FAQs on Back Pain
Back pain is the most frequent of all musculoskeletal complaints. While about 80% of Americans suffer from the problem at any point of time, over 45 million patient visits occur every year due to it. Most common in people in their 40s and beyond, back pain is the cause of 40% of total work hour losses in the United States. According national health survey reports, more than 30% of those interviewed acknowledged back pain and a majority of these patients were between 35 and 55 years.
What is back pain?
Back pain refers to pain felt in the back that stretches from the back of the shoulder to buttocks. It is the most reported pain by human beings after headache. The source of the back pain lies in nerves, bones, muscles, or various structures in and around the spinal cord. Radiating pain in the back is also felt due to disorders in gallbladder and pancreas.
Dull, constant pain may start in the back making you discomfort and worsens slowly. It may also be sudden and sharp restricting your mobility. According to back anatomy, it is of two types – thoracic or upper and lumbar or lower. Lower back pain is the most common and debilitating back pain.
Considering the duration and impact, back pain is of two categories.
- Acute pain lasting for a short period, usually less than six months, traced to a musculoskeletal injury
- Chronic pain lasting for a long period beyond six months associated with a musculoskeletal injury and following complications or neuropathic pain, where nerves keep on sending pain signals even after the musculoskeletal injury is healed.
What are the symptoms of back pain?
- Shooting or stabbing pain in the back
- Back muscle ache
- Back pain radiating to thighs and legs, even beyond the knee
- Restricted back flexibility
- Restricted ability to stand straight
- Back inflammation
- Pain does not go despite resting
- Worsening pain when sitting
- May have fever and weight loss
What are the structures involved in back pain?
The back has several muscles, bones, joints, disks, and ligaments. The spine runs from the neck to the sacrum interconnecting many of these structures. For diagnostic purpose, the back is anatomically divided in to various parts and pain impact any of these.
- Cervical area pain or commonly known as neck pain felt just behind the neck area
- Thoracic area pain or the upper back pain affecting the thoracic vertebrae and nearby areas.
- Lumbar area pain or the lower back pain impacting the half of the back between ribs and hip bones
- Sacral or tail bone area pain affecting the lowest portion of the spine where it connects with the pelvic back.
As these structures are interconnected, pain originating in one part may radiate to the other. For example, neck pain often impacts the upper back and shoulders. If you feel back pain at the night, you may have a serious spinal problem.
What are the causes of back pain?
- Muscle or ligament strain
- Bulging or ruptured disks
- Injury to spinal ligaments
- Muscle spasm or injury
- Repeated heavy lifting
- Nerve impingement
- Intervertebral injury
- Spinal arthritis
- Severe scoliosis
- Skeletal injury, fracture, or osteoporosis
- Synovial joint inflammation
- Muscle tissue damage
- spinal disc herniation
- Gallbladder stone
- degenerative disc problem
- Lumbar spinal stenosis
Who are at the risk of back pain?
Improper lifting, absence of workouts, and excessive weight are important factors in causing back pain. A stressful physical work, sedentary life style, age, depression, and smoking may also increase the risk. Those with bone cancer, traumatic back injury, and inefficient treatment to earlier pain also put people at the risk of back pain.
When to see a doctor?
Consult a doctor immediately if you have persistent back pain with unexplained weight loss, night time back pain, urinary or bowel incontinency, chest pain, and discomfort.
How is back pain diagnosed?
Physical examination is the most used procedure for back pain diagnosis. X-ray may be suggested if you have disk problem or injury affecting the back.
What are the treatment methods available for back pain?
- Medications: Acetaminophen, NSAIDs, muscle relaxants, and narcotic pain killers help reduce pain and swelling.
- Physical Therapy: Use of active and passive therapies helps reduce pain and restore strength to your back and enhance functional parameters. Active therapies include use of back-mobilizing exercises, change of activities, and nutrition while passive therapies have back support, ice, heat, and soft tissue massage.
- Ice and Heat Therapy: Regular use of ice or heat therapy relieves back spasms and back pain associated with it.
- Therapeutic Treatment: Soft tissues massage, yoga, Pilates, acupressure, stone massage, and rubbing of the pain area relax contractions, take out stress, and eliminate building of tension. Such treatment is effective for chronic back pain.
- Epidural Injections: Anesthetic medications, botox, and corticosteroid directly injected to the pain spot alleviate symptoms through denervation of the area that inhibits pain and allow healing to take place.
- Acupuncture: Endorphin hormone, a natural pain reliever, release is encouraged by piercing the skin over the pain area with small needles.
- Chiropractic Manipulations: These “adjustments” are vital to facilitate proper nerve transmission and reduction in pain in the back.
- Medial Branch Block: Epidural injections containing anesthetic and steroid medications are used to numb “tiny nerves that sprout from the spine and extend to facet joints.” This reduces inflammation in the spine joints on semi-permanent basis and prevent occurrence of painful symptoms.
- Infusions Techniques: Intrathecal pump or small catheres are placed in the lower back area. These implants administer anesthetic and other medicines to the pain area continually keeping it numb and free from pain sensation.
- Spinal Cord Stimulation: Electrical device are placed in the back transmitting tingling electrical signals to confuse pain signal by the spinal nerves. It interferes with pain processing procedure and inhibits pain perception.
- Peripheral Nerve Stimulation: It also interferes with pain transmission by placing tiny electrodes near the area of pain.
- Kyphoplasty, Vertebroplasty: Acrylic cement is injected to stabilize crushed vertebrae. It adds support to the injured back area and provides pain relief.
- Percutaneous Discectomy: Sucking off material from the bulging disc using a needle. This relieves pressure and pain in the disc.
- Disc Denervation: Nerves are injured discs are denerved using electrical stimulation or anesthetic injections.
- Prolotherapy: Platelet rich plasma injections to painful muscles, ligaments, and tendons encourage the regenerative healing of a damaged parts and offer permanent relief.
- Surgical Treatment: Last resort, surgical intervention includes
- Spinal fusion procedure or welding of painful, loose vertebrae into a single bone so that there won’t be pain following movements of these separated bones.
- Injured disk replacement with artificial ones
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