Having a backache is not uncommon. In fact, about 80 percent of people in this country will have some type of injury or other condition that results in a backache at some point in their life.
Lower back pain is just about the biggest reason that people miss work or visit their doctor.
Luckily, 80 percent of these backaches will go away on their own or can be reduced with simple things that can be done at home or by some non-invasive mainstream treatments.
Surgery is always a last resort to solving back pain issues and is not often required.
There are a number of things that can cause a backache and there are simple preventative measures that can be taken every day to avoid having back issues.
Backaches are sometimes referred to as low back pain or lumbar pain since this is the most common area in which backaches occur.
Causes of Backaches
There are any number of reasons you may suffer from a backache. The source of the pain can be muscles or ligaments, nerve damage, disc issues, or decompression of the spine.
The most common causes of backache are
A sprain or strain
A sprain happens when ligaments in the back, usually the lower back, is injured. A back strain is the result of injured muscles. With a sprained ligament or a muscle strain these soft tissues have stretched too much or have even been torn. These injuries can easily be caused with improper lifting, bad posture, or being overweight.
This often results when fluid it lost from the discs as the body ages. Loss of fluid makes the discs become dry which can cause them to crack. When this happens, chemicals leak out of the disc into the spinal canal and irritate the ends of the nerves, resulting in back pain.
Another common affect of the aging process, spinal stenosis, is the pain caused by pressure on the nerves when the spinal cord narrows.
Facet joint syndrome
The facet joints are the part of the spine that allow for movement. Each of the nerves in the spinal cord has small branches that come out through these joints. If any of the bones in one of these joints rub together or if there is some type of inflammation, the nerves send out pain signals. This type of pain occurs most commonly in the lower lumbar section of the back.
This type of pain usually results when disc degeneration irritates the sciatic nerve. The pain starts in the back and ultimately extends to the thigh and the outer leg.
In the spine, osteoarthritis can cause stiffness and pain in the neck or in the lower back. This condition often leads to spinal stenosis.
Aging can cause the bones in the spine to become spongy and brittle. This can eventually cause compression fractures
Symptoms of a backache often depend on the underlying cause. Symptoms can be:
- Muscle ache or spasms
- Stabbing or shooting pain
- An electrical shock sensation
- Pain that extends from the back down the side, back, or front of the leg
- Limited movement and flexibility
- Being unable to stand up straight
Sometimes the pain from a backache can get worse with any kind of activity or may be worse at night or when sitting for a long time. Depending on the cause of the backache, there can occasionally be weakness or numbness in a leg affected by a compressed nerve. This can result in the inability to flex the foot upward or downward or raise the big toe.
To avoid recurrent backaches there are a number of risk factors. Not all of these things can be avoided, but many are lifestyle issues that can be corrected.
Smoking – Smoking can make you one-and-a-half to two-and-a-half times more apt to have backaches because it decreases the blood supply to the back. A lower blood supply can make the discs less elastic and lead to degeneration.
Body Weight and Body Size – Obesity is one of the largest risk factors for backache. A lot of additional weight puts more pressure on the spine and can bring on degenerative disc disease and other back problems.
For women, having large breasts can placde extra strain on the back ligaments and muscles and cause pain in the upper back.
Aging – As the body grows older the back changes. The vertebrae get thicker and the discs dry up and lose shape. This results in a narrower spinal canal causing excess pressure on the spinal cord and nerves. All this can add up to pain.
Other risk factors for backaches include certain occupations that are physically strenuous and jobs that are sedentary like those that involve sitting in front of a computer all day.
Since there are statistics that show there is an 80 percent chance of something happening that will cause a backache, it makes sense to start implementing the measures that may lower your chances.
Most of these are simple things based on improving your overall physical conditioning and the mechanics of your body.
Low impact exercise like swimming and walking can do wonders to strengthen the muscles in your back.
