About Back Pain

Back pain is a symptom of a strain, sprain, spine disorder or condition affecting organs in your pelvis or belly. Pain can range from mild to severe, and it may spread to your legs or elsewhere. A healthcare provider can identify the cause of your back pain and recommend treatment to help you find relief.

What is back pain?

Back pain is discomfort you feel anywhere along the back of your body, from the base of your neck to the top of your butt. It’s a common symptom of many different underlying injuries and conditions. Back pain is one of the top reasons why people visit healthcare providers.

Types of Back Pain

Back pain is generally classified by duration and cause:

• Acute back pain: Sudden onset, lasting a few days to weeks.
• Subacute back pain: Lasts 4 to 12 weeks.
• Chronic back pain: Lasts longer than 12 weeks and may be constant or intermittent.
• Specific types include:
  • Flexion dominant back pain: Worsens with sitting, bending, lifting; improves with standing and walking.
  • Neurogenic claudication: Caused by nerve compression, common in older adults, characterized by leg pain or weakness triggered by walking and relieved by sitting or bending forward.

Back Pain Signs and Symptoms

Back pain can feel different depending on its cause. You might describe your pain as:

• Burning
• Aching
• Dull
• Sharp
• Shooting
• Stabbing
• Throbbing

You may also experience:

• Muscle tightness or stiffness
• Tingling, numbness or weakness
• Sudden muscle twitches or contractions, which can range from mild to extremely painful (back spasms)

Pain or other sensations may spread (radiate) from your back to other areas, like your butt, hips or legs.

Certain positions (like standing up, bending over or lying down) may worsen or improve your symptoms. Pain may come and go. It may be worse at certain times of the day (like when you first wake up).

Back Pain Causes

Back strains and sprains are the most common causes of back pain. These injuries can occur suddenly (that “ouch” moment) or over time. Strains and sprains affect different parts of your back:

• Strains are injuries to your muscles or tendons. They can occur from a single event (like lifting a heavy object) or from prolonged, repetitive movements (like constantly bending down at work).
• Sprains are injuries to your ligaments. They typically occur after a sudden fall, twist or blunt force injury that stretches a ligament beyond its normal range of motion.

With a strain or sprain, you may notice:

• Muscle spasms
• Pain that gets worse when you move
• Decreased range of motion (it’s hard to walk, bend or stand like you normally would)

For a sudden injury, you might hear a pop or feel a tearing sensation right when it happens.

Other back pain causes

Besides strains and sprains, there are many other possible causes of back pain. These fall into several main groups:

• Mechanical or structural problems in your back
• Conditions that cause referred back pain (pain you feel in your back due to a problem somewhere else in your body)
• Infections
• Tumors

Mechanical or structural problems in your back

These are issues with any of the following:

• The bones that make up your spine (vertebrae)
• The flat, round cushions between your vertebrae (intervertebral disks)
• The soft tissues surrounding your vertebrae and discs, including muscles, tendons and ligaments

Examples of mechanical or structural problems that cause back pain include:

• Arthritis. There are several forms of arthritis that can affect your back, including osteoarthritis and ankylosing spondylitis. You may feel pain and stiffness in your lower back, with additional symptoms depending on the type of arthritis.
• Degenerative disk disease. You may feel pain in your lower back that extends into your arms, legs or butt. The pain may come and go or get worse after certain movements, like bending or twisting.
• Fractured spine. Sudden injuries that cause spinal fractures involve sharp, intense back pain that may get worse as you walk or move.
• Herniated disk. The damaged disk may press on nearby nerves, causing lower back pain and sharp, shooting pain down one side of your butt and leg (sciatica). Herniated disks can lead to cauda equina syndrome, which is a medical emergency.
• Myofascial pain syndrome. You may have aching, throbbing or vice like pain, trigger points, weak muscles and/or other symptoms.
• Sacroiliitis. Inflammation leads to lower back pain, which may spread into your butt, hips or thighs.
• Scoliosis. This abnormal curvature of your spine can, in severe cases, cause back pain, trouble standing upright, leg pain, numbness or weakness.
• Spinal stenosis. Lumbar (lower back) spinal stenosis and related “pinched nerves” can cause lower back pain, sciatica, a heavy feeling in your legs, and pain that worsens with prolonged standing or walking.
• Spondylolisthesis. You may have lower back pain, muscle spasms in the back of your thigh, pain when bending over, and trouble walking or standing for long periods.
• Spondylosis. The most common symptom is lower back pain, which typically spreads into your thigh and butt. The pain gets worse when you move and eases when you’re less active or resting.

Back Pain Risk Factors

Several factors increase the likelihood of developing back pain:

• Age (common after 30-40 years, more so after 45).
• Poor physical fitness and weak core muscles.
• Obesity adds stress to the spine.
• Jobs involving heavy lifting, twisting, or prolonged sitting with poor posture.
• Genetic predisposition to certain spinal disorders.
• Race (e.g., higher risk of spondylolisthesis in African-American women).
• Smoking, which impairs healing and increases risk of nerve-related back pain.
• Other diseases such as arthritis and cancer.

Back Pain Complications

• Reduced Productivity and Disability: Back pain is a leading cause of disability among working adults, often resulting in missed workdays and decreased efficiency. 
• Nerve Damage: Conditions like herniated discs can compress spinal nerves, causing weakness, numbness, or sharp pain radiating to the legs. ​
• Depression and Anxiety: Persistent pain can disrupt daily life, leading to psychological distress, including depression and anxiety. ​
• Weight Gain and Muscle Loss: Limited mobility due to pain can lead to weight gain and muscle atrophy, further exacerbating back issues.
• Postural Changes: To avoid discomfort, individuals may adopt poor posture, leading to muscle imbalances and additional strain on the back

Back Pain Diagnosis

• Medical History & Physical Exam: A thorough review of symptoms and a physical examination help assess posture, range of motion, and neurological function.​
• Imaging Tests: X-rays, MRI, and CT scans are used to detect structural issues like fractures, herniated discs, or spinal stenosis.​
• Electrophysiological Tests: Electromyography (EMG) measures electrical activity in muscles to identify nerve compression or damage.​
• Bone Scans: These scans detect bone abnormalities such as fractures, infections, or tumors by highlighting areas of increased bone activity.​
• Blood Tests: Laboratory tests can reveal infections, inflammation, or other systemic conditions contributing to back pain.

Back Pain Treatment

Treatment depends on the cause and severity but includes:

Medications:

• Over-the-counter pain relievers and anti-inflammatory drugs.
• Muscle relaxants.
• Numbing or anti-inflammatory injections.
• Neuromodulatory agents for nerve-related pain.
• Prescription painkillers, including opioids, used cautiously and typically short-term.

Physical therapy and exercise:

• Core strengthening, stretching, posture retraining.
• Aerobic exercises tailored to individual comfort.
• Home exercise programs to maintain spine strength and flexibility.

Lifestyle Modifications:

• Weight management through diet.
• Avoiding prolonged poor posture.
• Mindfulness, meditation, and cognitive therapies for chronic pain management.

Alternative therapies:

• Acupuncture, massage, biofeedback, laser therapy, electrical nerve stimulation

Note. Medication is only adviseable under doctor’s conserderation.

Surgery:

• Reserved for severe cases with structural problems or nerve compression not relieved by conservative treatment.