Back pain: Difference between revisions

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Back pain is a widespread musculoskeletal disorder that affects approximately 80% of individuals at some point in their lives. It can present as a dull, constant ache or a sudden, sharp sensation. Acute pain typically lasts a few days to several weeks, while chronic pain persists for more than three months.

Although most cases of back pain resolve over time, recovery may be gradual. Over-the-counter analgesics and short periods of rest can provide temporary relief. However, extended bed rest beyond one or two days may worsen symptoms.

Medical attention is advised if severe back pain does not improve within three days or follows a spinal injury, fall, or lifting a heavy object. The causes and treatments for back pain vary widely and may involve medications, physical therapy, complementary and alternative medicine, and in some cases, spinal surgery.

Epidemiology

Back pain affects nearly 8 in 10 people at some point in life.
It is one of the most common reasons for missed work and doctor visits.
Chronic back pain is more common in adults over the age of 30.

Risk Factors

Back pain can affect anyone, but certain factors increase susceptibility:

Age: Risk increases with age, especially between 30 and 50 years.
Physical fitness: Weak core and back muscles contribute to instability and pain.
Obesity: Excess body weight places strain on the spine.
Genetics: Some spinal conditions have a hereditary component.
Race and ethnicity: African American women are more likely to develop spondylolisthesis.
Occupational hazards: Jobs involving heavy lifting, twisting, or prolonged sitting can cause back problems.
Smoking: Contributes to decreased blood supply and delayed healing.
Stress: Increases muscle tension and perception of pain.
Diseases: Arthritis, osteoporosis, and metastatic cancer can all contribute to spinal pain.

Classification

Back pain is broadly categorized into:

Acute back pain: Sudden onset, usually resolving within six weeks.
Chronic back pain: Lasting more than three months, may arise gradually or abruptly.

Causes

Back pain may result from a range of mechanical, traumatic, or pathological conditions:

Diagnosis

Evaluation typically involves:

Medical history and physical examination
X-rays to assess bone abnormalities
MRI or CT scan for soft tissue or nerve issues
Blood tests to rule out infections or inflammatory conditions
Nerve conduction studies if radiculopathy is suspected

Treatment

Acute Back Pain

Short-term use of NSAIDs or acetaminophen
Gentle movement and modified activity
Avoidance of prolonged bed rest

Chronic Back Pain

Physical therapy and guided exercises
Hot/cold packs
Muscle relaxants or low-dose antidepressants
Corticosteroid injections
Behavioral therapy to address posture and coping
Complementary approaches:

Surgical Options

Only considered in specific cases:

Discectomy: Removing part of a herniated disc
Laminectomy: Removing bone to relieve nerve pressure
Spinal fusion: Fusing vertebrae to prevent movement
Artificial disc replacement: Inserting a synthetic disc

Prevention

Regular exercise, especially core strengthening
Maintaining a healthy weight
Good posture
Ergonomic furniture and workspaces
Lifting with the legs, not the back
Avoiding smoking and managing stress

When to Seek Medical Attention

Consult a healthcare provider if you experience:

Persistent pain despite rest and medication
Neurological symptoms like numbness or weakness
Difficulty urinating or loss of bladder control
Fever, unintended weight loss, or history of cancer

Living With Back Pain

Use of hot or cold therapy as needed
Structured exercise programs such as flexion, extension, and aerobic routines
Avoid high-impact activities if you have existing disc disease
Follow a multidisciplinary approach for chronic conditions

