Back Pain (Lower and Upper) : Symptoms, Causes, Treatment, Diagnosis and Prevention

Overview

Back pain is a common health problem experienced worldwide from various demographics and lifestyle backgrounds. Currently, professionals across many industries suffer from this problem. However, low back pain is most common among software professionals, mainly because of the nature of their work, fitness-related issues, and lifestyle.

Back pain can be caused by activity, injury and some medical problems. It can affect people of any age, for various reasons. With age, the chances of developing lower back pain raise, due to factors including previous job and degenerative disk disease. Studies say that almost 90% of back pains do not require surgery. They get better on their own. However, you must seek medical help if you experience it.

What Are the Symptoms of Back Pain?

There can be numerous causes. Some include poor lifestyle habits, and others include muscle strains, sports injuries, accidents, etc. The reasons for back pain may differ, but the symptoms are common to all.

Some of the common symptoms are:

• Continuous stiffness along the spine. The most affected areas are the base of the neck and the tailbone.
• Intense pain in the neck, upper back, or lower back, especially after heavy lifting or involvement in strenuous activity. However, if you feel pain in the upper back, it could needs to be investigated for more serious underlying causes . Immediate action needs to be taken in such situations.
• Chronic pain in the lower back after sitting or standing for long
• Back pain that radiates from the low back to the buttock and thighs
• The incapability of standing straight without having muscle spasms in the lower back

Causes of Back Pain

Our back consists of a complex structure of bones, muscles, disks, tendons, and ligaments that work in tandem to support our body and enable us to move around. While there are many reasons back pain is mainly caused by, in some cases the cause of the back pain remains unclear.

Back pain is mainly caused by tension, disc surgery , strain or injury. In addition, our spine segments are cushioned with disks, cartilage-like pads. Problems with any of these components may cause back pain. Damage to the disk can result from medical conditions, strain including poor posture, among others. Problems with the spine such as osteoporosis can also lead to back pain.

Common back pain causes include:

• Muscle spasm
• Disc Herniation
• Muscle tension
• Hip arthritis
• Falls, fractures or injuries
• Strained ligaments or muscles
• Damaged disks

Activities that can lead to strains or spasms include:

• Lifting too heavy things
• Lifting something improperly
• Making a sudden and awkward movement
• Structural Conditions

Structural Conditions

A number of structural conditions may cause back pain including:

• Bulging disks: Our spine’s vertebra is cushioned by disks. If the disk bulges or ruptures there will be more pressure on a nerve.
• Ruptured disks: Similar to bulging disks, a ruptured disk can result in more pressure on a nerve.
• Sciatica: A shooting, sharp pain that travels through the buttock towards the back of your leg, which is caused by a herniated or bulging disk pressing on a nerve.
• Arthritis: Arthritis may cause problems with the joints in the lower back, hips and other places. In a few cases, back pain can be due to spinal stenosis, narrowing of the space around the spinal cord tumor.
• Kidney problems: Kidney infections, hemodialysis or stones in the kidney can cause back pain.
• Movement and posture: A few everyday activities or poor posture may also lead to back pain. For example, bending too low or a much hunched sitting position while using computers may cause an increased shoulder or back pain over a period of time. Other examples include:
• Sneezing or coughing
• Twisting
• Over-stretching
• Bending for a long time or bending awkwardly
• Pulling, pushing, carrying or lifting something
• Straining the neck forward (like while using a computer or driving)

Other Back Pain Causes

Some medical conditions may also lead to back pain:

• Shingles: Shingle is a viral infection of the nerve that causes painful skin rashes. Depending on the affected areas, such skin diseases may lead to back pain.
• Sleep disorders: People suffering from sleep disorders are more prone to experience insomnia, back pain, compared to others.
• Infection of the spine: Spine infection can be due to a fever that may lead to back pain. Also, you can develop back pain owing to a tender, warm area on the back, which could be due to an infection of the spine.
• Cancer of the spine: A cancerous tumor on the spine may press against the nerve, which may lead to back pain.
• Cauda equina syndrome: This occurs when cauda equine, the bundle of nerves from the lower end of the spinal cord stimulation, is damaged. Symptoms may include a dull pain at the upper buttocks and in the lower back, including numbness in the thighs, genitalia, and buttocks. This condition may sometimes cause bladder and bowel disturbances.
• Other infections: Kidney, bladder infections or pelvic inflammatory disease may also cause it.

Who experiences back pain?

Back pain is not a disease per se. It is a commonly identified symptom of various diseases. Issues with discs, nerves, ligaments, muscles, intervertebral discs or vertebrae themselves can cause severe back pain. Problems with kidneys may also contribute to this. So, anyone with medical conditions related to the above organs may experience back pain.

