Back Pain

Back Pain - Also called: Backache, Lumbago

Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.

Symptoms

Symptoms of back pain may include:

• Muscle ache
• Shooting or stabbing pain
• Pain that radiates down your leg
• Limited flexibility or range of motion of your back
• Inability to stand straight

Causes

Your back is an intricate structure composed of bones, muscles, ligaments, tendons and disks. Disks are the cartilage-like pads that act as cushions between the segments of your spine. Back pain can arise from problems with any of these component parts. In some people, no specific cause for their back pain can be found.

Strains
Back pain most often occurs:

• From strained muscles and ligaments
• From improper or heavy lifting
• After a sudden awkward movement

Sometimes a muscle spasm can cause or be associated with back pain.

Structural problems
In some cases, back pain may be caused by structural problems, such as:

• Bulging or ruptured disks. Disks act as cushions between the vertebrae in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve. But even so, many people who have bulging or herniated disks experience no pain from the condition.
• Sciatica. If a bulging or herniated disk presses on the main nerve that travels down your leg, it can cause sciatica — sharp, shooting pain through the buttock and back of the leg.
• Arthritis. The joints most commonly affected by osteoarthritis are the hips, hands, knees and lower back. In some cases arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
• Skeletal irregularities. Back pain can occur if your spine curves in an abnormal way. If the natural curves in your spine become exaggerated, your upper back may look abnormally rounded or your lower back may arch excessively. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain.
• Osteoporosis. Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle.

Rare but serious conditions
In rare cases, back pain may be related to:

• Cauda equina syndrome. This is a serious neurological problem affecting a bundle of nerve roots that serve your lower back and legs. It can cause weakness in the legs, numbness in the "saddle" or groin area, and loss of bowel or bladder control.
• Cancer in the spine. A tumor on the spine can press on a nerve, causing back pain.
• Infection of the spine. If a fever and a tender, warm area accompany back pain, the cause could be an infection.

Risk factors

Factors that increase your risk of developing low back pain include:

• Smoking
• Obesity
• Older age
• Being female
• Physically strenuous work
• Sedentary work
• Stressful job
• Anxiety
• Depression

Please make sure to discuss your individual symptoms as well as the suggested treatments with your health-care provider to determine the appropriate diagnostic and treatment plan for your circumstances.

Treatments and drugs

Most back pain gets better with a few weeks of home treatment and careful attention. A regular schedule of over-the-counter pain relievers may be all that you need to improve your pain. A short period of bed rest is OK, but more than a couple of days actually does more harm than good. If home treatments aren't working, your doctor may suggest stronger medications or other therapy.(video)

Medications
Your doctor is likely to recommend pain relievers such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others). If mild to moderate back pain doesn't get better with over-the-counter pain relievers, your doctor may also prescribe a muscle relaxant.

Narcotics, such as codeine or hydrocodone, may be used for a short period of time with close supervision by your doctor.

Low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline — have been shown to relieve chronic back pain, independent of their effect on depression.

Physical therapy and exercise - http://www.divyeshweb.com/backpain.html
A physical therapist can apply a variety of treatments, such as heat, ice, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques will help prevent pain from returning.

Injections
If other measures don't relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.

In some cases, your doctor may inject numbing medication and cortisone into or near the structures believed to be causing your back pain, such as the facet joints of the vertebrae. Located on the sides, top and bottom of each vertebra, these joints connect the vertebrae to one another and stabilize the spine while still allowing flexibility.

Surgery
Few people ever need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgical intervention. Otherwise, surgery usually is reserved for pain related to structural anatomical problems that haven't responded to intensive conservative therapy measures.

Understanding the cause of your back pain is the key to proper treatment. Because back pain is sometimes difficult to treat, a better understanding of the causes of this problem will assist patients in their recovery from back pain.