External Links

NIH: Low Back Pain Fact Sheet

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 {{SI}}
+'''Back pain''' is a widespread [[musculoskeletal disorder]] that affects approximately 80% of individuals at some point in their lives. It can present as a dull, constant ache or a sudden, sharp sensation. [[Acute pain]] typically lasts a few days to several weeks, while [[chronic pain]] persists for more than three months.
-Back pain is a pervasive health concern that afflicts eight out of ten individuals at various points throughout their lifetime. The spectrum of back pain varies significantly, ranging from a persistent, dull ache to a sudden, sharp pain. Acute back pain, characterized by its sudden onset, typically persists from a few days to several weeks. When back pain extends beyond three months, it is categorized as chronic.
+[[File:Dolor espalda.png|thumb|Back pain can range from mild to debilitating]]
-[[File:Dolor espalda.png|thumb|Dolor espalda]]
-While most back pain cases tend to improve over time, the healing process might be prolonged. Temporary relief can often be found in over-the-counter pain medications and sufficient rest. However, excessive bed rest exceeding one or two days can exacerbate the problem.
-If you experience severe back pain that doesn't show signs of improvement after three days, or if you experience back pain following a significant [https://medlineplus.gov/backinjuries.html injury], it is strongly advised to consult a healthcare provider. Back pain can manifest suddenly, as a result of an accident, a fall, or lifting something heavy, or gradually, due to age-related spinal changes. The treatment for back pain varies according to its nature and cause, and may involve hot or cold packs, exercise, medicines, injections, complementary therapies, and sometimes, surgery.
+Although most cases of back pain resolve over time, recovery may be gradual. Over-the-counter [[analgesics]] and short periods of rest can provide temporary relief. However, extended bed rest beyond one or two days may worsen symptoms.
-== Who is Susceptible to Back Pain? ==
+Medical attention is advised if severe back pain does not improve within three days or follows a [[spinal injury]], [[fall]], or lifting a heavy object. The causes and treatments for back pain vary widely and may involve medications, [[physical therapy]], [[complementary and alternative medicine]], and in some cases, [[spinal surgery]].
-While back pain can affect anyone, several factors can heighten an individual's risk:
+== Epidemiology ==
-[[File:Depiction of a person suffering from back pain.png|thumb|Depiction of a person suffering from back pain]]
+* Back pain affects nearly 8 in 10 people at some point in life.
-* '''Age''': The likelihood of experiencing back pain tends to increase with age, usually becoming prevalent between the ages of 30 and 40.
+* It is one of the most common reasons for missed work and doctor visits.
-* '''Fitness level''': Individuals who lack physical fitness, especially those with weak back and abdominal muscles that fail to adequately support the spine, are more prone to back pain. A sudden increase in exercise after a prolonged period of inactivity can also provoke back pain.
+* Chronic back pain is more common in adults over the age of 30.
-* '''Diet''': Consuming a high-calorie, high-fat diet, coupled with a sedentary lifestyle, can lead to obesity, which in turn places added stress on the back.
-* '''Heredity''': Genetic predispositions can play a role in certain disorders that induce back pain.
-* '''Race''': African American women, for instance, have a higher likelihood than white women to develop spondylolisthesis, a condition where the lower spinal bones dislocate.
-* '''Other diseases''': Certain diseases, such as specific types of arthritis and cancers that metastasize to the spine, may cause or exacerbate back pain.
-* '''Occupational hazards''': Jobs that necessitate heavy lifting, pushing, pulling, or twisting can potentially injure the back. Conversely, desk jobs, particularly those involving poor posture or extended sitting in an uncomfortable chair, can also contribute to back pain.
-* '''Cigarette smoking''': While smoking may not directly induce back pain, it increases the risk of developing lower back pain and sciatica—pain that radiates to the hip and/or leg. Additionally, smoking can delay recovery from back injuries or surgeries.
-== Classifying Back Pain ==
-* '''Acute pain''' is a sudden, often severe pain that follows an accident, a fall, or heavy lifting. It represents the most common type of back pain and usually subsides within six weeks.
+== Risk Factors ==
-* '''Chronic pain''' may develop abruptly or gradually, persisting for a significant duration, typically longer than three months. This type of back pain is less common.
+[[File:Depiction of a person suffering from back pain.png|thumb|Postural habits can contribute to back pain]]
-== Potential Causes of Back Pain ==
+Back pain can affect anyone, but certain factors increase susceptibility:
+* '''[[Age]]''': Risk increases with age, especially between 30 and 50 years.
+* '''[[Physical fitness]]''': Weak core and back muscles contribute to instability and pain.
+* '''[[Obesity]]''': Excess body weight places strain on the spine.
+* '''[[Genetics]]''': Some spinal conditions have a hereditary component.
+* '''[[Race and ethnicity]]''': [[African American women]] are more likely to develop [[spondylolisthesis]].
+* '''[[Occupational hazards]]''': Jobs involving heavy lifting, twisting, or prolonged sitting can cause back problems.
