Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.
Most back pain goes away on its own, though it may take awhile. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.
If your back pain is severe or doesn't improve after three days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.
Causes
There are many different causes of low back and neck pain. You may feel pain in your back that is caused by organs not even near the back. This type of pain is called referred pain. For example, kidney pain is often felt in the back and even some forms of vascular problems can cause back pain. When you have back pain that is not getting better, or the intensity is increasing, be sure to contact your doctor.
The most common causes of back and neck pain are:
- Sprain and strain of the back or neck.
- Pain arising from the discs themselves called discogenic pain.
- Pain from bulging discs compressing exiting nerve roots or radicular pain, which can lead to sciatica from the back or pain radiating down from the neck to one or both arms.
- Pain from arthritis of the facet joints — the joints that hold the spine in alignment, also called facet joint syndrome.
- Pain from bony compression of the nerves of the spine called spinal stenosis.
Sprain or strain of the spine
Fast Facts
- Sprain is an injury to the ligaments of the spine.
- Strain is an injury to muscles of the spine.
- Sprain and strain are the most common causes of back and neck pain in children and young adults.
- The symptoms and signs of sprain and strain are usually self-limiting — that is, relief of symptoms is expected to occur within a reasonable amount of time.
- More than 90% of people with low back muscle strain or sprain recover completely within one month.
Sprain is an injury to the ligaments of the spine. Strain is an injury to muscles of the spine. These injuries are the most common cause of back and neck pain in children and adults and are usually self-limiting — that is, relief of symptoms is expected to occur within a reasonable amount of time.
The symptoms of strain and sprain include back or neck spasm, stiffness, and pain. This pain results from the stretching or tearing of the soft tissue of the back or neck (eg, muscles and ligaments). Low back sprains or strains can be caused by a single event, such as lifting a heavy object, or can be due to repeated small injuries to the back. Adults with poor posture, individuals who are overweight or obese, workers who repeatedly lift heavy objects, workers who have constant vibrations around their work place, pregnant women, people who smoke, and older adults are at high risk for sprains and strains of the spine.
Treatment of back sprain or strain:
Initially, treatment of a sprain or strain involves icing and rest, combined with anti-inflammatory medication (such as Advil or Naproxen), to relieve the pain and spasm. After this, you may slowly begin normal activities and exercise. It is important to start moving again. Resting your back for more than three days has been shown to cause more harm and should be avoided. After healing takes place, you may benefit from a back rehabilitation program that includes education about proper lifting techniques and stretching and strengthening of the back, leg and abdominal muscles. Surgery is never used to treat low back sprain and strain.
Patients with pain around the low back and upper buttocks, low back muscle spasm, and pain associated with activities that is relieved with rest do not need x rays or other imaging studies such as CT scans or MRIs. If the pain lasts in spite of good treatment, you should talk to your doctor.
Back Pain Warning Signs:
If you answer yes to any of the following questions, you should consult a spine specialist:
- Has your low back pain extended down your leg?
If the pain persists and is severe, it is a sign that something is compressing a nerve running from your back to your leg. - Does your leg pain increase if you lift your knee to your chest or bend over?
If so, there is a good chance a disc is irritating a nerve. - Have you had severe back pain following a recent fall?
A fall may cause damage to your spine. Chances of injury increase if you have osteoporosis. - Have you had significant back pain lasting more than 3 weeks?
Often pain will go away with simple treatment. However, if your pain persists you should consult a spine doctor. - Have you had back pain that becomes worse when you rest, or wakes you up at night?
If this is accompanied by a fever, it may be a sign that there is an infection or other problem. - Do you have persistent bladder or bowel problems?
Bladder and bowel problems may be due to many causes, but some spine problems may cause these symptoms. - Do you get numbness or weakness in your legs while walking?
These problems can be caused by a narrowing of the spinal canal. This is called spinal stenosis.
Do you need back surgery?
In most situations, an operation won't be considered unless conservative measures have failed, and even then it's not often indicated. Back surgery is usually reserved for times when a nerve is pinched, the spinal cord is compressed or there's too much movement between the spinal bones.
Your doctor may recommend back surgery if you have neck or back pain accompanied by symptoms of nerve damage. Signs and symptoms include:
- Pain that radiates down your legs (sciatica) or arms
- Numbness, weakness or tingling in your arms or legs
- Loss of bladder or bowel control
Information from the National Institutes of Health, November 2008