondylitis , rheumatoid arthritis, lupus , Crohn’s disease , fibromyalgia, and others.

NOT!

The list above includes rare causes of back pain, but there are many more conditions that can cause back pain. Finding the most appropriate treatment for back pain often depends on obtaining an accurate clinical diagnosis that identifies the underlying cause of the patient’s symptoms.

What are the causes of back pain during pregnancy?

During pregnancy, your ligaments in the body relax and stretch to prepare your body for birth. This puts strain on your joints, which can cause back pain. Pregnancy also affects your posture, the way you hold your body upright while standing or sitting.

When you’re pregnant, the natural curve in your spine increases as your body tries to cope with the extra weight of your baby, which can cause pain. Some women with back pain also experience pelvic girdle pain , a common condition during pregnancy . This describes pain caused by the pelvic joints becoming stiff or less stable during pregnancy.

Many women report that the pain is felt more in the evening and after 28 weeks of pregnancy.

What are the symptoms that may accompany back pain?

Back pain may start acutely due to an injury, but can become chronic. Properly managing pain at an early stage can help limit symptoms in both time and severity. Identifying the symptoms and making a diagnosis that pinpoints the underlying cause of the pain is the first step to obtaining effective pain relief.

Common symptoms of back problems

Back pain is typically characterized by a combination of the following symptoms:

  • Dull back pain : Dull pain is often described as dull and aching rather than burning, stinging, or stabbing. This type of pain may be accompanied by mild or severe muscle spasms, limited mobility, and pain in the hip and groin .
  • Back pain radiating to the hips, legs, and feet : The pain is sometimes accompanied by a sharp, stinging, tingling, or numb feeling that moves down the thighs and down the lower legs and feet, also called sciatica . Sciatica is caused by nerve irritation and is usually felt on only one side, right or left of the body.
  • Back pain that worsens after prolonged sitting : Sitting puts pressure on the discs, and this pressure causes back pain to worsen after prolonged sitting. Walking and stretching can quickly relieve back pain, but returning to a sitting position may cause symptoms to return.
  • Back pain that goes away when changing positions : Depending on the underlying cause of the pain, some positions will be more comfortable than others. For example, with spinal stenosis, walking normally can be difficult and painful, but bending over something like a shopping cart can reduce pain. How symptoms change with changing positions can help identify the source of the pain.
  • Pain that worsens upon waking and improves after moving : Many people who experience back pain report symptoms that are worse in the morning. But once you get up and walk around, the symptoms subside. Pain in the morning is due to stiffness caused by prolonged rest, decreased blood flow with sleep, and possibly the quality of bedding and pillows used.

NOTE! The symptoms that can accompany back pain vary at the individual level, and many factors influence the pain experience and associated symptoms, including mental and emotional health, financial stress or exercise and activity level.

Symptoms of conditions that trigger the onset of back pain

  • Pain that comes on gradually over time : Symptoms caused by repetitive movements or stressful positions tend to come on gradually and get progressively worse. The pain may develop after certain activities or at the end of a long day and may be felt as back pain that does not go away.
  • Pain that comes and goes and worsens over time : Back pain caused by degenerative disc disease may be felt intermittently, but pain flares become progressively more severe over a long period of time.
  • Back pain that begins soon after injury : Sudden or jarring movements can damage the spine and supporting muscles, causing sudden, acute and severe pain.
  • Back pain that begins some time after injury : Sometimes symptoms develop or worsen a few hours or days after an accident or injury. Delayed pain is often thought of as a side effect of the muscles’ natural healing processes.

Serious symptoms of back pain

Sometimes back pain can indicate a serious underlying medical condition. People experiencing any of the following symptoms are advised to seek immediate medical attention:

  • Loss of urine and stool control
  • Weight loss not due to lifestyle changes such as diet and exercise
  • High fever and chills
  • Severe and persistent abdominal pain

Additionally, people who experience pain symptoms after a major trauma (such as a car accident) are advised to see a doctor. Medical attention should be sought if back pain interferes with daily activities, mobility, sleep, or if there are other bothersome symptoms. Chronic back pain is often associated with other symptoms. Most people with ongoing back pain or leg pain report difficulties with sleep problems, depression, and anxiety.

Which doctor should I go to for back pain?

If your back pain is caused by a strain, sprain, or other minor injury, a visit to your family doctor will suffice. If the pain is severe, does not go away, and you have numbness or tingling in your arms and legs, you may be seen by a healthcare professional such as a psychotherapist, physical therapist or orthopedist.

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How is back pain diagnosed?