+* '''[[Smoking]]''': Contributes to decreased blood supply and delayed healing.
+* '''[[Stress]]''': Increases [[muscle tension]] and perception of pain.
+* '''[[Diseases]]''': [[Arthritis]], [[osteoporosis]], and [[metastatic cancer]] can all contribute to spinal pain.
-Back pain can stem from a multitude of factors, including:
+== Classification ==
+Back pain is broadly categorized into:
+* '''Acute back pain''': Sudden onset, usually resolving within six weeks.
+* '''Chronic back pain''': Lasting more than three months, may arise gradually or abruptly.
-* '''Mechanical issues''': Problems with the way your spine moves or how it feels when you move in specific ways can lead to back pain. Mechanical causes include degeneration of the spinal disks, disk rupture, muscle spasms, and muscle tension.
+== Causes ==
-* '''Injuries''': Injuries like sprains and fractures can instigate short-term or chronic pain. Sprains result from tearing of the ligaments that uphold the spine, often due to improper twisting or lifting. Fractured vertebrae commonly arise from conditions like osteoporosis. Severe injuries leading to back pain may occur from significant accidents or falls.
+Back pain may result from a range of mechanical, traumatic, or pathological conditions:
-* '''Medical conditions''': Various health conditions can cause or contribute to back pain:
-* ''Scoliosis'', a curvature of the spine, typically does not cause pain until middle age.
-* ''Spondylolisthesis'', a condition in which a spinal bone dislocates.
-* Different types of ''arthritis''.
-* ''Spinal stenosis'', a narrowing of the spinal column that pressures the spinal cord and nerves.
-* ''Osteoporosis'', which can induce painful fractures of the vertebrae.
-* ''Pregnancy''.
-* ''Kidney stones'' or infections.
-* ''Endometriosis'', a condition characterized by uterine tissue growing outside the uterus.
-* ''Fibromyalgia'', a disorder of widespread muscle pain and fatigue.
-* ''Infections'' involving the spinal bones or intervertebral disks can cause pain.
-* ''Tumors'', although rare, can instigate back pain. Tumors can originate in the back or be secondary, spreading from other body regions.
-* '''Stress''' can exacerbate pain by causing muscle tension and pain in the back.
-== Approaches to Back Pain Treatment ==
-[[File:Spinal_column_curvature-en.svg|Spinal column curvature|thumb]]
-The treatment approach for back pain largely depends on the duration and intensity of the pain:
-[[File:Lower back pain.jpg|thumb|Lower back pain]]
+=== Mechanical Causes ===
-'''Acute (short-term) back pain''' often improves independently. Exercise and surgery are generally not recommended for acute back pain. However, while waiting for the pain to subside, some relief options include:
+* [[Herniated disc]] or [[degenerative disc disease]]
-Over-the-counter pain relievers like acetaminophen, aspirin, or ibuprofen can mitigate the pain.
+* [[Spinal stenosis]]
-Engaging in mild physical activity can ease stiffness, relieve pain, and expedite return to regular activities.
+* [[Scoliosis]] or abnormal spinal curvature
-'''Chronic (long-term) back pain''' typically involves non-surgical treatment options before considering surgery:
+* [[Spondylolisthesis]]
-''Nonsurgical treatments'':
+* [[Facet joint]] dysfunction
-* Hot or cold packs can provide relief to persistently sore, stiff backs.
-* Regular exercise can alleviate chronic pain and potentially lower the risk of its recurrence. Always consult your doctor before initiating a new exercise regimen.
-* Over-the-counter or prescription medications can be used to treat chronic back pain.
-* Topical or oral pain relievers such as acetaminophen and aspirin.
-* Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, ketoprofen, and naproxen sodium help relieve pain and inflammation.
-* Muscle relaxants and some antidepressants might be prescribed for certain types of chronic back pain.
-* Your healthcare provider might recommend steroid or numbing shots to alleviate pain.
-* Traction, which involves using pulleys and weights to stretch the back, might enable a bulging disk to reposition itself. Pain relief during traction might not persist after the session.
-* Behavioral modification techniques can teach proper body movement during daily activities, especially those involving heavy lifting, pushing, or pulling, along with fostering healthy habits such as regular exercise, relaxation, sufficient sleep, a balanced diet, and cessation of smoking.
-Complementary and alternative treatments may be beneficial when other therapies fail to provide relief. Examples include:
-* ''Manipulation'': Professionals adjust or massage the spine or nearby tissues with their hands.
-* ''Transcutaneous electrical nerve stimulation'' (TENS): A small box over the skin transmits minor electrical signals to the body.
-* ''Acupuncture'': This treatment involves inserting thin needles into specific body points.
-* ''Surgical treatments'': Surgery is generally a last resort, when other therapies have failed, and severe, persistent pain is accompanied by nerve compression resulting in weakness or numbness. The main types of surgery for back pain are:
-* ''Diskectomy'': Removal of a portion of a herniated disk to relieve irritation of nearby nerves.
-* ''Laminectomy'': The surgeon removes the bone overlaying the spinal canal, enlarging it to relieve nerve pressure caused by spinal stenosis.
-* ''Fusion'': Fusing spinal bones together restricts movement and prevents stretching of nerves.
