Everything you need to know about back pain
Back pain is a very common condition, albeit a uniquely experienced one. Ranging from the dull or throbbing aches of spine osteoarthritis to the shooting, sharp pain of a ruptured disc, back pain can also come and go, be constant, worsen with exercise or prolonged sitting, and/or be associated with neurological symptoms like numbness and tingling. While back pain can be frustrating and debilitating, the upside is that the majority of episodes of back pain improve or resolve with minimal care, and usually within a few weeks.
Illustration by Alexandra Gordon, Verywell
There are multiple potential causes for back pain. Here are some of the more common causes, although this is not an exhaustive list.
Bulging and Ruptured Disc
Over time, the bulging disc (without treatment) can eventually tear. When a disc tears, its inner content (nucleus pulposus) is released, which compresses nearby nerve roots or the spinal cord itself. A torn disc is called a ruptured disc or a herniated disc.A ruptured disc in the lower back causes sharp back pain that may move down into the buttocks, groin, and/ or down one leg. Likewise, a ruptured disc in the neck may cause pain that moves down an arm. Besides pain, a herniated disc may cause neurological symptoms like muscle weakness, numbness, and tingling.
Osteoarthritis can affect any joint in the body, including the small joints of the spine (called vertebral or facet joints).Spine osteoarthritisoccurs as a result of “wear and tear” of the cartilage located between the spine’s joints. As the cartilage wears away, a dull, aching, or throbbing pain that is worse with movement may develop. An unpleasant feeling of crepitus (a popping sensation) may be felt as the cartilage wears away completely and the joints begin rubbing against each other. Joint stiffness and a limited range of motion may also occur with spinal osteoarthritis.As spine osteoarthritis progresses, the body makes new bony growths to stabilize the joint. These bone spurs can eventually compress nearby spinal nerve roots, causing numbness and tingling, similar to that of a ruptured disc.Besides the natural process of aging, obesity may contribute to the development of spine osteoarthritis, as the excess weight places additional stress on the vertebral joints.
Spondylolysis and Spondylolisthesis
Less commonly, back pain is due to a whole-body (systemic) illness, such as ankylosing spondylitis, or something more alarming, like a tumor or infection.
Ankylosing Spondylitis (AS)
Cauda Equina Syndrome
When to See a Doctor
Most episodes of back pain last a few days and have completely resolved within a few weeks. If you have new back pain, you should contact your doctor to see if you need further evaluation. There are also a few warning signs that may indicate a problem that needs immediate evaluation:
- Your back pain persists beyond a few days
- Your back pain awakens you at night
- You have difficulty controlling your bowels or bladder
- You have a fever, chills, sweats, or other signs of infection
- Any other unusual symptoms
A detailed medical history and physical examination lay at the crux of diagnosing back pain, followed by imaging and labs if a person has “red flag” symptoms, like a fever, suggestive of a possible infection, or unexplained weight loss, suggestive of cancer or inflammatory arthritis like AS.
- Pelvic inflammatory disease
- Kidney infection
The most frustrating aspect of the treatment of back pain is that it often takes time for symptoms to resolve. Most individuals recover completely by simply avoiding stress to the back. Keep in mind, though, that this does not mean prolonged bed rest. Instead, slow and mild physical activity can improve recovery time.
Complementary and Alternative Medicine
- Massage therapy
- Tai Chi
- Chiropractic care
Supplements, like magnesium or vitamin D, may also help ease your back pain. However, be certain to speak with your doctor before taking any vitamins, herbals, or supplements to ensure they are right and safe for you.
Back pain is one of the most common and uncomfortable ailments. The upside is that there are several strategies you can undertake to prevent the onset of and/or progression of back pain.
- Maintaining a healthy weight
- Engaging in an exercise program that strengthens your core muscles and is gentle and low impact (for example, swimming, walking, yoga, or Pilates)
- Practicing good posture and body mechanics (e.g. lifting by bending your knees, rather than your waist)
- Sleeping on a bed that supports your spine well
- Avoiding harmful habits like smoking