About 80 percent of the population at one point in their lifetime will suffer from lower back pain.
Being physically active is a blessing that you will never fully appreciate until you start developing pain. I guess it is funny that only as I write this am I thinking about the importance of the backbone and how much of a role it plays in our everyday lives.
What I mean is that compared to the more visible parts of our body, it is somewhat forgivable that we forget about the spinal cord. Well, that’s until we feel niggling pain or ache in our backs.
The balance the backbone brings is an underestimated factor in many of our day to day activities.
Athletes require fully functioning backbones to operate at optimal performance. Even white-collar professionals will not be able to spend hours upon hours in the office getting tasks done with this pain.
What I’ve been trying to say is that the back is the centre of our excellence and balance and without it we’d be crippled.
Don’t get me wrong, there are crippled people who are still excellent at what they do. But take care of it while you still have yours my good friends.
Around the world, it is one of the leading causes of disability. It is also a common reason many miss work and go to the doctor.
While back pain is not limited to age, it is still more common in the elderly. This is because the body at an older age cannot be expected to keep up with hustle and bustle.
It can sometimes be the effect of wear and tear of very adventurous youthful years. Other times, it can be the result of degenerative disk disease.
I must tell you the pain isn’t always mild and can be very uncomfortable and debilitating. It can even cause anxiety and depression if not properly managed.
The good thing is that the episodes can be prevented and rarely requires surgery.
Often, simple home treatment or proper body mechanics is all that’s needed to have your back fully functional. Most of the episodes improve within a few weeks even with minimal care.
In order to fully understand the causes of this pain, you have to understand the back.
The back is made up of many parts, some of which include:
- Blood vessels
Lower back pain for example can be associated with the ligaments around the spine and discs, lower back muscles, the bony lumbar spine, abdominal and pelvic organ, discs between the vertebrae, spinal cord and nerves, among others.
Pain in the upper back region can often be associated with tumors in the chest, disorders of the aorta, and spine inflammation.
A report by the American Association of Neurological Surgeons, suggests that about 75 to 85 percent of Americans experience back pain at one time or the other in their lifetime.
They also reported that 90 percent of this pain limits without requiring surgery. It is however advisable to seek your doctor if pain lasts more than a few days.
Causes of Back Pain
There are multiple possibilities of what is causing back ache. These are some of the most causes:
A strain is a tear of a muscle or tendon while a sprain is a tear of a ligament. The most common causes are muscle strains and sprains.
These tears can be as a result of heavy lifting or gradual overuse, which triggers an inflammatory healing process and causes pain as well as muscle spasms.
Muscle strain or sprain in the back usually ranges from mild to debilitating and are usually accompanied by muscle stiffness and a restricted range of motion.
Osteoarthritis affects the body joints and this can include the vertebral or facet joints of the spine. Spine osteoarthritis is a consequence of wear and tear of the cartilage located between the vertebral and facet joints.
This wear and tear is usually accompanied with a dull aching or throbbing pain which gets worse with movement. As the wear becomes worse, a popping sensation (crepitus) can be felt when the joints rub against each other.
As spinal osteoarthritis progresses, joint stiffness and inability to move properly are experienced. Numbness and tingling are also experienced as a result of the body producing bony growths to stabilize the growth.
The two most common causes of spinal osteoarthritis are aging and obesity.
Bulging and Ruptured Disc
Spinal discs serve as shock-absorbing cushions and are located between adjacent vertebrae as a result.
There are several reasons why spinal discs deteriorate over time; some of them are – trauma to the spine, weight gain, aging, smoking, and repeated stress to the spine which can be as a result of habit for example lifting heavy objects.
This deterioration causes the discs to protrude or bulge outward, this is usually called a bulging or slipped disc.
Ruptured disc or herniated disc is usually caused when the bulging disc is not treated. This leads to the release of nucleus pulposus which in turn compresses nearby nerve roots or the spinal cord.
In the lower back, a ruptured disc causes sharp pain that is felt in the groin, buttocks, or down one leg.
A ruptured disc in the neck can be felt as referred pain in an arm. Herniated discs are also responsible for neurological symptoms such as numbness, muscle weakness, and tingling.
Spondylolysis and Spondylolisthesis
Spondylolysis is a stress fracture in the spine vertebrae. It is mostly common in children and adolescent involved in sports that place repetitive stress on the lower back.
Another cause of Spondylolysis is trauma to the spine or degenerative changes in the spine that comes with aging.
Spondylolisthesis occurs as a result of the vertebrae being weakened by stress fracture which makes the vertebrae become unstable and eventually start slipping.
Symptoms of Spondylolisthesis include neurologic effects like numbness, tingling, and weakness, pain and stiffness, as well as radiating pain.
Sciatica is often caused by a herniated disc or bone spur. This is as a result of compression or pinching of the sciatic nerve.