Obtaining an accurate diagnosis that identifies the underlying cause of pain and is not solely related to symptoms is important in guiding treatment. As the basis for the diagnostic process, the patient provides a detailed description of the symptoms and medical history. From this information, the doctor will usually have a general idea of ​​the source of the patient’s pain.

medical history

Before starting the physical examination, the patient will be asked to provide information about symptoms and medical history. Queries typically include:

  • Information about current symptoms : Is the pain better or worse at certain times of the day, such as waking up or after work? Where does the pain spread? Are there other symptoms such as weakness or numbness at the same time? What does the pain feel like – sharp, stabbing, tight, dull, hot, stinging?
  • Activity level : Is the person generally more active or leading a sedentary lifestyle? For example, does the job involve sitting at a desk or standing on an assembly line for long periods of time?
  • Sleep habits : How many hours does the patient sleep in general? Which sleeping position is preferred? What type and/or beds and pillows does the patient use?
  • Posture : What type of posture makes you feel comfortable or uncomfortable? Is the patient typically sitting upright or hunched over?
  • Injuries : Has the person suffered any recent injury? Have you had an injury in the past that could be related to the current situation?

The answers to the above questions provide the doctor with a more complete picture of the patient’s daily life, indicating more specific possibilities for back pain. The medical history is often the most powerful tool for finding a diagnosis.

physical examination

The purpose of the physical examination is to further narrow down possible causes of pain. A typical physical exam for back pain includes some combination of the following steps:

  • Palpation : The doctor will palpate your lower back to find any muscle spasms or tightness, areas of tenderness, or joint abnormalities, this is what is called palpation.
  • Neurological examination : An examination will likely include forward and backward movement of the hip, knee, and big toe, and ankle movement, for diagnosis. A sensory examination will likely include testing the patient’s response to light touch, pinprick, or other sensations in the lower body, hips, and legs.
  • Range of motion test : The patient may be asked to bend or twist in certain positions. These activities are done to look for positions that aggravate or reoccur and to see if certain movements are limited by discomfort.
  • Reflex test : The patient’s reflexes will be checked to assess decreased muscle strength. If reflexes are reduced, a nerve root may not be responding as it should.
  • Leg lift test : The patient is asked to lie on his back and raise one leg as high and straight as possible. If this leg raise test recreates low back pain, a herniated disc may be suspected.

Usually, a doctor can diagnose the cause of low back pain based on information from the medical history and physical exam, and no further testing is needed.

Imaging tests

Sometimes an imaging scan is needed to learn more about the cause of the patient’s pain. Image screening tests used for diagnostic purposes include the following:

  • X-ray : X -ray is used to examine the bones of the spine . X-rays show abnormalities such as arthritis, fractures, bone spurs, or tumors.
  • Computed tomography : This imaging procedure provides a cross-sectional view of the spine. In a CT scan , an X-ray is sent through the spine, which a computer takes and reformats into a 3D image. This detailed image allows doctors to take a close look at the spine from different angles.
  • MRI : Also known as magnetic resonance imaging , MRI provides a detailed view of spinal structures without using the radiation required for x-rays. Emar; It can detect abnormalities even in soft tissues such as muscles, ligaments and intervertebral discs.

Sometimes doctors know what is causing the back pain but not exactly where it is, so an imaging test will be used to find the source more specifically. Imaging tests are also used in patients who are candidates for surgical treatment so doctors and surgeons can plan the procedure in advance.

What is good for back pain?

Many treatment options for back pain can be tailored to the needs of the affected patient. Treatments include home care, medical remedies, alternative treatments, and even surgery. Depending on the patient’s diagnosis, some treatments may be more effective than others. Also, many people find that a combination of treatments works best.

Things that are good for back pain

Home remedies for back pain can be effective in treating mild or acute pain caused by muscle tension, as well as reducing the effects of chronic, severe, and persistent back pain. Self-care is managed by the individual and can be easily adjusted.

Things that are good for back pain include:

  • Over-the- counter pain relievers : Over-the-counter pain relievers such as ibuprofen and naproxone are anti-inflammatory drugs that relieve back pain caused by swollen nerves or muscles.
  • Rest : Many back pain attacks can be relieved by avoiding strenuous activities and resting for a few days. Resting for more than a few days is not recommended, as too much inactivity can complicate recovery.
  • Change in activity : Stay active, which includes staying active but avoiding activities and positions that aggravate the pain. For example, if sitting in a car or at a desk for a long time makes the pain worse, set the timer every 20 minutes to get up and walk around or stretch gently. If standing makes the pain worse, avoid tasks that require standing, such as washing dishes in the sink. Avoiding or minimizing activities and positions that aggravate pain helps prevent or reduce painful back spasms.
  • Heat and ice therapy : Heat from a warm bath, hot water bottle, electric heating pad, or chemical or adhesive heat wraps can relax tense muscles and improve blood flow. The increased blood flow provides the nutrients and oxygen that muscles need to heal and stay healthy. If your back is sore due to inflammation, ice or cold packs can be used to reduce swelling. It is important to protect the skin when applying heat or ice to prevent tissue damage.

