Back Pain: Definition, Symptoms, Causes, Diagnosis, and Treatment

Posted on Healthcare By Prof. Dr. Erich Ringelstein - Published on 2019-08-19

 

Back pain

is among the most common medical problem in modern society. It can be caused by anything from an injury, activity, or even an underlying medical problem. This condition can affect anyone regardless of age, but, the older people get the higher the risks of developing back-related problems. However, unlike the conventional healing process associated with most injuries, back pain tends to diminish with time regardless of an underlying medical problem such as Arthritis or Sciatica.

Symptoms and complications associated with back pain vary depending on intensity, from mild to severe, and whether the pain is on the upper, middle, or lower back. Fortunately, there are several preventive or relief measures you can take to make the discomfort bearable as your back heals. Surgery is rarely the go-to treatment for these cases, unless otherwise.

Definition

Spine degeneration is natural to aging. Both men and women are affected, approximately 80% of adults globally complain of low, middle or upper back pain at one point in their lifetime notes the National Institute of Neurological Disorders and Stroke (NINDS). Your spine is your body’s primary structural support, meaning a lot is riding on the spinal column from being stable for you to maintain an upright position to being flexible for movement. It’s no surprise the high numbers of people suffering from back problems.

Lower back pain (lumbago) is particularly the most common and is mostly associated with spinal cord and nerves, the bony lumbar spine, lower back muscles, discs, internal abdominal and pelvic organs, among others. While upper back pain may be linked to complications in the aorta, spine inflammation, and tumors in the chest.

Signs and Symptoms

The main symptom of back pain is an ache or strain on the upper, middle, or lower back. The pain can either be acute, meaning it strikes suddenly and lasts for a few days or weeks or chronic, meaning it lasts for more than three months and is usually caused by trauma or other medical conditions.

Other signs and symptoms of back pain can include:

  • Muscle aches
  • Pain down your leg
  • Stabbing or shooting pain
  • Restricted  flexibility and range of motion
  • Pain in the back, buttocks or legs
  • Inability to stand upright

Causes

The back of a human being consists of a complex structure of bones, muscles, tendons, ligaments, and discs that function together to support the body as well as allow for flexibility. The spine, for instance, is made up of several segments each cushioned with cartilage-like pads referred to as discs.

Problems with any of these segments can result in back pain. Although in some cases causes of back problems remain unclear. Commonly, back injuries stem from strains, underlying medical issues, poor posture, among others. However, contrary to popular belief, rarely do back injuries strike when somebody is lifting a heavy object or doing an intensive activity notes research from Harvard Health Publishing. In fact, only 5% of cases of new-onset disc herniation are a result of heavy-lifting activities, the rest are from simple tasks, like sneezing or reaching out for something, notes the research. Conditions commonly associated with back pain include:

  • Strains or sprains on muscles and ligaments, muscle tension, fractures, falls or injuries.
  • Ruptured or bulging discs. As mentioned earlier, discs act as cushions between vertebrae along your spine. In some cases, the contents within your disk may rupture or bulge which puts pressure on your nerve and results in discomfort.
  • Arthritis. Osteoarthritis, arthritis in the spine, affects the lower back causing the space around the spinal cord, referred to as the nerve root canal or the spinal canal to become narrow. This condition is referred to as spinal stenosis.
  • Osteoporosis: If your bones are or become brittle, your spine’s vertebrae can develop compression fractures.
  • Sciatica: This refers to back pain caused by compression of the Sciatic nerve  and is characterized by a sharp and shooting pain that radiates through the buttocks, hips and down the leg.
  • Spine cancer:  A tumor on the spine can exert pressure on the nerve, resulting in back problems.
  • Infections: Kidney or bladder infections, pelvic inflammatory diseases can lead to back problems.
  • Intervertebral disc degeneration: as people age, discs deteriorate and lose their cushioning ability.
  • Cauda equina syndrome: This is a rare but severe problem of a ruptured disc. This condition occurs when disc material press into the spinal canal compressing the nerve roots.

Diagnostic Procedures

The diagnostic procedures used depend on the patient’s complete medical history and physical examinations which determine if there is any serious underlying condition that could be causing the pain. Only after a thorough back examination and neurological tests can a healthcare provider establish the cause of back pain and the appropriate treatment.

In most cases, imaging is not necessary, but in some instances, it may be required to rule out specific causes of pain in the lower, middle or upper back, including spinal stenosis and tumors. Some of these medical tests may include:

  • Physical examination
  • Blood tests
  • Neurological examination
  • X-ray
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Electromyography (EMG)
  • Nerve Conduction Velocity (NCV)

Treatment and prevention

Treatment for back pain depends on the intensity of the pain. Surgery is only necessary for back problems causing progressive nerve damage or involves structural changes that require corrective surgery. Some of the treatment and preventive measures include:

  • Activity: Although bed rest seems like the logical thing to do, it should be limited. Individuals should remain active, do light stretching exercises, and resume daily activities while avoiding movements that strain the back.
  • Physical therapy programs help to strengthen core muscles that support your back, promote proper posture and positioning, and enhance mobility and flexibility.
  • Medications: A wide range of drugs such as painkillers, antidepressants, narcotics, and muscle relaxants are available for treating both acute and chronic pain. Some are available over the counter (OTC) while others require a physician’s prescription. However, some of these drugs may be unsafe for use with other medications, during pregnancy, can cause serious side effects, or have adverse side effects. Individuals should seek medical advice and review options with their doctor before taking any medicines.
  • Transcutaneous Electrical Nerve Stimulation (TENS): TENS involves placing a device that emits electrical impulses on the sensitive parts.
  • Acupuncture involves the insertion of sterilized needles at specific points on the body through the skin. Individuals with low back pain claim that acupuncture provides pain relief.

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About

About Author

Prof. Dr. Erich Ringelstein

Prof. Erich Ringelstein is a Neurologist and Psychiatrist, he was the Head of Neurology Department at the University Hospital of Münster in Germany, managing eighty beds, a neurological intensive care unit and a stroke unit as well. Prof. Ringelstein also managed subdivisions that covered neuromuscular disorders, sleep disorders epileptic seizures, movement disorders, multiple sclerosis, as well as, dementia and cognitive impairment. Prof. Ringelstein was very active in academic teaching and was awarded for these efforts several times. He is trained in epileptology, neuroradiology, neuro geriatrics, evoked potentials, neurovascular and neuromuscular ultrasound. In 1992, Prof. Ringelstein received the Hugo Spatz Prize from the German Neurological Society for his research on cerebrovascular disease. Prof. Ringelstein is an active member of the editorial boards of scientific journals like Stroke, European Neurology, Cerebrovascular Diseases, Journal of Neuroimaging. He serves as a Reviewer for well-known journals like Stroke, Brain, Neurology, Annals of Neurology and others. Prof. Ringelstein was trained in Mainz University, Aachen Medical Faculty and Bonn University Hospital. In 1987, he worked as a Research Fellow at Scripps Clinic and Research Foundation in La Jolla, CA, USA. In 2006, Prof. Ringelstein received an Honorary Doctor title from the University of Debrecen, Hungary, for his intensive and fruitful scientific collaboration with this university hospital. He was elected Corresponding Member of the Austrian Stroke Society.

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