-* ''Artificial disks'': An alternative to fusion, which involves inserting an artificial disk into the spine to mimic a real one.
-== Preventive Measures ==
-Adopting certain lifestyle habits can reduce the risk of developing back pain:
+=== Injuries ===
+* [[Ligament sprains]] or [[muscle strains]]
+* [[Vertebral fractures]], often related to [[osteoporosis]]
+* [[Whiplash]] or trauma from accidents
-* Regular exercise to keep the back muscles strong and flexible.
+=== Medical Conditions ===
-* Maintaining a healthy weight to avoid excessive pressure on the spine.
+* [[Arthritis]], including [[rheumatoid arthritis]] and [[osteoarthritis]]
-* Smoking cessation, as smoking impairs blood flow, depriving the spine tissues of necessary nutrients.
+* [[Kidney stones]] or [[urinary tract infections]]
-* Wearing low-heeled shoes.
+* [[Endometriosis]] or [[fibromyalgia]]
-* Avoiding heavy lifting, but if you must lift, bend your legs, not your back, and keep the load close to your body.
+* [[Spinal infections]] or [[tumors]]
-* Practicing good posture. Don't slump or slouch when you sit or stand.
+* [[Pregnancy]]-related musculoskeletal stress
-Back pain is a symptom of a medical condition, not a diagnosis itself. In rare cases, back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome. In these cases, surgery is needed right away to ease the pain and prevent more problems.
+== Diagnosis ==
+Evaluation typically involves:
+* Medical history and physical examination
+* [[X-rays]] to assess bone abnormalities
+* [[MRI]] or [[CT scan]] for soft tissue or nerve issues
+* [[Blood tests]] to rule out infections or inflammatory conditions
+* [[Nerve conduction studies]] if [[radiculopathy]] is suspected
-You probably don’t need to see your doctor for back pain, unless you have:
+== Treatment ==
+[[File:Spinal_column_curvature-en.svg|thumb|Curvatures of the spine can affect posture and pain]]
-* Numbness and tingling.
+=== Acute Back Pain ===
-* Severe back pain that does not improve with medication.
+* Short-term use of [[NSAIDs]] or [[acetaminophen]]
-* Back pain after a fall or injury.
+* Gentle movement and modified activity
-* Back pain along with:
+* Avoidance of prolonged bed rest
-** Trouble urinating.
-** Weakness, pain, or numbness in your legs.
+=== Chronic Back Pain ===
-** Fever.
+[[File:Lower back pain.jpg|thumb|Lower back pain is common and may persist]]
-** Weight loss that you didn’t intend.
+* [[Physical therapy]] and guided exercises
+* Hot/cold packs
+* [[Muscle relaxants]] or low-dose [[antidepressants]]
+* [[Corticosteroid injections]]
+* [[Behavioral therapy]] to address posture and coping
+* Complementary approaches:
+** [[Chiropractic adjustment]]
+** [[Acupuncture]]
+** [[TENS (Transcutaneous electrical nerve stimulation)]]
+=== Surgical Options ===
+Only considered in specific cases:
+* '''[[Discectomy]]''': Removing part of a herniated disc
+* '''[[Laminectomy]]''': Removing bone to relieve nerve pressure
+* '''[[Spinal fusion]]''': Fusing vertebrae to prevent movement
+* '''[[Artificial disc replacement]]''': Inserting a synthetic disc
+== Prevention ==
+* Regular [[exercise]], especially [[core strengthening]]
+* Maintaining a [[healthy weight]]
+* Good [[posture]]
+* Ergonomic furniture and workspaces
+* Lifting with the legs, not the back
+* Avoiding [[smoking]] and managing stress
+== When to Seek Medical Attention ==
+Consult a healthcare provider if you experience:
+* Persistent pain despite rest and medication
+* [[Neurological symptoms]] like numbness or weakness
+* Difficulty [[urinating]] or loss of [[bladder control]]
+* Fever, unintended [[weight loss]], or history of [[cancer]]
 == Living With Back Pain ==
-There are a few things you can do to help you live with back pain:
+* Use of hot or cold therapy as needed
+* Structured [[exercise programs]] such as flexion, extension, and aerobic routines
+* Avoid high-impact activities if you have existing [[disc disease]]
+* Follow a multidisciplinary approach for chronic conditions
-* Hot or cold packs can be soothing to constantly sore, stiff backs. Heat dilates the blood vessels to increase blood supply to the back and reduce muscle spasms. Cold may reduce inflammation and numb deep pain.
+== External Links ==
-* Exercise can help ease chronic pain and may reduce the risk of it returning. Check with your doctor before starting a new exercise routine, which may include the following:
+* [https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet NIH: Low Back Pain Fact Sheet]
-** ''Flexion exercises'' have you bending forward to reduce pressure on the nerves, stretch the back and hip muscles, and strengthen the stomach and buttock muscles.
-** ''Extension'' involve bending backward, such as lying on your stomach while you lift your leg or raise your trunk. These exercises may reduce pain that spreads from one place and develop muscles that support the spine.
-** ''Stretching'' improves the extension of muscles and other soft tissues of the back. These exercises can reduce back stiffness and improve range of motion.
-** ''Aerobic exercise'' gets your heart pumping faster and include brisk walking, jogging, and swimming. Avoid exercise that requires twisting, bending forward quickly, such as aerobic dancing and rowing. Avoid high-impact activities if you have disk disease.
-== External links ==
-*[https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet Low back pain fact sheet]
-{{Stub}}
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+{{stub}}
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 [[Category:Pain]]
 [[Category:Bones of the vertebral column]]
 [[Category:Human back]]