Who Is Affected By Back Pain?
Back pain is an extremely common musculoskeletal condition that can affect any area of the spine; however, it most commonly affects the lumbar spine. Back pain is either classified as acute or chronic in nature, depending on the duration of pain. Often back pain can be worsened with certain movements such as lifting, bending, and twisting, and it may also be worsened with prolonged positions and walking. Some patients may experience pain or numbness and tingling in the upper and lower extremities in addition to their back pain.
It is estimated that approximately 80% of the adult population will experience an episode of back pain at some point during their life. It is the most common cause of job-related disability and is a leading contributor to missed time from work.
Back pain affects men and women equally. The pain experienced can range in severity from a dull ache to a sharp stab. Pain can begin suddenly or develop over time. Most low back pain is acute in nature and tends to resolve on its own with self-care; however, some patients require more intensive therapy.
What Are The Risk Factors And Causes Of Back Pain?
Due to the complexity of the back, there are a variety of conditions that can cause back pain, including muscle strains and sprains, degeneration (i.e. osteoarthritis, degenerative disc disease), ligament injuries, vertebral fractures, osteoporosis, tumors of the spine, infections of the spine, inflammatory arthritis, pregnancy, and other medical conditions (i.e. fibromyalgia, endometriosis)
Various risk factors have been found to be associated with back pain, including:
- Excessive weight gain
- Heavy drinking, smoking
- Improper lifting technique
- Having a physically demanding job
- Poor posture
- Mental health conditions (anxiety and depression)
- Infection of the spine
- A history of cancer
Diagnosing Back Pain
Physicians will generally take a detailed history of the patient’s symptoms and conduct a physical examination of the affected area to diagnose the cause of back pain. If nerve damage is suspected, neurological testing may be performed. Diagnostic imaging tests, including X-ray, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), myelograms, discography, or bone scans may be utilized to rule out serious underlying pathology. Although rare, lab testing may be ordered to rule out certain medical conditions that may be contributing to a patient’s back pain.
Lifestyle Changes To Manage Back Pain
Patients are encouraged to make simple lifestyle changes to help manage their back pain symptoms, including:
- Alter activities by avoiding prolonged positions and using proper lifting technique
- Practice better posture
- Engage in regular physical activity
- Eat a healthy, balanced diet
- Maintain a healthy weight
- Quit smoking
- Drink in moderation
- Learn to manage stress (meditation, yoga, breathing exercises, relaxation techniques, etc.)
- Modify work environment to make it more ergonomically friendly
Treatments For Back Pain
Treatment of back pain aims to reduce, relieve, and prevent chronic pain symptoms. Initial treatment of back pain consists of patient education, hot and cold packs, pain medication, and physical therapy. Additional complementary therapies are also effective at managing back pain symptoms, including acupuncture, massage therapy, and chiropractic care. Spinal injection therapy may also be recommended for persistent pain.
Acute back pain, lasting less than three months, is generally treated with analgesic medications and non-steroidal anti-inflammatory medications, and physical therapy. Sometimes a combination of both therapies is utilized to obtain optimal results. The medications that are used help to reduce inflammation and pain of the affected area. Physical therapy helps to restore range of motion and strength of the back. This will help to enhance healing and prevent future back pain episodes.
Massage therapy focuses on the soft tissues and muscles of the back. Massage therapy helps to increase blood flow to the area, which can help to reduce muscle spasm and pain. Furthermore, massage therapy may help to reduce stress.
Acupuncture treatment consists of inserting tiny needles into specific areas of the back. The needles may be placed in the area of pain as well as at distant sites that may be adding to the patient’s pain. When acupuncture is performed by a skilled professional, it can help to decrease pain, muscle spasm, and stiffness in some patients.
Chiropractic care typically utilizes a manipulation of the spine often called an adjustment. This technique involves applying a controlled thrust to the affected area of the spine in an effort to restore proper joint motion. Chiropractic treatment has been shown to provide the most benefit when it is utilized within the first month of the onset of pain.
Steroid injections are another type of treatment that is often recommended to back pain sufferers. Epidural steroid injections involve the injection of steroid medication, often combined with an anesthetic, into the epidural space of the affected area. The steroid acts to reduce inflammation in the area, while the anesthetic helps to reduce pain by numbing the area. These injections are most effective for patients experiencing chronic back pain due to disc herniation, spinal stenosis, or degenerative disc disease.
Anti-convulsants, which are primarily used to treat seizures, may be used to treat patients with back pain due to radiculopathy and radicular pain. Additionally, antidepressants, including tricyclics and serotonin and norepinephrine reuptake inhibitors, are sometimes prescribed to patients suffering from chronic back pain.
Surgery is sometimes necessary for patients suffering with back pain. However, it is not routinely used unless there is severe nerve damage or if a herniated intervertebral disc has been found on imaging. Back surgery may be recommended to patients if their symptoms have resulted in a significant decrease in mobility or if they are contributing to other serious health issues. There are a number of surgical procedures, including a laminectomy or discectomy.
If you suffer from back pain and would like to learn more, please review the links to the literature below. Furthermore, if you have questions or concerns about your back pain, do not hesitate to discuss them with your doctor.