What Is Back Pain? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Medically Reviewed

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:

  • Vertebrae
  • Spinal cord
  • Intervertebral discs (cushion-like pads between vertebrae)
  • Ligaments (connective tissues between bones or cartilage)
  • Muscles
  • Tendons (inelastic tissue connecting muscles to bones)
Problems with any of these structures can cause back pain, including injuries, inflammatory conditions such as ankylosing spondylitis, infections, and tumors and cancers.

Treatment for back pain depends on the type and causes of your pain. It can include hot or cold packs, pain-relieving medications, exercise, physical therapy, complementary and alternative therapies, and even surgery.

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.

The pain you feel may:

  • 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
  • Sciatica
  • Fractured vertebrae
  • Trauma or injury
  • Pinching of a nerve root

Various types of arthritis, including ankylosing spondylitis, can cause back pain. Other medical conditions that can cause back pain include:

Risk factors that may put you at greater risk of back pain include:

  • Age
  • Lack of exercise
  • Poor posture
  • Being overweight or obese
  • Cancer
  • Smoking
  • Psychological conditions including depression and anxiety
  • Improper lifting
  • Jobs that require heavy lifting, pushing, pulling, or twisting, or sedentary desk jobs
  • Genetics

How Is Back Pain Diagnosed?

To diagnose your condition, your doctor will begin by reviewing your personal and family medical history and conducting a physical exam. During this exam, your doctor will examine your spine and posture and ask you to move your body in certain ways so he or she can understand the characteristics of your pain, including if you have abnormal reflexes, weakness, and numbness.

Your doctor may order tests to rule out or confirm a cause for your back pain, though most people don’t need any additional testing. Imaging and blood tests your doctor may order include:

  • 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.

More serious conditions causing back pain, such as cancer, fractures, and fibromyalgia, may require sustained treatment, procedures, and possibly surgery to achieve significant improvement.

Duration

Back pain can be acute (lasting a few days to a few weeks), subacute (lasting 4–12 weeks), or chronic (lasting more than 12 weeks).

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.

Women who have back pain from pregnancy almost always get better after delivery.

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

Some symptoms of back pain can be signs of something more serious that requires immediate attention. See your doctor if your pain doesn’t improve within a few weeks or follows an injury, or if you also have any of the following symptoms:

  • Weakness or numbness, especially if it’s in your legs
  • Severe pain that doesn’t improve with rest or medications
  • Trouble urinating
  • Incontinence
  • Fever
  • Unexplained or unintended weight loss
  • Chest pain
  • Poor sleep from pain
  • Back pain that worsens when sneezing, coughing, or defecating

Medication Options

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.

Various other prescription medications may also aid pain relief:

Physical Therapy

A physical therapist can teach you exercises to help you strengthen the muscles that support your back, increase your flexibility, and improve your posture. When performed regularly, these exercises can help relieve pain and prevent back pain from returning.

A physical therapist can also educate you about how you can modify your movements and posture to avoid flaring your pain while being active.

RELATED: Physical Therapy to Help Chronic Pain

Surgery

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.

The most common surgeries that doctors perform are:

  • 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.
Other potential surgeries and procedures include:

  • 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

If your back pain is caused by ankylosing spondylitis (AS) or other types of arthritis, taking a curcumin (turmeric) supplement may ease pain but won't stall disease progression. Don’t replace prescribed medications with natural remedies, or start using such remedies without consulting your doctor. Curcumin or turmeric works by blocking inflammatory pathways involved in ankylosing spondylitis. In fact, some studies have shown curcumin can be similar in effectiveness to certain NSAID drugs for this purpose.

Other alternative therapies that might alleviate back pain include:

Prevention of Back Pain Symptoms

Not all back pain can be prevented, but regular exercise, good posture, and other lifestyle adjustments can reduce your chances of developing back pain. Here are some suggestions.

  • 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

Back pain is the leading reason for worker’s compensation and lost work hours and productivity. It can lead to depression and anxiety, as well as weight gain if you don’t remain active.

If the underlying cause of back pain is not treated, it may result in a variety of complications (depending on the cause), including:

  • 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

  • Disability
  • Deformity
  • Difficulty getting pregnant (from endometriosis)

Research and Statistics: How Many People Have Back Pain?

Back pain is one of the most common non-life-threatening conditions, affecting 80 percent of Americans at some point in their lives, according to Harvard Health Publishing.

Nearly 65 million Americans — about 20 percent — report a recent episode of back pain and 16 million American adults — about 8 percent —?experience chronic back pain, according to Georgetown University’s Health Policy Institute.

Related Conditions

Back pain is a common form of chronic pain. Other common types of pain include:

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.

U.S. Pain Foundation

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.

Arthritis Foundation

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.

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