Back pain and Pregnancy

Back pain is a constant companion of most pregnant women and the reasons are myriad. Some of them are: 

• Weight gain: An expectant mother is expected to put on weight to support the growth of the baby in the womb. Even though this weight gain is healthy, it may cause strain on the mother’s back, causing back pain. 
• Force of gravity: As the womb of a pregnant woman grows, the centre of gravity of the woman’s body grows outwards. To support this, the spine of the mother arches, putting more pressure on the back. 
• Hormonal changes: As a woman approaches delivery, her body releases hormones that make her ligaments loose and the spine shift to allow smooth delivery. This may also result in back pain in pregnant women.  

What Are Some Lifestyle Factors That Contribute to Back Pain?

Some of the most common lifestyle habits and activities are:

• Driving: Driving for long periods results in a sore lower back. Commuting for long hours while travelling to work is one of the major causes of back pain. Hence, it is important to maintain the right posture while driving.
• Wrong sleeping positions: Wrong positioning of the spine while sleeping causes back pain over time. This is commonly seen in stomach sleepers.
• Sports: Playing sports like golf and tennis causes a significant strain on the lower back. For example, Golfers usually coil their bodies, which creates tension on the sides.
• Smoking: Research studies have also established a strong link between smoking and lower back pain.
• Taking the stairs: Taking stairs frequently exerts stress on the back and knees.
• Sitting all day long: Sitting at your desk for long hours without a break can cause both back and neck pain.
• Lifting grocery bags or other heavy objects: Heavy lifting can also result in back issues. If you do not carry your heavy purse, grocery bag, or even a backpack the right way, it has good chances of resulting in back pain.

How Can the Cause of Back Pain be Diagnosed?

Usually, the healthcare provider makes the diagnosis after conducting a physical examination of the patient along with studying the symptoms. But in some cases, other tests may be required to correctly determine the diagnosis. Some tests that are commonly done are: 

• X-rays: This imaging test can help the healthcare provider find broken or arthritic bones. The doctor can also check whether the alignment of bones is right. 

• CT or MRI scans: This imaging test helps to find out issues with muscles, tendons, ligaments, blood vessels, nerves and tissues. 

• Electromyography: This test measures the electrical impulses produced by nerves to check whether they are not in a compressed state. If they are compressed, a herniated disk or spinal stenosis may be diagnosed.

   

• Blood Check: A blood test may be done if the doctor suspects an infection at the back. 

A chiropractor, an osteopath or a physiotherapist may also diagnose the cause of back pain using different methods. A chiropractor diagnoses through touch and visual inspection and focuses on adjusting the joints of the Spine. They may also ask for imaging or blood test result to confirm the case. An osteopath also diagnoses through visual inspection and palpation but they focus more on the mobilization and manipulation of joints and muscles. A physical therapist majorly works on the soft tissues and joints of the body. 

When Should You See a Doctor?

Those mentioned above are some important yet simple lifestyle changes that you can consider. Try these routine changes and see which one works best for you. However, you must consult your doctor before the condition worsens.  You should visit your doctor in any of the following cases:

• If pain occurs frequently.
• If pain persists for over six weeks.
• If back pain radiates to other parts of the body like arms or legs.
• If back pain interferes with daily activities like walking, sitting, and bending.

Bringing lifestyle changes helps reduce the level of pain. But, if you are experiencing acute pain, lifestyle changes may not bring expected results.

Make an appointment soon. Depending on your needs, the doctor will suggest a quick test to identify the cause.

Book An Appointment.

Preventions for Back Pain

You can avoid back pain and can also prevent its recurrence by practicing proper body mechanics and improving your physical condition. You can keep your back healthy and strong by the following actions:

Enhance muscle strength and flexibility.

You can start with abdominal and back muscle exercises that strengthen your core, help condition muscles so they can work together to strengthen your back. Your doctor or a physical therapist can tell you what exercises may work for you.

Posture

The way you hold your body is important for maintaining the right posture. Avoid slouching and focus on keeping a good posture while sitting or standing. Do not curve your body unnecessarily. Follow these tips to improve posture:

• Make sure your workspaces are at a convenient height.
• Adjust the seat in a way so that it is comfortable while working.
• Sit upright and straight.
• Move around and stretch your muscles regularly.
• Place a pillow behind the lower back while sitting to improve support.

Most of the back pains are mechanical in origin, meaning repetitive stress to your back like awkward or static postures, prolonged sitting, bending forward, standing and carrying heavy loads are some of them that may lead to sprains to the lower back.

Stretching

The lower back needs to be nurtured and stretched the most.  Try some neck and shoulder stretches every few hours to avoid stiffening up. They are great for relieving tension.

