Back Pain

What is back pain? Pain in your back can be an annoying ache, or it can get so bad that it’s unbearable. Back pain is the second most common reason why people visit their healthcare providers (just after colds). Many people miss work because of it. Around 80% to 90% of people in the United States will have back pain at some point in their lives.

What are the types of back pain? Back pain is categorized in a number of ways by medical professionals. You can describe your back pain by its location: upper, middle or lower back pain that’s on the left side, center or right side. You may also define different types of pain to your healthcare provider. Is your pain mild, moderate or severe? Is the pain a broad ache or a smaller sharp stab? Also, back pain can be categorized by how long it lasts. An acute episode is one that is sudden and brief, and often related to an injury. Chronic/persistent means your back pain has lasted more than three to six months.

How common is back pain? Back pain is very common. Daily, about 2% of the U.S. workforce is disabled by back pain, which is the most common reason cited for an inability to perform daily tasks.

Who is at risk for back pain?

The older you are, the more likely you are to experience back pain. You’re also at a higher risk if you:

- Don’t exercise.

- Already have some types of cancer or arthritis.

- Are overweight.

- Lift using your back instead of your legs.

- Have anxiety or depression.

- Smoke or use other tobacco products.

What causes back pain?

There are causes of local back pain (pain in your spine, muscles and other tissues in your back) and then there are causes of radiating back pain (pain from a problem in an organ that spreads to or feels like it's in your back). Examples of both include:

Local back pain

Back pain in your spine may be caused by:

- Ankylosing spondylitis.

- Arthritis.

- Degenerative spondylolisthesis.

- Intervertebral disk degeneration.

- Radiculopathy.

- Sacroiliac joint dysfunction.

- Spinal disk degeneration.

- Spinal stenosis.

- Spondylolisthesis.

- Trauma/injury.

- Tumor.

Back pain localized in your tissues may be caused by:

- Sprain of a ligament.

- A strain of a muscle. In the U.S. 85% of cases of back pain are caused by a muscle strain.

- Muscle tightness.

- Radiating back pain

Radiating back pain may be caused by:

- Abdominal aortic aneurysms.

- Appendicitis.

- Cancers (very rare).

- Fibromyalgia and myofascial pain syndrome.

- Infections (very rare).

- Gallbladder inflammation.

- Kidney infection and kidney stones.

- Liver problems.

- Pancreatitis.

- Pelvic inflammatory diseases (sexually transmitted infections).

- Perforating stomach ulcers.

- Urinary tract infections.

In people designated female at birth (DFAB), radiating back pain may be caused by:

- Endometriosis.

- Pregnancy.

- Uterine fibroids.

In people designated male at birth (MFAB), radiating back pain may be caused by:

- Testicular injury or torsion.

How long does back pain last?

Back pain can last a day, a few weeks, months or a lifetime. The length of time depends on the cause and the treatment.

Is back pain a symptom of pregnancy?

It can be. Many people who are pregnant experience back pain.

Can back pain be a sign of cancer?

It’s extremely rare – only about 1% of the time will back pain be a sign of cancer.

How is back pain evaluated and diagnosed?

In many cases, your healthcare provider may get all the information they need from interviewing you about your symptoms, health history and lifestyle and then doing an exam. However, sometimes image tests are necessary. These may include:

- X-rays.

- MRI.

- CT scans.

- Bone scan.

- EMGs.

Which healthcare providers evaluate and diagnose back pain?

Your primary healthcare provider is often able to determine the cause and diagnose your back pain. If needed, they’ll send you to a specialist and/or order tests. Possible specialists include:

- A physical therapist.

- An osteopath.

- A chiropractor.

- A medical spine provider who specializes in back pain.

- An orthopaedic provider who specializes in bones and joints.

- Your healthcare provider may also recommend a therapist or psychiatrist if you’re struggling to cope with your pain.

What questions might a healthcare provider ask to help diagnose back pain?

Your healthcare provider will ask if you injured yourself, how long you’ve had back pain and how severe your pain is. They need to know other medical problems you have and what medications you take. If you have family members who have had similar issues, let your provider know. They might also ask questions such as:

Are you able to work every day?

Does what you do for a living involve lifting?

Do any of your hobbies aggravate your back pain?

Do you have any other symptoms? (For example, if you have pain when you urinate in addition to your back pain then that may indicate a urinary tract infection.)

Where is your pain located?

How does the pain affect your daily activities?

What at-home treatments have you tried? (ice packs, heat pads, etc.)

How long will I have back pain?

This depends on the cause of your back pain. If your pain is caused by an infection, for example, it might go away after the course of antibiotic is complete. If your pain is caused by spinal degeneration, you may need treatment through your lifetime.

How is back pain treated?

The cause of your back pain determines the treatment. For your back pain you may feel better with:

- Cold packs and/or heating pads.

- Stretching exercises.

- Massages.

- Surgery.

- Antibiotics.

- Cortisone.

- Traction.

- Physical therapy.

- Other over-the-counter and prescribed muscle relaxants, steroids and pain medications.

- Exercise — specifically strengthening exercises.

- Chiropractic care.

- Acupuncture.

What can I do to help relieve the symptoms of back pain?

If you had an acute injury, use a cold pack for 20 to 30 minutes at a time for the first 48 hours or so. After that (or if there was no acute injury), you may find it helps more to alternate a cold pack and a heating pad. Keep one on the area for 20 to 30 minutes, and then switch. Take over-the-counter pain medications like ibuprofen (Advil®) or acetaminophen (Tylenol®). Get plenty of rest and fluids.

If you see your provider, make sure you take all medications prescribed, get all of your testing done and attend all of your appointments.

How should I sleep with back pain?

It may feel most comfortable to sleep on your back with a pillow under your knees to relieve pressure on your back. If this isn’t comfortable for you, try sleeping on your side with a pillow between your knees. Avoid sleeping on your stomach.