Exercises that build muscles and improve flexibility are very important for making a stronger back that is less likely to have pain. When all of these muscles are strong they can more easily keep the spine stable. Yoga is one of the best ways to improve your flexibility and strengthen muscles.
Pilates exercises concentrate on the muscles in the trunk of the body. When all of these muscles are strong, they can more easily keep the spine stable. There are a number of other core strengthening exercise programs that are ideal for the back.
It is always important to stretch before any physical workout. But there are a number of stretches you can do any time to keep the back muscles in the lower back more flexible. One such example is lying flat on the floor with the knees bent and bringing one knee at a time to the chest and holding it in position for 10 seconds.
This refers to ensuring that the posture when sitting and lying down as well as standing is correct.
Poor posture is a big cause of lower backaches because when the spine is not in proper alignment, the ligaments, muscles, and joints in the back are stressed.
Bad posture can cause muscle strain and ultimately a backache.
The proper posture when standing is to be sure that the middle part of your head, your shoulders, torso, knees, and feet are lined up.
While sitting you should make sure that your bottom is somewhat forward in the chair. Having the body at 90 degrees while sitting is not good posture.
If you lay on your back, it is best to put a pillow under your knees. A pillow should also be placed between your knees when you lay on your side. The pillow keeps the spine properly aligned. You should really never sleep on your stomach as this make the back arch and your head turn to the side.
Always bend at the knees so that the legs do the bulk of the lifting. Keep the back straight and hold the object close to the body.
Test and Diagnosis
Most backaches will heal on their own or with home remedies given enough time. But if the pain has gone on for more than four to six weeks, it may be time for a professional opinion from a doctor.
For doctors, determining the actual source of a backache can be frustrating. A doctor has no way to quantify pain and when a physiological reason can’t be readily found, it is difficult to define a specific treatment.
However, often times a bevy of diagnostic tests are not required. Simple things like examining your back and ascertaining how well you can sit, stand, walk, and lift up your legs as well as testing your reflexes can help the doctor find out what part of the back the pain is coming from.
Finding out just how much you can do before the pain becomes too great may aid in eliminating some of the more serious possibilities.
If there are some specific conditions that the doctor believes could be causing your backache such as a fracture or disc problems, you may require testing such as:
An x-ray can show if there is a broken bone or if you have arthritis. It can also show the alignment of the bones in the spine. X-rays cannot, however, reveal problems with muscles, nerves, spinal cord, or discs.
MRI or CT
A magnetic resonance imaging or computerized tomography scan can show if there are any herniated discs or issues with muscles, bones, tissues, tendons, nerves, ligaments, or blood vessels in your back.
An electromyography (EMG) is used to measure the electrical impulses that the nerves make and the way in which the muscles respond to them. This test can confirm if there is a compressed nerve from a herniated disc or stenosis.
Tests used less frequently are blood and urine tests to look for an infection and bone scans to test for a compression fracture.
Since the majority of all backache pain will go away with time and care, there are certain things you can do at home to speed it along. If the pain remains and you visit a doctor, most mainstream treatments will take care of the pain, but some people prefer to use alternative, more natural treatments.
Surgery is usually the last option for treatment and is usually only recommended when all other traditional treatments have been tried and have failed.
Backaches are often the result of things like twisting the back awkwardly during some activity, lifting incorrectly, or even playing a sport or exercising. There are several things you can do to treat yourself at home that can help with the pain.
Taking an anti-inflammatory like ibuprofen can ease the pain and help the back heal quicker. An anti-inflammatory has ingredients that can both lessen the pain and reduce the swelling that may be the cause of the pain.
If the pain comes on suddenly and is debilitating, it is a good idea to rest in bed for the first 24 hours or so on your back with your knees up or on your side in the fetal position.
Even during a day of bed rest, you should get up and move around occasionally. Light stretches like those used to prevent back issues should be done to keep the muscles from tightening up.
When a backache first appears, apply ice two or three times a day for the first day or two. After that, you should apply moist heat with a heating pad. By the 4th day, if the backache still persists, alternate heat in the morning and ice at the end of the day before bed.
