One of the most common reasons for a visit to the doctor today is back pain. It affects people of all ages.
There are many causes of lower or upper back pain, such as poor posture, strenuous exercise schedules, psychological stress, and more serious reasons such as nerve damage, obesity, arthritis, and failed back surgery.
Sometimes, back pain can be treated with physical therapy, home remedies, injections, maintaining a healthy weight, and over the counter medication. Other times, however, back pain can cascade into a more chronic or acute condition, implying a more serious underlying issue that needs to be addressed.
What causes acute or chronic back pain?
Back pain is one of the most common medical problems today and affects 8 out of every 10 adults.1 In some cases, it can be a dull ache or escalate into an acute or chronic pain. In such cases, simple therapies and treatment, while providing some palliative care, do not help control the condition in the long run.
Some of the most common areas where back pain is experienced includes the large muscles that support the spine, and the facet joints that connect the vertebrae to each other. Back pain could also be experienced in the intervertebral discs that should provide shock absorption for the bones and the spinal nerves that connect to other parts of the body. Conditions affecting the bones, tendons and ligaments can also cause severe back pain.
The most common reasons for severe back pain are due to muscle or ligament tear, sprains, or irritated joints. In severe cases, the back pain, especially a prolonged condition, could be indicative of a far more serious underlying reason like:
- Kidney stones or infections (causes pain in the mid back)
- Slipped or ruptured disc
- Degenerative disc disease
- Sciatica (pinched nerves)
- Cauda equina syndrome
- Abdominal aneurysm
- Autoimmune disease
- Cancer of the spine
- Spinal stenosis
- Back injury
What are the symptoms that you may experience?
Those who experience back pain, often complain of a variety of symptoms. These can range from a stiffness along the spine, a sharp or tingling sensation, or a persistent feeling of soreness in the upper, middle, or lower back region.
Based on the region and type of pain that you experience, the pain can be classified as:
- Radicular Pain — Experienced as a searing or shock-like pain radiating along the spinal nerve; caused predominantly by conditions such as spinal stenosis, spondylolisthesis or sciatica.
- Referred Pain — Dull, achy pain that may vary in intensity and the region in which it is experienced; may be caused due to a degenerative disc disease that causes referred pain to hips and thighs.
- Axial Pain — Experienced along the spine itself; the most common reason is a muscle strain
How do you know when a visit to the doctor is needed?
Normal muscular back pain tends to hurt more while straightening the body after bending. In case of an underlying reason such as a disc herniation, pain could be experienced both while bending forward and while returning to the upright position. This could be a red flag for you to note.
Typical symptoms of back pain include the following:
- Pain radiating to the hip region but not to the legs
- Difficulty in standing straight or bending
- Pain during some movement alone
- Muscle cramps in the back
What are the additional factors that can put you at risk?
How can you prevent back pain? Taking the right precautions to maintain a healthy lifestyle with a strong focus on physical and mental health can help reduce the incidence of back pain. Factors that can put you at risk for back pain include:
- Stress and/or Other Psychological Conditions
- Overuse or Heavy Lifting
- Poor Body Posture
- Excessive Smoking
- Lack of Exercise
You should immediately schedule a consultation with a doctor if you have been experiencing pain for over 6 weeks (and it is getting steadily worse) and/or you are experiencing any of the above symptoms.
Getting the right diagnosis and treatment
Pain in the upper back or the mid back region usually improves with rest and mild medication and, when required, some simple therapies. Constant ache in the upper back should be attended to as it could be indicative of the associated cancer risk.
Depending on the classification of the pain as well as the accompanying symptoms, a pain management specialist, orthopedic specialist, or a neurosurgeon at Advanced Pain Care may recommend a simple regime of; medication (anti-inflammatory medicines, muscle relaxants, etc.), lifestyle modifications, diet, exercise, therapy, application of hot/cold packs, and/or a procedure to relive the pain.
In more serious conditions that are diagnosed using X-rays, MRIs, CT scans, electro myelogram, or a nerve conduction study to understand the extent of nerve damage. Treatment options vary from injection therapy such as nerve block injections, precision nerve injections, or epidural injections; to surgery to procedures such as spinal cord stimulation, radiofrequency ablation, and stronger medications.
