What is Back Pain?
The back is composed of a combination of tendons, ligaments, muscles, bones and discs. Issues with any of these components can lead to back pain. Patients with back pain may experience symptoms severe enough to cause an interruption in their daily lifestyle or routines. An injury, disease, or other condition that affects the back can cause a large amount of pain in the upper, middle, and lower back. The location of your pain symptoms determine which part of the back is suffering. For those with severe symptoms, back pain can have a major impact on overall quality of life.
Location of Back Pain
Back pain can be felt in three locations of the back:
- Lower back pain – Lower back pain is pain felt within the lower portion of the back, or the lumbar spine. This section of the spine consists of a structure of interconnecting joints, bones, nerves, ligaments, nerves, and muscles that work together to provide support, strength, and flexibility. However, because of the complexity of the lower back, it is left susceptible to injury and pain. Most acute pain in the lower back is the result of an injury to the muscles, joints, ligaments, or discs. The body reacts to these injuries by producing an inflammatory healing response, which can cause the pain to become worse. While muscles and ligaments within the lower back usually heal quickly, a more severe injury, such as a torn disc, may take a while to heal. The length of time the lower back pain has been felt can actually help determine the cause of the pain. Common symptoms of lower back pain include:
- Difficulty standing up straight, walking, or switching from a sitting to a standing position
- Dull, achy pain in the lower back
- Muscle spasms in the lower back
- Pain that becomes worse after long periods of sitting or standing
- Pain that spreads from the lower back to the hips, pelvis, legs, or buttocks
Additionally, there are three classifications of lower back pain symptoms: acute, subacute, and chronic. The classification of your lower back pain depends on the type of onset and the amount of time the pain is felt.
- Acute pain: The pain occurs suddenly and lasts for a few days or weeks. This is usually a normal response of the body to tissue damage or injury, and it gradually reduces as the body heals.
- Subacute pain: This pain lasts anywhere from 6 weeks to 3 months. It is usually mechanical in nature, but prolonged.
- Chronic pain: This type of low back pain lasts more than 3 months, and is usually severe. Chronic pain often does not respond to initial treatments, and may need a medical professional to determine the source of the pain.
The most common types of back pain are mechanical and radicular:
- Mechanical pain: The most common type of low back pain is mechanical pain. This type of pain primarily stems from the muscles, bone, and ligaments around and in the spine. While it usually is contained within the lower back, it can also spread to the buttocks, hips and legs. Mechanical pain usually increases, or decreases, based on motion, such as twisting, standing, sitting, or resting.
- Radicular pain: Radicular pain can occur if a nerve root within the spine becomes inflamed or injured. This pain may follow a nerve root pattern that causes it to spread to the buttocks, pelvis, hips, or les. It is often classified as a burning pain that is often associated with numbness or weakness, and is usually felt on only one side of the body.
- Middle back pain – Middle back pain occurs in the thoracic spine, between the bottom of the neck and the bottom of the rib cage. This section of the spine consists of 12 vertebrae and is built for stability to hold the body upright and protect the organs in the chest. It also includes discs that separate each vertebra and absorb the shock from movement and muscles and ligaments that hold the spine together. Middle back pain has a number of potential causes, from muscle stain to a collapsed vertebra. Common symptoms of middle back pain include:
- Burning sensations within the middle back
- Chest pain
- Dull pain in the middle back
- Muscle aches in the middle back
- Stiffness of muscles in the middle back
- Neck pain – The neck is located within the cervical spine and is composed of tendons, ligaments, muscles, nerves, and bones that house the spinal cord. It is a flexible section of the spine, allowing for movement in all directions. With the many forces and stresses that are placed on the neck through various activities, the neck is at risk for developing many painful conditions. Neck pain is often located in one area, and subsides within a few days without any medical treatments. In some cases, the pain is constant and can spread to other parts of the body, such as the arms or shoulders. The most common neck pain symptoms include:
- Stiff neck
- Sharp pain in the neck
- Pain that stems to the arms or shoulders
- Tingling, numbness, or weakness
- Difficulty gripping or lifting objects
The symptoms may be constant, or come and go. Simple movements, such as sneezing or coughing, can potentially cause the pain to become worse. If symptoms progress, neck pain can make it difficult to sleep and can interfere with daily activities.
Neck pain typically develops:
- Delayed after an injury: Neck pain may get worse in the hours or days following an injury.
- Immediately following trauma: Neck pain may occur immediately following an injury, or even after a night of sleeping in an awkward position.
- Slowly over time: Neck pain may be mild in the morning, and worsen toward the end of the day.
- Suddenly, without any prior signs: Neck pain may develop suddenly for no apparent reason.
Because the cervical spine houses the vital spinal cord, there are some instances where immediate medical attention is necessary, such as:
- Fever or chills
- Loss of balance or coordination
- Loss of bladder or bowel control
- Radiating pain in the arms or legs
- Sudden, unintended weight loss
- Tingling, numbness, or weakness in the arms or legs
Additionally, neck pain as a result of major trauma should be looked at immediately by a medical professional to reduce the risk for paralysis.
