Back Pain

Definition

Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Chronic back pain is pain that persists for more than 3 months. It is often progressive and the cause can be difficult to determine.

African-American men with chronic pain related to an accident, injury, illness, surgery or other causes were more likely to experience depression, affective distress and disability than white men with chronic pain, according to a new study by the University of Michigan Health System

In one study with the Armed Forces Health Surveillance Center database for the International Classification of Diseases, African Americans were the most likely to visit their healthcare provider about lower back pain with the highest incident rate at 43.7%.

Causes

There are many causes of back pain. Mechanical problems with the back itself can cause pain.

Examples are:

• Disk breakdown
• Spasms
• Tense muscles
• Ruptured disks

Injuries from sprains, fractures, accidents, and falls can result in back pain. Back pain can also occur with some conditions and diseases, such as:

•  Scoliosis
• Spondylolisthesis
• Arthritis
• Spinal stenosis
• Pregnancy
• Kidney stones
• Infections
• Endometriosis
• Fibromyalgia.

Other possible causes of back pain are infections, tumors, or stress.

Symptoms

Most people have experienced back pain sometime in their life. The causes of back pain are numerous; some are self-inflicted due to a lifetime of bad habits. Other back pain causes include accidents, muscle strains, and sports injuries. Although the causes may be different, most often they share the same symptoms.

The symptoms for back pain are:

• Persistent aching or stiffness anywhere along your spine, from the base of the neck to the hips.
• Sharp, localized pain in the neck, upper back, or lower back — especially after lifting heavy objects or engaging in other strenuous activity.
• Chronic ache in the middle or lower back, especially after sitting or standing for extended periods.
• Back pain that radiates from the low back to the buttock, down the back of the thigh, and into the calf and toes.
• Inability to stand straight without having severe muscle spasms in the low back.

Exams and Tests

To diagnose back pain, your doctor will take your medical history and do a physical exam. Your doctor may order other tests, such as:

• X rays
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan
• Blood tests.

Medical tests may not show the cause of your back pain. Many times, the cause of back pain is never known. Back pain can get better even if you do not know the cause.

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Treatments

Treatment for back pain depends on what kind of pain you have. Acute back pain usually gets better without any treatment, but you may want to take acetaminophen, aspirin, or ibuprofen to help ease the pain. Exercise and surgery are not usually used to treat acute back pain. Following are some types of treatments for chronic back pain.

Hot or Cold Packs (or Both)

Hot or cold packs can soothe sore, stiff backs. Heat reduces muscle spasms and pain. Cold helps reduce swelling and numbs

deep pain. Using hot or cold packs may relieve pain, but this treatment does not fix the cause of chronic back pain.

Exercise

Proper exercise can help ease chronic pain but should not be used for acute back pain. Your doctor or physical therapist can tell you the best types of exercise to do.

Medications

The following are the main types of medications used for back pain:

• Analgesic medications are over-the-counter drugs such as acetaminophen and aspirin or prescription pain medications.
• Topical analgesics are creams, ointments, and salves rubbed onto the skin over the site of pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that reduce both pain and swelling. NSAIDs include over-the-counter drugs such as ibuprofen, ketoprofen, and naproxen sodium. Your doctor may prescribe stronger NSAIDs.
• Muscle relaxants and some antidepressants may be prescribed for some types of chronic back pain, but these do not work for every type of back pain.

Behavior Changes

You can learn to lift, push, and pull with less stress on your back. Changing how you exercise, relax, and sleep can help lessen back pain. Eating a healthy diet and not smoking also help.

Injections

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Your doctor may suggest steroid or numbing shots to lessen your pain.

Complementary and Alternative Medical Treatments

When back pain becomes chronic or when other treatments do not relieve it, some people try complementary and alternative treatments. The most common of these treatments are:

• Manipulation. Professionals use their hands to adjust or massage the spine or nearby tissues.
• Transcutaneous electrical nerve stimulation (TENS). A small box over the painful area sends mild electrical pulses to nerves. Studies have shown that TENS treatments are not always effective for reducing pain.
• Acupuncture. This Chinese practice uses thin needles to relieve pain and restore health. Acupuncture may be effective when used as a part of a comprehensive treatment plan for low back pain.
• Acupressure. A therapist applies pressure to certain places in the body to relieve pain. Acupressure has not been well studied for back pain.
• Surgery

Most people with chronic back pain do not need surgery. It is usually used for chronic back pain if other treatments do not work. You may need surgery if you have:

• Herniated disk. When one or more of the disks that cushion the bones of the spine are damaged, the jelly-like center of the disk leaks, causing pain.
• Spinal stenosis. This condition causes the spinal canal to become narrow.
• Spondylolisthesis. This occurs when one or more bones of the spine slip out of place.
• Vertebral fractures. A fracture can be caused by a blow to the spine or by crumbling of the bone due to osteoporosis.
• Degenerative disk disease. As people age, some have disks that break down and cause severe pain.

Rarely, when back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome, surgery is needed right away to ease the pain and prevent more problems.

Possible Complications

In most cases, main complications of back pain include nothing more than decreased flexibility and movement. However, in severe or chronic cases, back pain can be extremely debilitating, and may cause a range of lifestyle, sleep, work, social, and other issues.

When to Contact a Medical Professional

You should see a doctor if you have:

•  Numbness or tingling
• Severe pain that does not improve with rest
• Pain after a fall or an injury
• Pain plus any of these problems:
• Trouble urinating
• Weakness
• Numbness in your legs
• Fever
• Weight loss when not on a diet.

Preventions

The best things you can do to prevent back pain are:

• Exercise often and keep your back muscles strong.
• Maintain a healthy weight or lose weight if you weigh too much. To have strong bones, you need to get enough calcium and vitamin D every day.
• Try to stand up straight and avoid heavy lifting when you can. If you do lift something heavy, bend your legs and keep your back straight.

Natural Remedies

Get real relief from back pain. Strengthen your back with regular exercise and good nutrition. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

• Take care of your back
  
  Practice good workplace and lifestyle habits, such as lifting and standing properly; learn proper exercises to reduce back pain from a qualified instructor
• Try an enzyme preparation
  
  Take 4 to 8 tablets a day of proteolytic enzymes containing trypsin, chymotrypsin, and/or bromelain to control inflammation
• Try B vitamins
  
  Take vitamins B1 (150 mg a day), B6 (150 mg a day), and B12 (250 mcg a day) so you need less anti-inflammatory medication, and to help you prevent relapses of back pain
• Consider seeing a chiropractor
  
  A qualified practitioner may be able to help correct spinal problems that contribute to back pain and disability
• Get a checkup
  
  See your healthcare provider to make sure your symptoms are not related to a medical problem
• Quit smoking
  
  Smokers suffer more from back pain, probably due to reduced nutrition to spinal discs

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full low back pain article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.