Back Pain is a common health problem most of us suffer in our daily life. Experts estimate that up to 80% of the population will experience back pain at some time in their lives. Back pain can affect people of all ages, from adolescents to the elderly. Back pain is the third most common reason for visits to the doctor’s office, behind skin disorders and osteoarthritis/joint disorders.
The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.
Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain.
How do I know if my back pain is serious?
‘If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, it’s usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
Types of back pain
How do you describe back pain?
The most common pain types are:
Sharp stabbing pain.
Extreme heat or burning sensation.
Throbbing, “swollen,” inflamed tissue.
Sensitivity to contact/touching.
Numbness, tingling, pins and needles.
2. Conditions commonly linked to back pain include:
Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. …
Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in your spine. …
3. A muscle strain, or pulled muscle, occurs when your muscle is overstretched or torn. This usually occurs as a result of fatigue, overuse, or improper use of a muscle. Strains can happen in any muscle, but they’re most common in your lower back, neck, shoulder, and hamstring, which is the muscle behind your thigh.
Injury or weakness can cause the inner portion of the disc to protrude through the outer ring. This is known as a slipped, herniated, or prolapsed disc. This causes pain and discomfort. If the slipped disc compresses one of your spinal nerves, you may also experience numbness and pain along the affected nerve.
What are the causes of back pain?
Causes of Chronic Lower Back Pain
Pain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back often involves a disc problem, a joint problem, and/or an irritated nerve root.
Common causes include:
Lumbar herniated disc:
The jelly-like center of a lumbar disc can break through the tough outer layer and irritate a nearby nerve root. The herniated portion of the disc is full of proteins that cause inflammation when they reach a nerve root, and inflammation, as well as nerve compression, cause nerve root pain. The disc wall is also richly supplied by nerve fibers, and a tear through the wall can cause severe pain.
Degenerative disc disease:
At birth, intervertebral discs are full of water and at their healthiest. As people age over time, discs lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well and transfers force to the disc wall that may develop tears and cause pain or weakening that can lead to a herniation. The disc can also collapse and contribute to stenosis.
Facet joint dysfunction:
There are two facet joints behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is richly innervated by nerves. These joints can be painful by themselves, or in conjunction with disc pain.
Sacroiliac joint dysfunction:
The sacroiliac joint connects the sacrum at the bottom of the spine to each side of the pelvis. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The sacroiliac joint can become painful if it becomes inflamed (sacroiliitis) or if there is too much or too little motion of the joint.
This condition causes pain through narrowing of the spinal canal where the nerve roots are located. The narrowing can be central, formal, or both, and can be at a single level or multiple levels in the lower back.
This condition occurs when one vertebra slips over the adjacent one. There are 5 types of spondylolisthesis but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain can be caused by instability (back) or compression of the nerves (leg).
This condition results from wear and tear of the disc and facet joints. It causes pain, inflammation, instability, and stenosis to a variable degree, and can occur at a single level or multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly progressive. It is also referred to as spondylosis or degenerative joint disease.
The curvature of the spine can include scoliosis or kyphosis. The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis.
Acute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be medically evaluated.
A fracture that occurs in the cylindrical vertebra, in which the bone essentially caves in on itself, can cause sudden pain. This type of fracture is most common due to weak bones, such as from osteoporosis, and is more common in older people.
NOTE: It is important to the presence of one or more of these conditions does not necessarily mean that is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study but the person may not report pain.