Back pain is one of the most common painful and non-life-threatening conditions. It affects four in five Americans at some point in their lives. The good news is that back pain need not govern how you live your life.
If you have back pain, medication, exercise, and changes in your lifestyle are likely to offer the most relief. Surgery is useful in a minority of people
Most back pain isn't dangerous, but it's important to learn the "red flag" situations that require immediate medical attention. These include:
- back pain that occurs at the same time as a fever
- leg weakness that comes on abruptly or gets progressively worse
- numbness in the groin
- loss of bowel or bladder control
- pain that worsens instead of getting better
- inability to find a comfortable position for sitting or sleeping during times when you feel back pain
Other self-care steps you can take to mend your back include different types of exercise and complementary therapies such as chiropractic care, acupuncture, and massage, as well as choosing the right mattress.
Back Pain Articles
Doctors use back x-rays to examine the vertebrae in the spine for fractures, arthritis, or spine deformities such as scoliosis, as well as for signs of infection or cancer. X-rays can be taken separately for the three areas of the spine: the cervical spine (neck), thoracic spine (middle back), and lumbar spine (lower back). Occasionally, doctors x-ray the pelvis to help diagnose the cause of back pain.
Chiropractic manipulation of the spine provided a small but short-term benefit in relieving back-related leg pain in a recent study.
Systemic lupus erythematosus, commonly known as lupus, is an autoimmune disease. The immune system mistakenly attacks connective tissue in the body, injuring and sometimes destroying vital organs such as the joints, kidneys, brain, and heart.
The word "lupus" is Latin for wolf. Many people with this condition developed a rash on the face over the bridge of the nose and on the cheeks below the eyes that looks like the facial markings of a wolf.
Lupus affects several hundred thousand people in the United States. It strikes women more often than men, and blacks more often than whites.
Sciatica is pain along the sciatic nerves, the longest nerves in the body. The pain begins in the lower spine, passes through the buttock, down the back and side of the leg, and into the foot and toes. A common cause of sciatica is a herniated disk. It can also be brought on by spinal stenosis, infection, a broken pelvis or thighbone, or a tumor. Sciatica tends to affect people in their 40s and 50s, and it is more common in those who are overweight.
The main feature of sciatica is numbness, tingling, or pain in the lower back, buttock, and leg. It can be relatively mild or erupt into violent throbbing pain that grips the back and leg, making any movement excruciating.
Doctors recommend conservative measures first to treat back pain conditions. This rule of thumb applies to strain-and-sprain back pain as well as pain related to irritated nerves near the spine. After trying and failing to control back pain with conservative measures, injections of anti-inflammatory steroid medication may be an option. Research suggests that the average pain relief and improved function after steroid injections is small, though some individuals may benefit more. The effect of the injection is temporary and will not improve long-term outcomes. The therapy has risks such as infection, but these are uncommon. Having too many injections at the same location can cause breakdown of soft tissue and bone.
A clinical trial found that acetaminophen (Tylenol) does not help people recover from new episodes of back pain.
The first advice you are likely to get if you have low back pain is "take a Tylenol." However a study published July 24, 2014, online by the journal Lancet indicates that you might do just as well without Tylenol.
Back pain can be a symptom of many different illnesses and conditions. The main cause of the pain can be a problem with the back itself or by a problem in another part of the body. In many cases, doctors can't find a cause for the pain. When a cause is found, common explanations include:
Stress or injury involving the back muscles, including back sprain or strain; chronic overload of back muscles caused by obesity; and short term overload of back muscles caused by any unusual stress, such as lifting or pregnancy
Disease or injury involving the back bones (vertebrae), including fracture from an accident or as a result of the bone-thinning disease osteoporosis
Degenerative arthritis, a "wear and tear" process that may be related to age, injury and genetic predisposition.
Disease or injury involving the spinal nerves, including nerve injury caused by a protruding disk (a fibrous cushion between vertebrae) or spinal stenosis (a narrowing of the spinal canal)
Women with osteoporosis have many options for preserving bone strength and preventing fractures. The mainstays of treatment are bisphosphonate drugs.
A CT scan of the back may view one or more of the three areas of the spine: the cervical spine (neck), thoracic spine (middle back), and lumbar spine (lower back).
Doctors can use a CT scan of the spine to examine the vertebrae in the spine for fractures, arthritis, or pinching of the nerves or spinal cord (spinal stenosis). Occasionally, doctors x-ray the pelvis to help diagnose the cause of back pain.
A CT scan of the spine can be combined with a test called a "myelogram" (discussed separately) to give a clear view of the spinal cord and places where the vertebral bones might be pinching it.