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What is Back Pain?

Backache is pain that could be anywhere at the back with or without radiation to buttocks and legs. The cause for backache ranges from simple strain and sprain to debilitating illness that impacts intervertebral discs. Pain could be acute or chronic that might even need some form of surgical intervention. Factors that lead to backache include age, occupation, lifestyle, injuries, degenerative diseases, etc.

What are the causes of Back Pain?

Problems in the components that comprise the entire back like muscles, ligaments, tendons, discs, bones result in backache. The main causes include strain or spasms that occur due to lifting heavy weights, making an awkward movement, injuries, and falls. Besides, there are structural problems like sciatica, scoliosis (abnormal curvature of the spine), kyphosis, arthritis, osteoporosis, disc bulge, ruptured discs etc. The most common cause of frequent backache in recent times is due to a sedentary lifestyle and poor posture. Simple twisting, overstretching, sitting or sleeping in a wrong posture for prolonged periods, lack of physical exercise, excessive driving etc. often presents itself with a backache. Other medical conditions that cause backaches are chronic cough, kidney disease, tuberculosis of the spine, infections like pelvic inflammatory disease, tumors and cauda equina syndrome.

What are the symptoms of Back Pain?

As one gets older, there is a high chance of developing degenerative illnesses like arthritis that lead to back pain. Excessive weight/obesity, pregnancy, smoking, an occupation that involves lifting heavy weights, standing for a long duration, genetic factors, people with anxiety are at high risk for developing backache. Immediate medical attention should be given when the patient presents with inflammation or swelling, fever, urinary and fecal incontinence, numbness, tingling, weight loss along with back pain.

What is the treatment for Back Pain?

There are certain measures that help in preventing back pain.

  • Exercise: Daily physical activity will help to build strength in back muscles. Back strengthening exercises, core strengthening exercises, swimming can prevent spasms of the back. Exercising every day for at least one hour improves the flexibility of the back muscles.
  • Maintaining weight by a healthy diet and daily diet includes required amount of calcium and vitamin D. Quitting smoking and adopting a healthy lifestyle are also important.
  • Posture: Make sure to sit in the right posture that keeps the vertebrae straight. Stooping posture affects the back muscles. Posture should be straight, upright without bending forward or backward, balancing weight equally on both sides of the buttocks while sitting and on legs while standing. The back should be supported with rest while sitting and the elbows should be at right angles with forearms in a horizontal position while working in front of a computer.
  • Sleeping on a surface that gives support to the back is essential. Never choose a very soft or very hard mattress to sleep on. This is because such posture changes the curvature of the vertebrae.
  • Avoid driving at a stretch for prolonged periods.
  • Avoid lifting heavy weights. If so, keep head in an upright position without bending or looking down so that the spine stays straight.

Medications like NSAIDs and muscle relaxants are available over the counter and are helpful in the case of acute back pain. Applying hot patches, physiotherapy, yoga, traction in some conditions are few therapies that can improve back pain. Treating the cause or underlying condition that resulted in back pain either the medical or surgical method is the mainstay for relief.

Types of Back pain

1. Based on the duration of symptoms: Back pain is usually classified as acute or subacute and chronic back pain[1] 

Type of Pain Duration of Pain
Acute Sudden pain lasts for 6wks or less
Subacute Between 6 to 12 wks.
Chronic For >12 wks

2. Based on Causes[2],[3]

  • Mechanical Back Pain[4] (97% of cases are reportedly due to pain arising from the spine and surrounding structures)
    • Trauma, lifting heavy objects, and excessive repetitive use of muscles can cause damage which may result in strains or disc herniation[5]
    • Joint diseases
    • Pain due to Nerve Lesions (pinched or compressed nerve causes severe, sharp pain)
    • Pain due to Degeneration of the vertebrae and intervertebral disc
  • Non-mechanical pain Pain caused by tumours, inflammations, and infections (Tuberculosis)
  • Non-mechanical pain Pain caused by tumours, inflammations, and infections (Tuberculosis)
  • Pain due to other causes
    • Referred pain: Pain referred from other organs like liver, Kidney, uterus etc.
    • Psychogenic pain: associated with depression and fibromyalgia

Home Remedy for back pain


  • Use a cold compress immediately after injury to reduce the inflammation.
  • Resume to physical activities slowly.
  • Application of anti-inflammatory cream and massage based on doctor’s advice.
Types Acute Chronic
Duration 4-6 wks. >12 wks
Doctors for Back pain  General practitioners
 Physicians
 Orthopaedic surgeons (if fracture suspected
 Physiotherapist and Occupational Therapists for rehabilitation
 Orthopaedic surgeons
 Neurologists
 Neurosurgeons
 Pain Specialists
 Physiotherapist and Occupational Therapists
Treatment  Initial Rest
 Exercises(stretch and relaxation, strengthening)
 Painkillers
 Correction of cause along with strengthening exercises.
 Transcutaneous electrical nerve stimulation (TENS).

 Local block and nerve block.
 Surgery.

FAQ

Muscle strain due to trauma or overuse is the most common cause

Severe pain in the night, numbness and tingling, weakness of the leg, urine or bowel incontinence, or history of cancer are warning signs that suggest a visit to the doctor immediately.

Apply a cold compress (ice pack) to reduce inflammation and pain relief.

Treatment depends on the type and cause of pain.

REFERENCES

[1]https://www.orthopt.org/uploads/content_files/ICF/Updated_Guidelines/Low_Back_Pain_Clinical_Practice_Guidelines___JOSPT_2012.pdf

[2] https://link.springer.com/article/10.1007%2Fs00586-010-1502-y

[3] http://www.med.or.jp/english/pdf/2004_05/227_233.pdf

[4] https://www.ncbi.nlm.nih.gov/pubmed/18973732

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