Understanding & Treating Back Pain

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Many people have some type of back pain at least once in their lives. Others suffer with chronic back pain that’s often ongoing and debilitating enough where it disrupts their lives. In fact, according to a 2010 Global Burden of Disease study, lower back pain causes more disability worldwide than any other ailment.

At any given time, there are around 31 million individuals in the U.S. alone who struggle with back pain. It’s among the most common reasons for missing work and the second most common reason people go to the doctors.  On top of this, back pain is a huge economic burden on families, individuals, governments, industry and communities, according to the World Health Organization.

What is Back Pain?

Lower back pain (lumbago) isn’t a condition in itself, but rather a symptom of a wide-range of medical problems. Normally, it’s caused by an issue with one or more parts of your back, including your:

  • Muscles
  • Ligaments
  • Nerves
  • Vertebrae (bony structures of your spine)

Problems with neighboring organs could also be causing your lower back pain, such as your kidneys, for example.

Back pain falls into two categories. These are:

  1. Acute back pain where your pain is temporary, lasting less than three months and is often remedied with home treatment.
  2. Chronic back pain where your pain lasts more than three months and requires more intensive treatment

Your spinal column is your body’s primary structural support system. Therefore, it’s not surprising many people struggle with back issues from time to time.

Causes and Conditions Associated with Back Pain

Many conditions can cause back pain. Some common conditions leading to back pain include:

Strains and Sprains

Strain and sprain injuries of your muscles and ligaments are common causes of back pain. There are various ways these injuries occur, such as using poor posture, lifting improperly lifting or lacking exercise. You also increase your risk of a strain or sprain injury that affects your back by being overweight.

Herniated Disk

Herniated disks are problems with one of your disks (rubbery cushions) between your vertebrae. In most cases, a herniated disk occurs in your lumbar spine (lower back), but it can also occur in your cervical spine (neck). If you have a herniated disk in your back, generally you’ll feel most of your pain in your buttocks, calves and thighs.

Arthritis

Most types of arthritis affect your muscles, joints and bones and cause issues like stiffness, pain and swelling in your back. While arthritis can affect any part of your back, the most common area you’ll experience arthritis back pain is in your lower back, probably since you support most of your body weight in this area.

Osteoarthritis

Osteoarthritis affects millions of people and is the most common type of arthritis. It results when your bone’s protective cartilage wears down over time. It’s a degenerative disease that gets worse with time making day-to-day tasks more difficult to perform. Some osteoarthritis symptoms occur in your lower back like swelling and pain.

Sciatica

Sciatica is pain that branches out along your sciatic nerve that extends from your lower back, buttocks and hips down one or both legs.

There doesn’t always need to be a reason for your back pain. In some cases, you may experience back pain for no apparent reason. This is known as nonspecific or idiopathic back pain, and may be a result of weak muscles not being able to handle everyday bending, walking and stretching.

Back Pain Symptoms

 

Back pain may have an array of symptoms, including:

  • A shooting or stabbing pain that radiates down your leg to your foot.(Sciatica)
  • An aching and dull sensation in your lower back.
  • A reduced ability to flex your back.
  • A reduced range of motion.
  • A reduced ability to stand up straight without experiencing pain.

Most back pain symptoms are typically short-lived if caused by misuse or strain and only last for a few days or couple weeks. If you’re experiencing back pain for more than three months, it’s likely chronic and you’ll need treatment. It could also be an indication of a serious medical condition, and you should seek evaluation.

Diagnosis of Back Pain

The overall goal of treatment with back pain is to help you move freely again without pain. Unless you have an injury keeping you from moving at all, your doctor will likely start off by:

  • Checking how your nerves are working.
  • Testing your range of motion.
  • Pressing on your back to identify the area giving you problems.

Your doctor may also give you urine and blood tests to rule out another issue, such as a kidney stone or infection. Your doctor may use imaging tests if something hit your back, you have ongoing pain, you have a fever, or you have problems with your nerves, such as numb or weak legs and arms.

Some imaging tests they may use include:

  • An X-ray to check for broken bones or other spinal problems.
  • A CT scan or MRI to check for herniated disk or other soft tissue damage.
  • An electromyogram(EMG) to check for muscle and nerve damage.

Your diagnosis will determine what course of treatment follows.

Which Physician to See

If you’re confused about which physician to see, the following are recommended physicians based on your specific back pain.

Primary Care Doctor

Typically, your first step should be to schedule an appointment with your primary care doctor. Your doctor will ask you some questions and perform a physical exam to pinpoint the cause of your back pain. They will also likely refer you to a specialist specific to your back pain, such as one of the specialists below.

Orthopedic Surgeon

An orthopedic surgeon focuses on treating musculoskeletal conditions. They specialize in diagnosing and treating most joint and bone disorders like:

  • Arthritis
  • Spinal disorders
  • Bone tumors
  • Sports injuries
  • Hand injuries or deformities
  • Trauma
  • Total joint replacement

Some orthopedic surgeons even practice spine surgery exclusively.

Physical Therapist

A physical therapist will help you improve your mechanical body function and treat you for various types of spine conditions. They’ll work with you through strengthening exercises and targeted stretching to strengthen your supporting muscles to relieve spinal column pressure and improve posture. If you’ve had back surgery or have had an injury, you might need to see a physical therapist for rehabilitation.

Chiropractor

Chiropractors specialize in identifying diseases and disorders of the musculoskeletal system. They provide treatments like therapeutic massage and adjustments to assist in spinal alignment.

Rheumatologist

Rheumatologists are internal medicine physicians who specialize in diagnosing and treating rheumatic diseases affecting your musculoskeletal system. They’ll also serve as your main back-care specialist if your back pain is due to arthritis, such as ankylosing spondylitis.

Pain Management Specialist

The role of your pain management specialist is to improve your quality of life. They’ll work along with other members of your healthcare team to coordinate your care, determine the cause of and treatment options for your back pain, including managing your pain.

There are many specialists who have a different set of skills, training and interests in treating your back pain. You can find a doctor for back pain or start with your primary physician to get the appropriate recommendation to begin treatment and start living a better quality of life — free of pain.

Reviewed By : Mitchell Cohen, MD. 11/7/2017

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