Pharmaceutical and other Mainstream Treatments
Depending on the diagnosis a doctor may provide, there are a number of different treatments that he or she may prescribe.
Physical therapy is a conventional method of treatment for back pain and probably the most prescribed by doctors. Pain that lasts beyond one month is often treated with physical therapy. This is a very effective way to reduce your pain and help you regain mobility and function.
Physical therapy usually starts with what is called “passive” therapy in which the therapist may use a variety of treatments on you to help reduce the pain. These treatments may include heat and ice, electrical stimulation, techniques to release the muscles, and even ultrasound.
Once the pain is better you go on to the “active” therapy. The therapist will teach you exercises that will improve your posture, increase the flexibility in your back, and strengthen the muscles in the back and abdomen.
Chiropractic, once considered an alternative therapy to treat backaches and other back-related issues, is now very commonly used. The belief of chiropractic is that if something is restricting the movement of the spine, pain will be the result. Chiropractors use their hands to manipulate the spine and return it to the proper position. They include massage and stretching techniques to help the muscles in the back to relax.
Back doctors will often use injections to relieve the pain from a backache. They can also be an excellent way to diagnose what the problem is because of the way the pain responds or not to the injection.
Different injections that can be used include
- Nerve blocks
- Lidocaine combined with saline
These injections are done directly into the spine and can help with severe bouts of pain. The saline mixed with the lidocaine in an injection can aid in flushing out the inflammation that may be causing the pain.
Side effects are minimal with these traditional treatments and in most cases health care insurance will pay for physical therapy or chiropractic treatments that are prescribed by a doctor.
Massage therapy can be very helpful in getting rid of a backache. Muscles that are in spasm often are at the root of back pain. Muscle spasms can occur when there is not enough blood flowing into them. Massage therapy relaxes the muscles, thus releasing built up lactic acid. When the lactic acid is released, the muscles are able to receive more blood and oxygen.
Many people swear by Traditional Chinese Medicine and acupuncture. This involves the inserting of sterile stainless steel needles into points on the body that are connected to the painful area. It is believed that the normal flow of energy is restored to that area, relieving the pain.
There are some dietary supplements that contain certain herbs that have the properties of an anti-inflammatory that can reduce backache pain. These include willow bark and devils claw. Capsicum made into a plaster that is applied topically can also help with pain and inflammation.
There are few known side effects of any of these treatments and cost is minimal as compared to more mainstream treatments.
Ultimately, there are certain back problems that can cause chronic backache that do require surgery to correct. Generally, surgery can be of benefit when the pain is radiating beyond the back because of a compressed nerve. Surgery is also used when there are structural issues with the back that have not been helped with more conservative treatments.
Some of the more mainstream back surgeries include:
A discectomy can be performed to take out the part of a herniated disc that is applying pressure to a nerve. The rest of the disc is left as it is so that it can continue to absorb the shock between vertebrae. This surgery can be done traditionally, requiring a long incision and general anesthesia. However, there are techniques that use x-ray imaging and a small probe that require only small incisions and less recovery time.
Spinal fusion surgery is used when the pain is caused by the movement between vertebrae due to an injured disc or degenerated disc. A spinal fusion can also be done to connect two adjacent bones in the spine in order to stabilize a break.
This is the type of procedure performed to relieve the pain caused by spinal stenosis. During the surgery, the part of the bone in the spinal canal that is applying the pressure on the nerve is removed. This widens the opening and relieves the pressure.
Surgery is the treatment option with the most possible side effects and the highest cost. After spinal fusion surgery, for example, it is possible to experience degeneration in the areas that are adjacent to the fused segment.
Cost may depend on where you live and the size of the city. More minor surgeries done on an outpatient basis can run between $5,000 and $9,000. Back fusion averages around $14,000 and a laminectomy to correct stenosis can be over $75,000. Depending on your health insurance coverage, the costs to you can be considerably lower.