Other common causes of sciatica include injury or trauma to the buttocks, thighs, or pelvis, diabetes, piriformis syndrome, and prolonged sitting. It can also be caused by irritation of the sciatic nerve.
The sciatic nerve is the longest nerve in the body and runs from the base of the spine down both legs.
When sciatica develops, low back pain is felt and that pain is referred to the buttocks, and down the legs. Other symptoms include burning or cramping pain, neurological symptoms like tingling, muscle weakness, and numbness.
This condition usually affects the aging population.
The spinal canal gradually becomes narrower with age and this tightening can lead to the compression of the nerve roots. This causes neurological symptoms like weakness, numbness, and tingling.
Age is not the only cause of spinal stenosis. Arthritis, Paget’s disease, or a traumatic injury to the back can also cause spinal stenosis.
People with scoliosis usually experience curves and twists in their spine. This is usually in the shape of a letter ‘S’ or ‘C’.
It’s most common stages of development are during childhood or adolescence and its real cause is still unknown.
Although cases of multiple family members having scoliosis have been reported. This suggests it might be hereditary.
Other signs and symptoms of scoliosis include neck back discomfort, and trouble breathing in severe cases.
Osteoporosis develops as a result of weakening of the bones which makes them more susceptible to breaking.
Back pain that develops from osteoporosis is often related to a compression fracture of the vertebrae.
People with osteoporosis which developed as a result of compression fracture often note sudden back ache after an activity like sneezing or bending over.
This pain can be felt in the lower back or middle back. Compression fracture gets worse with movement and can be eased by resting or lying down.
Back pain during pregnancy is a common occurrence and with good reason.
Weight is being gained, the centre of gravity is shifting, posture is being adjusted to accommodate the new weight, and hormones are relaxing the ligaments in the pelvic joints.
Back pain is notorious for springing up at the most unexpected of times. For example when sitting, sneezing, coughing, taking a step, bending, or even after eating.
When it occurs after eating, it is usually related to digestive problems as the back is often the site of referred pain.
Ulcer and heartburn are two such digestive conditions that can cause this pain. Peptic ulcer for example causes pain to be felt in the back especially in serious cases.
Low back pain is also common during menstruation and is often caused by hormonal changes.
Prostaglandins, a hormone released during menstruation can affect low back muscles.
It is brought about by the release of excess prostaglandins which then causes dysmenorrhoeal or painful menstruation.
Heavy contractions also lead to pain being referred from the lower abdomen into the low back. Women with endometriosis are also known to experience back pain during menstruation.
Rare Causes of Back pain
Back pain isn’t caused by conditions affecting the spine alone. It can also be caused by systemic illness.
Some of these rare causes will be discussed below.
Spinal tumor often develops on its own but in some cases it can be as a result of cancer developing elsewhere in the body.
This is also called metastatic cancer. Gnawing back pain that becomes worse at night, fatigue and weight loss are some of the symptoms experienced.
Ankylosing Spondylitis is a chronic inflammatory disease affecting the vertebrae. It is a rare cause of low back ache and stiffness. This condition is known to improve with exercise.
Vertebral diskitis or osteomyelitisin in the spine are some the infections that can cause severe and constant pain in the back.
Infection is not easily associated with back pain. This is because a person may not experience fever although prior back surgery can provide a timely clue.
Cauda Equina Syndrome
This is a rare syndrome that develops as a result of damaged nerves at the bottom of the spinal cord.
The most common symptom is pain in the lower back. Although numbness, tingling sensation that spreads down one or both legs, bladder problems and bowel control, and sexual dysfunction are some of the other symptoms.
Common Treatment For Back Pain
Resting, performing mild exercises, and doing away with activities causing the pain are some of the self-care treatment options.
Other ways of treating back pain include applying ice or heat to soothe pain and speed up healing process. Although heat should not be applied if there is swelling.
There are times when basic treatment won’t relieve back pain. When this occurs for a period 2-3 weeks, seeking a medical practitioner is the next course of action.
Treatment regimens by healthcare providers usually depend on the symptoms and length of pain.
The two most commonly used medications in the treatment of back pain are NSAIDs and muscle relaxants.
Epidural spinal injections are also used to alleviate the symptoms of conditions such as Spondylolisthesis, spine osteoarthritis, and sciatica.
Doctors will sometimes recommend physical therapy to strengthen and stretch back muscles. It is also done to improve movement and help ease pain.
Low-impact exercise regimen like biking, swimming, or walking can help improve movement and flexibility in conditions such as spine osteoarthritis, sciatica, or Spondylolisthesis.
Complementary and Alternative Medicine
If physical therapy or medications are not your preferred options, you can employ the use of complementary and alternative medicine to ease the pain.