When will surgery be required?
In case more conservative treatment options have failed to provide you relief from back pain, your specialist may discuss surgery as an option to address the persistent pain you are experiencing.
Here are some of the most commonly recommended surgeries we provide at Advanced Pain Care:
- Spinal Fusion — This is considered only for an unstable spine. An unstable spine is recognized when there is progressive weakness or loss of bowel or bladder function.
- Discectomy — A portion of the spinal disc (the herniated portion) is surgically removed to reduce the inflammation and irritation of the nerves.
- Laminectomy — The surgeon removes parts of the ligaments, the bone, or bone spurs to relieve pressure on the spinal nerves. This procedure is commonly performed for lumbar spinal stenosis.
- Disc Replacement — The damaged spinal disc is surgically replaced with an artificial one. Recovery for this procedure is said to be faster than when spinal fusion is done.
- Foraminotomy — The foramen is the bony window where an individual spinal nerve exists. Sometimes the window becomes narrowed, pinching the nerve. The surgeon performs a foraminotomy to widen that window.
- Interlaminar Implant — This is a minimally invasive procedure where a U-shaped device is placed between two vertebrae in the lower back. This helps ease the pressure on the spinal nerves. This implant provides more stability to the spine.
What is post-surgery recovery like?
The post-surgery recovery period in the different procedures will depend on the general health of the patient as well as the extent of the procedure performed. In case a spinal fusion has been done, it takes 6 months to a year for the backbone to completely heal. If you have undergone a laminectomy or discectomy, recovery is usually estimated at 12 weeks.
Once you are out of surgery, a physical and occupational therapist at Advanced Pain Care will discuss an exercise and therapy routine with you. Along with walking, a set of range of motion exercises will also be prescribed which you will be required to do with your physical therapist. Depending on your specific case, your surgeon will also recommend specific do’s and don’ts regarding posture and movement.
You will be required to visit your doctor after 4 to 6 weeks for a thorough evaluation, and this cadence is most likely going to continue for about 2 years. The doctor will also get an X-ray or imaging tests done to see how far your back has healed.
If you are experiencing chronic low back pain or upper back pain and need to know if you must schedule an appointment with one of our physicians immediately, look for these 3 pointers:
- Persistent pain for over 6 weeks.
- A steady increase in pain.
- Age is over 50 or under 20 and you are experiencing some of the more symptoms listed above.
Q: How do I know if my back pain is serious?
A: Back pain is predominantly a condition that abates with rest and simple medication. In some cases, however, it may warrant expedited medical attention.
Immediately schedule a consultation with a doctor if you have been experiencing pain for over 6 weeks and it is getting steadily worse.
Schedule a doctor’s visit if you are experiencing any of the following:
- Back pain after trauma
- Severe exhaustion and loss of strength
- Loss of bowel or bladder control as well as stomach ache
- Unexplained weight loss
- Severe pain
Q: Should you rest if you have back pain?
A: While rest is prescribed by physicians in case of back pain, it is very case specific and has to be done as recommended by the doctor. If it has been diagnosed with a normal and easily treatable back pain, doctors will often ask you to begin a routine with light exercises along with application of hot/cold packs on the region to relieve discomfort.
In case there are manifestations of the more serious symptoms, rest is not sufficient to relieve pain; you need to schedule an appointment with a medical care provider.
Q: What can cause lower back pain?
A: Lower back pain can be caused by different reasons – muscle sprains, muscle tension, ligament or tendon tears or strains, obesity, arthritis, osteoporosis, bulging or ruptured discs, overuse and heavy lifting.
Q: What can I do to relieve my back pain?
A: Simple remedies to provide relief from back pain in few weeks. These include pain relievers, rest, lifestyle modifications, application of hot/cold pack, therapies as recommended by the physician.
Q: What is the most common cause of back pain?
A: Poor posture, strenuous exercise schedules, sudden movements, obesity or weight gain, arthritis, psychological stress and prolonged bouts of sitting. These are the major risk factors causing back pain.
Q: What happens if back pain is left untreated?
A: When back pain is left without proper diagnosis and specific treatment, it could make the pain worse, and cause nerve irritation, often leading to nerve damage, spinal stenosis and more permanent disabilities.