- Upper back pain – The upper back is often used interchangeably with the middle back, as both areas are included in the thoracic spine. The upper back is quite resilient to pain and injury, however, when pain does occur, it is because the injury or condition has overpowered the sturdiness of the thoracic spine. Unlike the neck or the lower back, the upper back is relatively immobile, due to each vertebra being connected to a pair of ribs. Pain in the upper back usually develops for one of two reasons:
- Muscular irritation: The large muscles in the upper back can develop strains or tightness that can be difficult to reduce. This is usually caused by a lack of strength within the muscles or overuse.
- Joint disfunction: The joints within the thoracic spine can cause pain either due to an injury or as the result of natural degeneration.
The most common symptoms of upper back pain include:
- General discomfort
- Radiating pain that may spread to the arms, chest, or stomach
- Sharp pain in the upper back
- Stiffness in the upper back
- Tingling, numbness, or weakness
Upper back pain that is severe enough to interfere with daily life is usually classified as a sharp, burning pain that can spread to other areas of the body, such as the shoulder or neck. The pain may occur suddenly or gradually.
Causes of Back Pain
The spine is a vital part of the skeletal system, and contains the spinal cord, which is a part of the nervous system. This means that pain symptoms in the back should be taken seriously to avoid damage or problems to major parts of two body systems. Anything from overuse to natural wear and tear can cause back pain problems.
These causes can turn into full disorders that debilitate the back, such as:
- Cervical degenerative disc disease– One or more of the cushioning discs in the cervical spine begins to break down as a result of wear and tear. This causes pain within the neck.
- Lumbar herniated disc– Broken or bulging of the small, flat, round discs that cushion the vertebrae that form the spine. This causes pain in the lower back.
- Osteoarthritis– The cartilage in between the bones wears away, causing the bones to rub against each other. This can occur in the upper back, lower back, middle back, or neck.
- Osteoporosis– The bones become weak and brittle as a result of the body losing too much bone or not making enough bone
- Pinched nerve– Pressure is placed on a nerve, leading to irritation or damage of the nerve. A pinched nerve can occur in the upper back, middle back, lower back, or neck.
- Sciatica– The sciatic nerve is irritated or compressed near or at its origin point. Sciatica occurs in the lower back.
- Spinal fracture– Bones within the spine break and collapse. A spinal fracture can occur in the neck, upper back, lower back, or middle back.
- Spinal stenosis– A narrowing of the spaces within the spine that adds pressure to the spinal nerves. Spinal stenosis can cause pain in the upper back, lower back, middle back, and neck.
Am I at Risk for Back Pain?
Unfortunately, many patients are at risk of back pain. Injuries, disease, and other lifestyle factors can cause patients to become at risk for back pain symptoms. While some risk factors contribute more to back pain than others, it is important to be aware of all factors that can pose a risk. By being aware of the risk factors associated with back pain, you are more likely to catch symptoms early and seek treatment.
The following factors can contribute to your risk for experiencing back pain:
- Fitness level
- Occupations and daily routines that require heavy lifting
What are Symptoms of Back Pain?
The symptoms of back pain may vary from patient to patient, depending on the individual’s conditions and causes of pain. However, the basic criteria for back pain is identified as pain that lasts for 12 weeks or longer, even after treating the original cause of the pain. The symptoms become more specific when focusing on a particular disorder.
Symptoms related to back pain include:
- Aching or stiffness along the spine that is persistent
- Inability to stand upright without pain or spasms in the back
- Localized, sharp pain in the back or neck after engaging in strenuous activity
- Pain or aching in the back after sitting or standing for extended periods of time
- Pain that originates in the back and stems to other areas of the body, such as the calf or thighs
Can I Stop Back Pain?
Patients who take proper measures can help avoid back pain. There are often initial indicators that can warn of a back pain problem. Lifestyle changes, along with keeping the back muscles strong, can reduce symptoms and avoid a condition from needing surgical treatment.
Some common ways to avoid back pain are:
- Avoid lifting heavy objects
- Include nutrient-rich foods in your diet and avoid processed or fried foods
- Maintain a healthy BMI
- Perform back-strengthening exercises two to three times a week
- Practice correct posture by standing up straight and avoiding slouching
At-Home Treatments for Back Pain
The most effective way to relieve back pain ultimately depends on how severe the symptoms are. Patients with less severe symptoms can benefit from simple home methods to reduce back pain, while patients with severe symptoms may need professional care or surgery.
At home, patients can ease their back pain with these tips:
- Alternate between applying ice and heat to the back for 20 minutes each time, several times per day
- Perform gentle stretches that focus on the muscles in the back
- Remain physically active and don’t rest for more than a day or two
- Sleep with a pillow under your body to maintain the natural curve of the spine
If at-home relief tips do not improve the symptoms of your back pain, you may need to seek the help of a medical professional. Finding an accurate diagnosis for your pain can help you discover the most effective treatment options.
Medical Treatments for Back Pain
Patients who are unable to treat their back pain with at-home remedies may need to seek the help of a medical professional. These specialized treatments can provide relief to those with more severe back pain symptoms.
Common medical treatments for back pain include:
- Cervical disc fusion
- Cervical disc replacement
- Lumbar fusion
- Lumbar laminectomy
- Lumbar microdiscectomy