Zacharia Isaac, MD | | Other Bone and Joint Q & A Topics:
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What causes back pain?
Back pain affects all ages, with 70 to 85 percent of all people experiencing back pain at some point in their life. It is typically caused by some combination of overuse, strain and injury to the muscles, ligaments and discs that support the spine. Here are some of the common causes of back pain:
- sprain, strain or fracture
- degeneration of vertebrae
- infection
- abnormal growth, such as a tumor or bone spur
- obesity or poor muscle tone
- ligament or muscle tears
- joint problems, such as arthritis
- protruding or herniated (slipped) disk, which often leads to pressure on the sciatic nerve
- osteoporosis
- spinal stenosis – narrowing of the spinal canal
- congenital (present at birth) deformities of the vertebrae and bones, such as scoliosis or kyphosis
What are the symptoms of a back injury?
The most common and obvious symptom of a back injury is pain, which can be felt in your back, buttocks, thigh – and even down to your foot. Numbness, weakness, stiffness and muscle spasms in the back or legs are also potential signs of back injury.
How is low back pain diagnosed?
After completing a medical history and a physical examination, your physician may order the following diagnostic procedures:
- x-ray
- computed tomography scan (CT/CAT scan) – imaging procedure that is more detailed than x-rays
- magnetic resonance imaging (MRI) – even greater detail than a CT scan
- radionuclide bone scan – a nuclear imaging technique that shows blood flow to the bone and cell activity within the bone
- electromyogram (EMG) – a test to evaluate nerve and muscle function
How is back pain treated?
The treatment will be determined by the specific type of back condition, as well as variety of other factors:
- your age, overall health and medical history
- extent of the disease
- your tolerance for specific medications, procedures or therapies
Here are some of the more common treatments:
- non-steroidal, anti-inflammatory medications
- applying heat or cold to sore muscles
- staying active – to minimize inflammation
- surgery
- activity modification (e.g., less lifting, changing sitting posture)
- medication
- physical rehabilitation/therapy
- occupational therapy
- weight loss
- smoking cessation
- assistive devices (e.g., mechanical back supports)
- acupuncture
- massage
Can back pain be prevented?
The following can help to prevent low back pain:
- practice proper lifting techniques
- maintain correct posture while sitting, standing and sleeping
- exercise regularly (with a sufficient warm-up)
- stop smoking
- maintain a healthy weight
- reduce emotional stress, which can lead to muscle tension
- sleep on your side
- wear low-heeled shoes
What type of exercises can help to prevent or relieve back pain?
Here are some exercises that can help to reduce or prevent back pain:
- aerobic exercise – to strengthen your heart, reduce the stress on your back by shedding pounds and speed up recovery
- strengthening exercises – focus on strengthening your back, stomach and leg muscles to provide greater muscle support for your back and improve your posture
- stretching exercises - to keep your muscles flexible and less injury prone
And here are some exercises to avoid:
- straight leg sit-ups, if you have low back pain
- bent leg sit-ups or crunches if you have acute back pain
- lifting both legs while lying on your back (leg lifts)
- lifting heavy weights above the waist
- standing toe touches
What are the surgical options for treating back conditions?
Your physician will examine a variety of treatments before considering surgery. However, in some cases, surgery is the best means of getting positive results. Here are some of the more common back operations:
- discectomy – removal of a herniated disc relieve the pressure on the nerves.
- foramenotomy – removal of a portion of bone and other tissue to reduce pressure on the nerve as it exits the spinal column
- laminectomy – used to treat conditions such as spinal stenosis and spondylolisthesis, this procedure removes bone to reduce pressure on the spinal column
- spine fusion – fusion of adjacent vertebrae to eliminate motion
Learn more
To make an appointment or learn more about comprehensive operative and non-operative care options offered at Brigham and Women's Hospital, call 1-800-BWH-9999 or visit the Orthopedic Spine Service Web page.
