Back pain is one of the most common medical reasons why people go to the doctor or miss work or school, and most people will experience it at one point in their life. It can range from mild to severe, affect different parts of the back, and last a few days to years.
Your back is composed of many structures that all work together to support your body. This includes your:
- Spinal cord
- Intervertebral discs (cushion-like pads between vertebrae)
- Ligaments (connective tissues between bones or cartilage)
- Tendons (inelastic tissue connecting muscles to bones)
Signs and Symptoms of Back Pain
Back pain may present as muscle aches, morning stiffness, and pain affected by activity, shooting, burning, or stabbing sensations.
- Radiate away from the back into the buttocks, legs, hip, or abdomen
- Increase when lifting, bending, or twisting
- Increase when resting, sitting, or standing
- Come and go
- Affect a specific spot in your back or spread all over the back
Causes and Risk Factors of Back Pain
Back pain can develop from numerous mechanical or structural problems in the back, including:
- Sprains and strains in the muscles or ligaments
- Herniated or ruptured discs
- Degenerative disc disease from aging
- Spondylolisthesis (when a vertebra slips out of place)
- Spinal stenosis
- Fractured vertebrae
- Trauma or injury
- Pinching of a nerve root
- Osteoporosis-related fractures
- Spinal tumor or cancer that has spread (metastasized) to the back or spine
- Infections of the bone, abdomen, pelvis, or bloodstream
- Kidney infection or kidney stones
- Lack of exercise
- Poor posture
- Being overweight or obese
- Psychological conditions including depression and anxiety
- Improper lifting
- Jobs that require heavy lifting, pushing, pulling, or twisting, or sedentary desk jobs
How Is Back Pain Diagnosed?
- X-ray This imaging test can reveal broken bones or fractures, age-related changes to your bones, and changes in the alignment of your spine.
- Magnetic resonance imaging (MRI) Powerful magnets and radio waves create a series of detailed cross-sectional images of your body. These images can help diagnose damage or disease to the soft tissues of your back, including the discs, ligaments, and nerve roots.
- Computerized axial tomography (CAT) This test creates three-dimensional views of the back using X-ray images taken at different angles. The scans help diagnose problems with the spine and surrounding tissues.
- Electromyography (EMG) or other electrophysiological tests In this test, the doctor inserts a needle into muscles to measure their electrical activity and detect muscle or nerve problems.
- Bone scans This imaging test looks for fractures, tumors, and infections of the spine using small amounts of radioactive materials.
- Blood tests Doctors can identify some inflammatory or medical disorders behind back pain from markers in the blood.
Prognosis of Back Pain
The severity, duration, and likelihood that your back pain will resolve on its own all depend on the underlying condition causing your pain.
Back pain caused by strains, sprains, and minor injuries will most likely respond to self-care and get better with time. Pain from issues like sciatica, herniated disc, and nerve pinching may take a little longer to heal.
How long your back pain lasts depends on what's causing it. Infection-related back pain might go away after the course of antibiotics, while back pain stemming from spinal degeneration may last a lifetime.
Treatment and Medication Options for Back Pain
The recommended treatment for back pain varies with the cause of your pain, with the goal being to relieve pain and improve physical function.
Back pain usually goes away within a month of home treatment. Self-care options that may speed up the healing process include:
- Hot or cold packs
- Back exercises and stretches
- As much activity as you can tolerate
- Avoidance of activities that increase pain
- Relaxation (but not bedrest) to keep stress and muscle tension low
- Over-the-counter (OTC) pain relievers
When to See a Doctor for Back Pain Relief
- Weakness or numbness, especially if it’s in your legs
- Severe pain that doesn’t improve with rest or medications
- Trouble urinating
- Unexplained or unintended weight loss
- Chest pain
- Poor sleep from pain
- Back pain that worsens when sneezing, coughing, or defecating
Common OTC medications can help relieve back pain. These include pain relievers (analgesics) like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen sodium (Aleve). Topical pain relievers applied via creams, ointments, salves, or patches may also help.