• To relieve pain and pressure, you may try Neck Flexion Stretch. The stretching is aimed at increasing the flexion range of motion of the neck. It also aids in supporting the back.
• Gently push your chin to the chest.  Repeat it several times a day to see optimum results.
• Neck retraction reduces spinal pressure. Place your fingers on your chin and push it far backwards. Do 3-4 sessions throughout the day.

Exercise regularly

Regular exercise provides strength to your back. Doing it consistently enables weight loss. You can also manage your stress level by exercising regularly. Make sure your routine exercises include stretching, balancing, and strengthening your back muscles.

Skip unhealthy habits

Unhealthy habits might not seem like they affect your back, but that is not the case. As mentioned above, smoking increases back pain. The same goes for drinking alcohol. Smoking reduces blood flow to your bones and soft tissues, which causes severe back pain. Drinking alcohol in excess raises the levels of inflammation, which also increases pain. Curbing, or in the least moderating, these habits will go a long way in preventing many ailments, including back pain.

Take care of your weight

Staying fit is an important aspect of reducing back pain. Excess weight causes stress on the spine muscles. For this reason, practicing a healthy diet along with exercises can help in reducing stress on your back in the long run.

Massage

Deep massage therapy relaxes muscles, promotes circulation, and releases endorphins. Getting a massage at regular periods can help speed up your recovery from chronic back pain.

Do not stress

When you are under stress, your muscles may tighten and contract. Relax, take a deep breath, and try chanting to stay away from stress.

Do not fall on your desk while at work

Sit upright in your office chair. Try and use the right posture while sitting and standing. Good posture keeps your back well supported, which is crucial to maintaining back health if you regularly sit for long hours.

Choose a chair with firm support for your lower back. Adopting a correct posture keeps your back pain-free.

Proper sleeping methods

Sleep for at least 6-7 hours daily to maintain good back health. Getting good sleep in a comfortable position reduces back pain and stiffness. Please make use of an orthopaedic mattress, as it provides much-needed support to the back.

Drive comfortably

While driving, carry a support pillow. Use lightweight bags for travel, so you do not have to strain your back while carrying them . Take breaks in between if you are travelling to a faraway destination. And do not forget to stretch now and then.

What is the treatment of Back pain?

Home Treatments

Taking pain relief or anti-inflammatory medication can help subside the pain. An icepack or a heat bag can be placed over the area of pain for relief. One can refrain from doing strenuous activities to avoid intensification of pain. But moving around is necessary to avoid the stiffness in joints and weakening of muscles. One should visit a doctor if the pain is not relieved with home treatments.

Medical Treatment

Medication: Take medications suggested by the healthcare provider if the pain is relieved by normal pain-relieving tablets. Muscle relaxants or anti-depressants may be prescribed if necessary.

Physical Therapy: Physical therapy includes all the techniques that release the muscle to reduce pain. Some of the techniques are applying heat or ice, ultrasound or electric stimulation, strengthening exercises and posture-improving techniques. Sometimes, the doctor may ask the patient to continue the therapy even when the pain has subsided to avoid its recurrence.

Cortisone Injections: Cortisone is an anti-inflammatory drug which is injected into the epidural space surrounding the spinal cord if the pain is not reduced with medication or therapies. It helps to reduce inflammation around the nerves or numbs the area that causes pain. 

Botox: These are also injections that are helpful in paralyzing the sprained muscles. The sprained muscles in spasm will be paralyzed with this injection to relieve pain. This injection may work for around 3 to 4 months. 

Traction: It is a method where pulleys or weights are used to help the back stretch and pushes the herniated disk back into its original position.

Cognitive Behavioral Therapy: This method of treatment works on the thought process of the patient. The therapists encourage patients with chronic back pain to think in new ways and maintain a positive attitude. Many studies have proven that the patients who undergo this therapy have become more active and continue strengthening exercises to stop the recurrence of the pain. 

• Complementary Therapies : Sometimes the doctor may prescribe some treatments that may be used along with existing treatments or alone. Such treatments are called complementary therapies. Below are some examples of it: 

• Chiropractic care: Chiropractors are the ones who majorly focus on spine. They can also treat muscle, joint and bone problems. 

• Acupuncture: Acupuncture is a traditional Chinese treatment practice which inserts sterilized needles at specific pain points. This helps in the release of natural pain killers called endorphins, thus reducing back pain. It also helps in stimulating nerve and muscle tissue. 

• Transcutaneous electrical nerve stimulation (TENS) : In this therapy, the doctor uses a battery-powered device on the skin. The device sends electrical impulses and studies say that these impulses stimulate the body to release endorphins and block the pain signals returning to the brain. 

