Back Pain

Back Pain

Back pain is one of the most common reasons people go to the doctor or miss work, and it is 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. Surgery is rarely needed to treat back pain.

Signs and Symptoms

Signs and symptoms of back pain can include:

  • Muscle ache
  • Shooting and /or stabbing pain
  • Pain that radiates down your leg or buttocks (sciatica)
  • Pain that is worse with bending, lifting, standing or walking
  • Pain that improves with reclining
  • Pain on one side of the back of the hip (sacroiliac joint mediated pain)

When to see a doctor?

Most back pain gradually improves with home treatment and self-care, usually within a few weeks. If yours doesn't improve in that time, see your doctor.
In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:

  • Causes new bowel or bladder problems (meaning serious complication or emergency)
  • Is accompanied by fever meaning possible infection
  • Follows a fall, blow to your back or other injury meaning possible ruptured disc or vertebral compression fracture.

Contact our doctors if your back pain:

  • Is severe and doesn't improve with rest
  • Spreads down one or both legs, especially if the pain extends below the knee
  • Causes weakness, numbness or tingling in one or both legs, meaning the nerves might be compressed.
  • Is accompanied by unexplained weight loss possible chronic mild infection or cancer.

Also, see your doctor if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or excessive drug or alcohol use.

One side back pain

The pain may come on suddenly, as a sharp stitch on the left side of your back. Or it may throb to life on your right or left side.
Some 80% of the population in the U.S. will have a back problem in their lifetime, and Americans spend upwards of $50 billion a year treating it, according to the American Chiropractic Association.
That pain can radiate from the bones, joints, ligaments, muscles, or a combination of sources. Lifestyle plays its part in back pain, too. Everything from sports injuries and poor posture to obesity and psychological stress can contribute to back pain.
When the pain is isolated to one side, though, you may wonder what exactly is going on. The pain could represent something minor from which your body will heal itself, or it could indicate a more serious condition.

Tissue Injuries

Injuries to the spinal structures can happen in the muscles, discs, or joints, and make up the most common cause of back pain on just one side. They often occur after minor injuries or from an impact in sports or a car accident.
Tissue injuries typically cause pain central to the spine, but they can lead to pain entirely on either the right side or the left side of the back. And of tissue injuries overall, muscle strains are the most common cause of lower back pain on one side.
Poor posture is another possible culprit for this type of one-sided back pain, according to Dr. Tucker. “Typically, when you sit, everything should be at a 90 degree angle: knees, ankles, hips, and elbows,” he explains.

What is the anatomy of the low back?

To understand various causes of low back pain, it is important to appreciate the normal design (anatomy) of the tissues of this area of the body. Important structures of the low back that can be related to symptoms in this region include the bony lumbar spine (vertebrae, singular = vertebra), discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
The bony lumbar spine is designed so that vertebrae "stacked" together can provide a movable support structure while also protecting the spinal cord from injury. The spinal cord is composed of nervous tissue that extends down the spinal column from the brain. Each vertebra has a spikes that are bony prominences behind the spinal cord, which shields the cord's nervous tissue from the impact of trauma. Vertebrae also have a strong bony "body" (vertebral body) in front of the spinal cord to provide a platform suitable for weight bearing of all tissues above the buttocks. The lumbar vertebrae stack immediately atop of the tail bone meets the iliac bone of the pelvis to form the sacroiliac joints of the buttocks.
The discs are pads that serve as "cushions" between the individual vertebral bodies. They help to minimize the impact of trauma on the spinal column. The nerves that provide sensation and stimulate the muscles of the low back as well as the lower extremities (the thighs, legs, feet all the way to the toes) all exit the lumbar and sacral spinal column through bony portals, each of which is called a "foramen."
The uterus and ovaries are important pelvic structures in front of the pelvic area of women. The prostate land is a significant pelvic structure in men. The kidneys are on either side of the back of the lower abdomen, in front of the lumbar spine.
The skin over the lumbar area is supplied by nerves that come from nerve roots that exit from the lumbar spine.

What is the function of the low back?

The low back, or lumbar spine, serves a number of important functions for the body. These functions include structural support, movement, and protection of certain body tissues and nerves.
When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.
Protecting the soft tissues of the nervous system and spinal cord as well as nearby organs of the pelvis and abdomen is a critical function the lumbar spine and adjacent muscles of the low back.

Most common causes of lower back pain

Common causes of low back pain (lumbar backache) include lumbar strain, nerve irritation, or sciatica, bony encroachment, and conditions of the bone and joints. Each of these is reviewed below.
Lumbar strain (acute, chronic): A lumbar strain is a stretch injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft-tissue injury is commonly classified as "acute" if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as "chronic." Lumbar strain most often occurs in people in all age groups.
The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues. The severity of the injury ranges from mild to severe, depending on the degree of strain and resulting spasm of the muscles of the low back. The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, X-ray testing is only helpful to exclude bone abnormalities.

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