Acute and Chronic Back Pain
What is back pain?
Back pain is one of the most common reasons people go to the doctor or miss work and a leading cause of disability worldwide. Most people have back pain at least once. Fortunately, you can take measures to prevent or relieve most back pain episodes. If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.
What are the symptoms of back pain?
Signs and symptoms of back pain may include: Muscle ache, Shooting or stabbing pain, Pain that radiates down your leg, limited flexibility or range of motion of the back
What causes back pain?
Back pain can come on suddenly and last less than six weeks (acute), which may be caused by a fall or heavy lifting. Back pain that lasts more than three months (chronic) is less common than acute pain.
Back pain often develops without a specific cause that your doctor can identify with a test or imaging study. Conditions commonly linked to back pain include:
Muscle or ligament strain: Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments. If you’re in poor physical condition, constant strain on your back may cause painful muscle spasms.
Bulging or ruptured disks: Disks act as cushions between the bones (vertebrae) in your spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally when you undergo spine X-rays for some other reason.
Arthritis: Osteoarthritis can affect the lower back. In some cases arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
Skeletal irregularities: Back pain can occur if your spine curves abnormally. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain, but generally only if the scoliosis is severe.
Osteoporosis: Your spine’s vertebrae can develop compression fractures if your bones become porous and brittle.
How is back pain diagnosed?
If you see your doctor for back pain, he or she will examine your back and assess your ability to sit, stand, walk and lift your legs.
These assessments help determine where the pain comes from, how much you can move before pain forces you to stop and whether you have muscle spasms. They will also help rule out more-serious causes of back pain.
If there is reason to suspect a specific condition may be causing your back pain, your doctor may order one or more tests:
X-ray. These images show the alignment of your bones and whether you have arthritis or broken bones. These images alone won’t show problems with your spinal cord, muscles, nerves or disks.
MRI or CT scans. These scans can generate images that may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
Blood tests. These can help determine whether you have an infection or other condition that might be causing your pain.
Bone scan. In rare cases, your doctor may use a bone scan to look for bone tumors or compression fractures caused by osteoporosis.
Nerve studies (electromyography, or EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).
How is back pain treated?
Most acute back pain gets better with a few weeks of home treatment. Over-the-counter pain relievers and the use of heat or ice might be all you need. Bed rest its no longer commonly recommended.
Typically it is best to continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain, but don’t avoid activity out of fear of pain. If home treatments aren’t working after several weeks, a thorough examination and evaluation by a trained Interventional Pain Physician can help determine the source of your back pain and treatments can be performed targeting the pain generator. These treatments may include various injections, medications, physical therapy, and possibly surgery.