• Shiatsu: A therapist who does Shiatsu treatment, applies pressure on fingers, thumbs and elbows which works along the energy lines of the body.
   
• Yoga: Yoga is a traditional Indian practice which involves forming different poses along with breathwork. These positions may also help in relieving back pain. But all poses are not suitable for people with pain and care should be taken while doing yoga. 

Upper Back Pain

The upper back pain can be due to spine inflammation, tumors in the chest and disorders of the aorta. Such pain mainly occurs due to poor posture for a long time or an injury that affects the thoracic spine’s sturdiness.

Lower Back Pain

Lower back pain may also be associated with the discs between the vertebrae, spinal cord and nerves, bony lumbar spine (lower spine), ligaments around discs and spine, lower back muscles, and the skin around the affected areas. In most cases, lower back pain gets better on its own in a couple of weeks. Painkillers and physiotherapy can help you manage the symptoms, mainly pain. Some people need surgery.

Surgery

Surgery is conducted on patients with back pain in very rare cases. Surgery may be recommended if the patient has a herniated disk or suffers from persistent pain due to nerve compression. The healthcare provider may perform any of the following procedures: 

• Artificial disk implantation: Discs are cushions between the vertebrae that function as shock absorbers. Damaged discs may get replaced by artificial discs through surgery.
• Diskectomy: This is a surgical procedure where a portion of disc is removed if it is compressing a nerve or is damaged. 
• Fusion: This is a surgical procedure where two vertebrae are joined together with a graft of bone in between. 
• Removal of vertebrae: If a particular portion of vertebrae compresses any nerve or parts of spinal cord, it will be removed through surgery. 

What are the risk factors of back pain?

Back pain is a condition which can happen to anyone irrespective of age and gender. But the following factors intensify the chances of it: 

• Smoking: It is observed that people who smoke have the tendency to get back pain. This may be because smoking decreases the blood flow to the spine area increasing the risk of osteoporosis. The habit of coughing, which is common in smokers, may also cause herniated discs resulting in back pain. 
• Improper lifting of weights: if one puts pressure on the back, instead of legs while lifting, it may cause back pain. 
• Obesity: Obesity or excess weight gain puts stress on the back leading to back pain. 
• Age: As a person ages, especially after 30, there are chances of getting back pain.
• Lack of exercise: The unused muscles in the back and the abdominal area may lead to back pain. 
• Diseases: Certain diseases such as arthritis and cancer can cause back pain.  

Conclusion

Either you suffer from back pain or not, avoid movements that may strain or twist your back. Use your body properly. Stand smart, sit smart, lift smart and keep your back straight. Also, change your position every half an hour to avoid or prevent recurrence of back pain.

Frequently Asked Questions (FAQs)

How do I know if back pain is serious?

All back pains need not be due to an underlying issue. It can be due to sprain, injury or fracture. Meet a healthcare provider and confirm the cause of the back pain if you are experiencing unbearable and intense pain.

How should I sleep with back pain?

A pillow can be used while sleeping to help you ease the pain. If you are sleeping on the sides, place a pillow in between the knees for support. If you are sleeping on the back, placing a pillow below the knees may provide extra support to the back.

Is heat good for back pain?

 Yes. Placing heat bags or applying heat over pain areas is a good therapy for relieving back pain.

What infection causes back pain?

STDs such as chlamydia, gonorrhea, trichomoniasis and other infections including yeast infection, may cause intense back pains. 

What are the causes of spinal infection?

Commonly spinal infections are caused by bacterial or fungal infections around the spine area. It can happen due to infection after surgery, infection in the blood, or infection spreading from surrounding tissues.

What is the most common cause of back pain?

Some of the most common causes include the following:

• Bad posture for a considerable time
• Strained ligaments or muscles
• Slipped disc
• Back injury
• Lifting heavyweights

 What can cause lower back pain in women?

 The main causes in women are:

• Kidney issues
• Slipped disc
• Restricted vertebrae (lumbar)
• Osteoarthritis
• Postural issues
• Menstrual pain
• Hormonal changes

 How do you know if back pain is muscle or disc?

The pain originating in your muscle is different from the pain in your spinal area. The symptoms of spine-related pain will likely include radiating pain, electric pain, pain when moving, or even in a resting position. The symptoms of muscle-related pain are muscle tightness and pain at movement or rest.

How is chronic pain different from acute back pain?

Acute back pain occurs as a result of injuries in the past, like an accident. Chronic pain is associated with underlying causes like arthritis or any other disease

Are there any medications available for back pain?

Doctors generally prescribe pain relievers. However, it is recommended not to consume medicines without prior consultation.