Self-care treatments don’t usually need a doctor’s guidance, but should still be used with caution. All types of drugs carry possible risks and side effects. If a patient is unsure of which one would be best for them, it is recommended to consult a doctor.

exercises for back pain

Physical therapy is often part of a low back pain management regimen. Types of exercises used to rehabilitate the spine include:

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stretching exercises

Almost everyone can benefit from stretching the muscles in the lower back, hips and legs. These muscles support the weight of the upper body. The more mobile these muscles are, the more the back can move without injury. It’s usually recommended to start with a small stretch of 20 to 30 seconds and stop if it causes pain.

strength exercises

Strengthening the abdominal, hip, and gluteus muscles that support the spine, also called the core muscles, can help relieve back pain. Plus, whatever your age or athletic ability, strength training is key to flexibility, mobility, improved performance and a lower risk of injury.

low-impact aerobic exercise

Low-impact aerobic exercise increases blood flow and promotes recovery from injury without jarring the spine. Low-impact aerobic exercises may include stationary bikes, elliptical or step machines, walking, and aquatic therapy. People who regularly do aerobic exercise and have back pain report fewer recurrent episodes of pain and are more likely to stay active and functional when pain flares up.

Any exercise that raises the heart rate over a sustained period of time benefits the body. Regular physical activity is important to maintain the range of motion and flexibility of a healthy spine. Stiffness and discomfort can worsen when spinal structures are not used for too long.

Medical treatment for back pain

The goal of medical treatments is to reduce pain, but these treatments do not change the underlying source of the pain. A doctor will typically administer medical treatments in conjunction with a physical therapy program or other method.

Common medical treatments include:

muscle relaxant drugs

Muscle relaxants act as depressants on the central nervous system and increase the mobility of tense muscles, relieving pain caused by muscle tension or spasms. However, muscle relaxants have no role in the management of chronic and persistent back pain.

Prescription pain relievers

These drugs, also called opioids or narcotic pain relievers, alter a person’s perception of pain by weakening the signals sent to the brain. Narcotic drugs are most commonly used to treat intense, short-term pain, such as acute pain after an operation. These drugs are rarely used to treat long-term pain, as they have many side effects and are easily addictive.

back support

Some patients say that a back brace can be used to provide comfort and possibly reduce pain. There is also some evidence that the use of an inelastic brace-style brace worn daily, along with a physical therapy exercise program, can speed recovery and reduce pain. A back brace can also help with pain after back surgery.

epidural steroid injections

This injection contains a steroid applied directly to the outside of the dural sac surrounding the spinal cord. A live x-ray called fluoroscopy is used to guide the needle into the correct area . The purpose of the injection is to temporarily relieve pain by reducing inflammation around a compressed nerve root.

Medical treatments are often used in conjunction with other methods. For example, an epidural steroid injection may provide sufficient and short-term pain relief to allow progress in physical therapy.

Alternative treatments for back pain

Non-medical treatments may be referred to as alternative or complementary therapy. Many patients report benefiting from alternative treatments for back pain.

Some alternative treatment options options include:

Manual manipulation

In this alternative therapy, a chiropractor makes physical adjustments to the spine to improve mobility and reduce stiffness, discomfort, or pain. Hand thrusts of varying speed and strength are applied to adjust the spinal structures. Manual manipulation has been found to relieve back pain in some people.

acupuncture

Based on ancient Chinese medicine, acupuncture stimulates points on the body that are thought to restore the body’s “qi,” or life force. Proper qi is believed to reduce pain and discomfort in the body. During a session, thin needles are inserted into the skin for about an hour. Acupuncture has been shown to provide significant pain relief for some people.

massage therapy

Massage therapy in the lumbar region can relieve muscle spasms that often contribute to back pain. Massage also increases blood flow to the lower back, which provides nutrients and oxygen to damaged muscles, accelerating healing.

conscious meditation

Meditation can be helpful in reducing the perception of pain and reduce the depression, anxiety and sleep problems that often occur with chronic back pain . Meditative techniques for reducing pain include everything from deep breathing exercises to a modified focus approach.

The above is not an exhaustive list; There are many more alternative treatment options available, including newer and less invasive surgical options.

Surgery for back pain

If the above treatments have not worked and your pain is persistent and interfering with your daily life, back surgery may be an option. Different types of back surgery include:

  • Discectomy : This involves removing the herniated portion of a disc to relieve irritation and inflammation of a nerve. Discectomy typically involves the complete or partial removal of the posterior portion of a vertebra (lamina) to access the ruptured disc.
  • Laminectomy : This procedure involves removing the bone above the spinal canal. It widens the spinal canal and is done to relieve nerve pressure caused by spinal stenosis.
  • Fusion : Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is sometimes used to eliminate painful movement between the vertebrae that can result from a degenerated or damaged disc.
  • Artificial discs : Implanted artificial discs are an alternative treatment to spinal fusion for painful movement between two vertebrae due to a degenerated or damaged disc. However, artificial discs are not a recommended option for most people.

If your doctor considers surgery necessary, he or she will determine the type of surgery based on the cause of your back pain and your personal medical condition.

Other articles on back pain

Articles on back pain in the Medical Directory include:

  • back pain in women
  • right back pain
  • pain in the middle of the back
  • Pain in the lower back when bending over
  • scapula pain
  • back pain when breathing
  • Back and hip pain

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