If these medications are not strong enough, your doctor might suggest prescription NSAIDs or analgesics.
- Muscle relaxants, such as diazepam, for back pain stemming from muscle tension
- Injections of anti-inflammatory agents, particularly for radiating pain from nerve compression or irritation
- Tricyclic antidepressants, such as amitriptyline, and some other antidepressants, particularly duloxetine (Cymbalta)
- Narcotics including oxycodone or hydrocodone, which don’t work well for chronic pain
RELATED: Physical Therapy to Help Chronic Pain
Surgery for back pain is typically suggested only if all other “conservative” or nonsurgical treatments do not effectively relieve your pain. Exceptions exist, of course, such as if you are experiencing weakness or numbness in your legs or you are incontinent.
The type of surgery your doctor recommends depends on the cause of your pain and your medical history, though they may decide you are not a good candidate for a procedure.
- Discectomy This surgery removes part of a herniated disc, relieving pressure on a nerve root or the spinal canal.
- Laminectomy This surgery involves removing bony spurs and the bone walls of the vertebrae to treat spinal stenosis and relieve pressure on the nerves.
- Spinal fusion If a laminectomy doesn’t do the job, you may need a spinal fusion, a surgery that joins two or more vertebrae in the spine. It can help treat degenerative disc disease and spondylolisthesis.
- Foraminotomy to treat spinal stenosis by widening the area where nerve roots leave the spinal canal
- Vertebroplasty and kyphoplasty to repair compression fractures of the vertebrae from osteoporosis
- Disc replacement surgery
- Laser surgery
- Radiofrequency lesioning or neurotomy, using targeted radio waves to interfere with pain signals being transmitted from nerves to the brain
- Implanted nerve stimulators
- Cortisone injections to decrease inflammation around nerve roots
Alternative and Complementary Therapies to Ease Back Pain Symptoms
- Transcutaneous electrical nerve stimulation (TENS)
- Massage therapy
- Spinal manipulation and mobilization through chiropractic adjustments
- Mindfulness-based programs to help cope with pain or reduce stress
- Tai chi
Prevention of Back Pain Symptoms
- Don’t slouch — keep your shoulders straight over your hips and your ears right above your shoulders.
- Balance your weight evenly on your feet when standing.
- When sitting, remove items from your back pockets, use chairs that support your lower back (adjusting their height so that your feet rest flat on the floor), and get up to walk around at least once every 30 minutes.
- Maintain a healthy weight and eat a nutritious diet with enough calcium and vitamin D.
- Wear comfortable shoes.
- Don’t try to lift objects that are too heavy, and make sure to lift with your legs and hips, not your back, and hold the object close to your body.
- Modify repetitive tasks so that you perform different body movements to achieve the same goal.
- Quit smoking.
- Use ergonomically designed furniture and equipment.
Complications of Back Pain
- Permanent nerve damage and associated motor or sensory deficits, including incontinence
- Diabetes, cardiovascular disease, arthritis, sleep apnea, and other health issues caused by weight gain
- Difficulty getting pregnant (from endometriosis)
Research and Statistics: How Many People Have Back Pain?
Back pain is a common form of chronic pain. Other common types of pain include:
- Neck pain
- Arm pain
- Abdominal pain
- Hip pain
- Leg pain
Resources We Love
American Chronic Pain Association
This group aims to support and advocate for people who experience chronic pain. It has information on coping with numerous back-pain-causing conditions, including ankylosing spondylitis, spinal stenosis, sciatica, and more.
National Spine Health Foundation
This patient-centered nonprofit is dedicated to helping patients overcome spinal conditions through patient education, research, and advocacy. The organization has resources to help patients make informed decisions about their spine health.
A nonprofit dedicated to helping people with chronic pain, along with their caregivers, U.S. Pain Foundation has numerous resources about different types of pain, their causes, and their treatments. It also has resources for finding support.
A leading arthritis research and advocacy organization, the Arthritis Foundation provides information on back-pain–causing arthritis, as well as detailed resources on managing pain.