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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Back Pain

Back Pain

Pain that persists in the back longer than 12 weeks and attributed to degenerative or traumatized conditions of the spine which is the most common cause of activity limitation. Acute back pain comes on suddenly and lasts for few days to weeks and if it stays for more than 3 months it is called chronic back pain.

 

Most people experience back pain sometime in their life. There are numerous causes the few common symptoms and causes are listed below

Signs and symptoms

  • Persistent aching or stiffness anywhere along neck to hip
  • Localized sharp pain either in neck or upper back or lower back
  • Radiating pain from lower back to buttocks or thighs or into legs or toes
  • Muscle spasms or sprains
  • Inability to stand or lift weights
  • Difficulty in walking or standing or working
  • Numbness, tingling sensation or loss of control
  • Symptoms of other diseases along with back pain if associated with some diseases

  • Tenderness or loss of reflexes or urinary symptoms or swelling or cough and fever can be present

Causes

Back composes of bones, spines, ligaments, tendons and muscles and any problems with these can cause back pain

  • Strains: Improper or heavy weight lifting and sudden awkward movement causing strain of the muscles or ligaments can lead to back ache
  • Structural problems: Bulging or rupture of the disc present between the vertebra can press on nerves and cause back pain
  • Arthritis: Inflammation of joints involving lower back and hips sometimes and cause narrowing of the disc space and cause back pain leading to deformity or stenosis
  • Skeletal abnormalities: If the spine is deformed bending to the sideways as in scoliosis can lead to back pain
  • Osteoporosis: The bones become brittle and porous making it weak and susceptible for fracture that causes back pain
  • Infection: Infection by tubercle bacilli or any other pathogenic organisms leading to swelling or redness or warmth can accompany back pain
  • Cancer: If a tumour of the spine or tumour spreading from other organs of the body to the spine deforming it or destructing it can cause nerve compression and back pain
  • Injuries: Any injury or blow or road traffic accident or surgeries of the back can cause the pain

  • Others: Diseases like cauda equina syndrome can cause back pain along with urinary and bowel incontinence

Tests and diagnosis:

  • History and Physical examination: Most of the causes are diagnosed through some questions and examination of the range of movements of back and assessment of ability to sit, stand, walk and lifting of legs
  • X-Ray: Images of the back showing alignment of bones whether fractured or deformed and also the space between the vertebra
  • Computed tomography or Magnetic Resonance Imaging: These scans can reveal more detailed information than X ray and provide all the structures governing back bone
  • Nerve Studies: Measures the electrical impulses produced by the nerves and response shown by the muscles

  • Blood and Urine tests: To know whether there is an infection or any other illness associated with

Treatment:

Avoiding activities that stress the back, some pain relievers, bed rest and application of ice or heat are all that required

  • Medications: Pain relievers’ non steroidal anti-inflammatory drugs or muscle relaxants available in the form of tablets and local application gel can be applied. Narcotics in case of intolerable pain is advised under supervision of a doctor
  • Physical Therapy: Heat, ice, ultrasound rays, electric stimulation, and muscle releasing techniques are applied to relieve the back pain.
  • Exercises: These are done for improving the flexibility, improving the posture, strengthening of muscles of abdominal and back muscles
  • Injections: In case of severe pain and radiating pain cortico-steroid injections are given locally or around the spinal cord space
  • Surgeries: Are done for extreme cases and structural abnormalities. Fusion of two vertebras, Disc replacement, Partial removal of disc and Partial removal of vertebra are the few surgeries done.