Back pain is one of the most common health problems. Backache, lumbago, sprain or strain, slipped disc, sciatica and pinched nerve are terms people often use to describe back pain. Where you feel back pain is related to the level or region of the spine affected.
Back pain can be acute or chronic. Acute back pain occurs suddenly, is often severe, and usually lasts a few days or a few weeks. Back pain becomes chronic when it lasts three months or longer. Both acute and chronic pain may include radicular pain and other symptoms. Radicular means pain and symptoms spread (radiate). Neck pain that spreads into the arms is an example of radicular pain, a cervical radiculopathy.
You may experience localized swelling, stiffness, or muscle spasms. It may be difficult to walk, sit, stand or twist. Certain skin areas may feel tender to touch. Odd sensations of numbness, tingling, burning, or pins and needles may develop.
Don’t let back pain mislead you. Sometimes pain felt is intense yet the cause is minor. A lumbar sprain or strain is an example of a painful injury that can feel serious, but is easily treated without surgery. On the other hand, sudden and intense back pain may be caused by a compression fracture; a diagnosis that requires medical care.
- Poor posture and body mechanics
- Sprain or strain
- Disc disorder, such as disc degeneration
- Osteoarthritis, spondylosis
- Spinal stenosis
- Spondylolisthesis (Isthmic or Degenerative)
- Tumor, such as cancer
In general, seek medical attention promptly if you experience:
- Back pain after injury, such as a fall
- Sudden, unrelenting or disabling back pain
- Pain that travels into the arms and/or legs
- Leg numbness, tingling sensations, weakness
- Buttock and/or genital area numbness and/or tingling
- Back pain accompanied by fever
- Bowel or bladder dysfunction
An accurate diagnosis begins with your medical history and physical and neurological examinations. You and your doctor discuss your symptoms, when they developed, and treatment tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.
A simple x-ray can help to rule out many different problems. Other diagnostic imaging studies may include a CT or MRI series. A MRI study is of particular use to assess nerve and/or spinal canal (cord) compression. Your doctor will explain the purpose of these and other tests.
Seldom is spine surgery necessary to treat back pain. Non-surgical treatments are often effective to relieve pain and symptoms. Your doctor may combine two or more therapies to maximize the success of your treatment.
- Activity modification
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Pain medication (a narcotic, painkiller)
- Muscle relaxing medication
- Spinal injection
- Short-term bracing supports the spine, may help relieve pain
- Physical therapy
- Spinal Decompression Machine
When your surgeon may discuss surgical treatment
Your surgeon may recommend spine surgery if your spine is not stable or you have neurologic dysfunction. In some cases, if back pain and symptoms are not responsive to non-operative therapies, surgery may be considered. If your surgeon discusses surgical options with you, be assured his recommendation is made with the greatest concern to your healthcare.