Some of them include:
- Tai Chi
- Chiropractic care
- Massage therapy
Supplements like vitamin D or magnesium can also relieve back pain. However, you have to inform your doctor about it.
Not all back pain resolve with simple treatment. When these methods fail, you have to look at spine surgery as an option.
Doctors can help determine if surgery is the appropriate treatment for your condition.
Prevention of back pain
As humans, we like progressive lifestyle. We enjoy going about our day to day activities without any hindrance to our performance levels.
Back pain is one of the most common and uncomfortable conditions that disrupt this lifestyle. The good thing is that there are several ways of preventing the onset or progression.
Some of them are:
- Maintaining a healthy weight
- Performing low impact exercises that strengthen core muscles like yoga, Pilates, walking, swimming or biking.
- Staying away from smoking
- Sleeping on a comfortable bed. Orthopaedic beds are recommended.
- Practicing good posture and body mechanics.
Understanding The Back
The back can be divided into the upper (middle) back and lower back. We will be discussing back pain in relation to these locations.
Lower Back Pain
It is also commonly known as lumbago and is an injury to the lower back or lumbar spine. The lumbar region is the region starting just below the rib cage. Pain in this region can be very intense.
The good news is that the pain often limits on its own even with little or no treatment. There are various effective treatment options if it doesn’t self-limit.
Understanding the lower spine is key to analysing low back pain. The lower spine is made up of:
- Nerves and the spinal cord
- Bones of the lower spine
- Muscles and ligaments
- Disks of cushioning tissue between the vertebrae.
Pain in this region is usually a symptom of several underlying medical conditions.
This pain stems from a problem with one or several parts of the lumbar region, such as:
- The vertebral bodies
The pain at times can be as a result of problems with nearby organs, like the kidneys.
Understanding Signs and Symptoms of Low Back Pain
The importance the lower back plays in our everyday lives is perhaps why pain in this area can be so debilitating.
The lower back plays the support system for the weight of the upper body and aids mobility.
Walking upright, bending, and twisting are just some movements made possible by our lower back. The lower back muscles aid flexing and rotation of the hips during movement. It also offers support for the spinal column.
The lower back nerves are however responsible for supplying sensation and power to the pelvis, legs, and feet muscles.
Acute low back pain that isn’t caused by the effects of a medical disorder is most likely caused by injury to the muscles, joints, ligaments, or discs.
When this injury occurs, the body automates an inflammatory healing response. This inflammation is also believed to be a cause of severe pain in the lower back.
The back is a complex system made up of several overlapping nerve supply to the discs, ligaments, muscles, and other spinal structures.
This complex overlap makes it difficult for the brain to pinpoint the cause of the pain.
The duration of pain in the low back helps streamline the cause. For example, ligaments and muscles generally heal rapidly but torn discs sometimes take longer.
Upper or Middle Back Pain
It is less common than lower back pain and even neck pain.
The location of the upper back is the region between the neck and the low back. The upper back is also called the thoracic spine.
Causes of Upper or Middle Back Pain
Pain in the upper back is often caused by soft tissue injuries like sprains and strains, or muscle tension.
Other causes include;
- Poor posture
- Heavy lifting
- Bending and twisting
- Accident trauma
- Repetitive use
- Outdoor activities such as rowing.
- Forceful sneezing.
Symptoms of Upper Back Pain
- Pain when taking deep breaths
- Pain when there is movement of the back or shoulders
- Tenderness to touch
- Muscle spasm
Treatment Options of Upper Back Pain
Most times stopping, reducing, or changing the activities causing the pain is enough for the upper back to heal.
When that doesn’t work, it is recommended to seek your healthcare provider for the next step of actions.
Home Remedies For Upper Back Pain
- Gentle stretching exercises
- Placing ice on it to reduce pain and swelling. You can wrap an ice pack in a towel and place on the injured area for 20 minutes every 2 to 3 hours. In the absence of an ice-pack, a gel pack or package of frozen vegetables wrapped in cloth can also be used.
- Apply moist heat after about 72 hours and gently stretch the muscles to relieve muscle stiffness, relax muscle spasms, and improve movement. Moist heat includes moist heating pads or heat patches which you can get from a drugstore, employing the use of heated wet towel or washcloth. It is important to note that heat should never be used when there is swelling.
- Over-the-counter medication: Take pain medications like acetaminophen, ibuprofen, or as directed by your health care provider. It is very essential to take the medicine with food and use exactly as directed by your physician because drugs like Nonsteroidal anti-inflammatory drugs (NSAIDS) can cause stomach bleeding and other problems and the risk is increased with age.
- Back massages can also relieve the pain.
Back ache isn’t always very easy to deal with and the effects at times can be quite debilitating. However, it can be prevented. The symptoms can be relieved in a few weeks with a few personal care and adjustments.
If the symptom of back pain persists for a week or two, please visit your medical doctor.