What is back pain?

Back pain can range from mild, dull, annoying pain to persistent, severe, disabling pain in the back.

Pain in the lower back can restrict mobility and interfere with normal functioning and day-to-day activities.

What causes back pain?

The exact cause of back pain can be hard to determine. In most cases, back pain symptoms may have many different causes. Some back pain symptoms are caused by:

  • Overuse, strenuous activity or improper use (such as repetitive or heavy lifting, exposure to vibration for prolonged periods of time)
  • Injury
  • Degeneration of vertebrae often caused by stresses on the muscles and ligaments that support the spine or the effects of aging
  • Infections
  • Abnormal growth (tumor)
  • Obesity often increases weight on the spine and pressure on the disks
  • Poor muscle tone in the back
  • Muscle tension or spasm
  • Sprain or strain
  • Ligament or muscle tears
  • Joint problems such as spinal stenosis
  • Smoking
  • Protruding or herniated (slipped) disk
  • Diseases such as osteoarthritis, spondylitis or compression fractures

Back pain is classified as acute (or short-term) and chronic. Acute back pain lasts from a few days to a few weeks; most acute back pain will resolve on its own. Chronic back pain lasts for more than three months and often gets worse. The cause of chronic back pain can be hard to find.

These are the most common symptoms of back pain. Symptoms may include discomfort or pain in the back that is:

  • Aching
  • Burning
  • Stabbing
  • Sharp or dull
  • Well-defined or vague

Back pain symptoms may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

How is back pain diagnosed?

Along with a complete medical history and physical exam,  back pain tests may include:

  • X-ray, a test that uses electromagnetic energy beams to make images of bones onto film
  • CT scan, an imaging test that uses X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays
  • MRI, a test that uses large magnets and a computer to make detailed images of organs and structures in the body
  • Radionuclide bone scan, a technique that uses a very small amount of radioactive material, which is injected into the patient's bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone

How is back pain treated?

Back pain treatment may include:

  • Activity modification
  • Medicine
  • Physical rehabilitation, therapy or both
  • Osteopathic manipulation
  • Occupational therapy
  • Weight loss (if overweight)
  • No smoking
  • Following a prevention program as directed by your physician
  • Surgery
  • Assistive devices such as mechanical back support

Rehabilitation is often a part of back pain treatment; generally, there are three phases of back pain rehabilitation:

  • Acute phase: During this initial phase of back pain treatment, the physiatrist (a physician who specializes in rehabilitation medicine) and treatment team develop a plan to reduce the initial back pain and source of inflammation. This may include using ultrasound, electrical stimulation or specialized injections.
  • Recovery phase: Once the initial pain and inflammation are better managed, the back rehab team focuses on helping you return to normal daily activities while starting a specialized exercise program to regain flexibility and strength.
  • Maintenance phase: In this phase of back pain treatment, you will learn ways to prevent further injury and strain to the back, as well as how to start a fitness program to help further increase strength and endurance to protect your back muscles.