Back Pain

Back pain is physical discomfort that occurs along the spine or back. It may feel like a constant, dull ache or sudden, sharp, stabbing, or burning pain. Problems with the spine, inflammatory disease, and other health conditions are common causes of back pain. Treatment for back pain varies, depending on the cause and severity of the pain. 

This article explores back pain symptoms, the various causes, risk factors, and treatment options.

Symptoms of Back Pain

Back pain can range from mild discomfort to severe pain. It may be localized (in one spot) or radiate to other areas of the back and body. Common symptoms of back pain include:

• Dull, aching sensation in the muscle(s) 
• Inability to stand up straight 
• Limited flexibility
  
• Radiating pain down the buttocks, hip, or leg 
• Reduced range of motion 
• Sharp, stabbing pain 
• Worsening pain when bending, lifting, twisting, standing, or walking 

Causes of Back Pain

Back pain can affect the parts of your spine that move or the surrounding support structures. Excess strain, structural issues, inflammation, or underlying health conditions can contribute to back pain.

Mechanical

Mechanical back pain occurs when there is excess stress or strain on the moving parts of the spine, including the muscles, discs, joints, tendons, and ligaments.

Poor posture, incorrectly lifting, repetitive movements, and overuse are the most common causes of mechanical back pain. This type of back pain is typically short term and resolves within a few weeks; however, some people experience recurrent episodes of mechanical back pain.

Structural

Structural back pain occurs when there are problems with any of the structures and tissues that make up the spine, including vertebrae, discs, and nerves. Ruptured, herniated, or bulging discs may put pressure on a nerve, such as the sciatic nerve, leading to radiating pain.

Osteoarthritis (wear-and-tear arthritis), scoliosis (abnormal curvature of the spine), and kyphosis (a pronounced forward rounding of the back) are all common causes of structural back pain.

Inflammatory

Inflammatory back pain is associated with inflammation that affects the spine and sacroiliac joints linking your pelvis with your lower spine. Chronic lower back pain is associated with inflammatory conditions, including ankylosing spondylitis and psoriatic or rheumatoid arthritis.

Other Health Conditions

Other health conditions that may cause back pain include:

• Asthma (lung disease causing wheezing, a tight chest, and breathlessness)
• Endometriosis (tissue similar to that lining the uterus grows outside the uterus)
  
• Fibromyalgia (chronic disorder causing pain throughout the body)
• Infections (e.g., kidney infection, bone infection)
• Kidney stones (hard deposits that form in the kidneys)
  
• Osteoporosis (weak and brittle bones)
  
• Pregnancy

What Medications Can Cause Back Pain? 

Certain medications may cause joint and muscle pain affecting the back. Medications that may cause back pain include: 

• Fluoroquinolone (broad-spectrum) antibiotics: Research shows these antibiotics may cause joint and muscle pain in some people.
• Statins: Cholesterol-lowering medications may cause muscle pain.
• Bisphosphonates: These medications are associated with severe bone, joint, and muscle pain in a small number of people who take them to prevent bone mineral loss. 

How to Treat Back Pain

There are a wide variety of treatments for back pain. The treatment your healthcare provider recommends will depend on the cause and type of back pain.

Medications

Over-the-counter (OTC) and prescription medications may reduce inflammation and pain. Medications for back pain include: 

• Analgesics or pain relievers are over-the-counter medications like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) and Aleve (naproxen). Prescription NSAIDs, such as Celebrex (celecoxib) or Mobic (meloxicam), may provide longer-lasting relief than OTC options.
• Muscle relaxants: OTC and prescription muscle relaxant medications may be used short term to reduce muscle spasms and pain. 
• Topicals: Topical creams, patches, gels, and sprays may provide temporary pain relief when applied directly to the skin on the affected area.
• Antidepressants: Your provider may prescribe antidepressant medications for off-label use to treat chronic back pain, including serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). 
• Corticosteroids: Oral and injected corticosteroids may be prescribed for certain types of back pain, especially for people with chronic nerve-related back pain (e.g., sciatica).
• Opioids: Your provider may prescribe opioid pain medications such as Vicodin (hydrocodone) or Oxycontin (oxycodone) to treat severe back pain. These medications should be used short term to prevent the risk of addiction and other side effects, including depression. 

Alternative Therapies and Home Remedies

Alternative therapies and home remedies may help relieve certain types of back pain. These include: 

• Acupuncture 
• Alternating hot & cold packs
• Massage therapy 
• Physical therapy
• Stretching 
• Transcutaneous electrical nerve stimulation (TENS) 

Surgery

Surgery is generally only considered if other treatments have not been effective. It is most often recommended for those with structural back pain (e.g., scoliosis) or if there is nerve damage, nerve compression, or severe musculoskeletal injuries. 

Risk Factors Associated with Back Pain 

Back pain can affect anyone, but certain factors increase the incidence of this type of pain, including:

• Age: As we age, the back can change and degenerate from wear and tear, which increases the risk of back pain. 
• Genetics: Some inflammatory conditions associated with back pain, such as ankylosing spondylitis, can be inherited. 
• Mental health conditions: Anxiety, depression, mood disorders, and stress may increase the risk of back pain. 
• Sedentary lifestyle: Lack of physical activity can cause the muscles in the back and supporting structures to weaken over time and lead to back pain. 
• Smoking: Tobacco use decreases blood flow to discs and may rapidly advance normal degeneration. 
• Weight gain: Carrying extra weight can put additional stress on the back. 

Are There Tests to Diagnose the Cause of Back Pain? 

Your healthcare provider will perform a thorough physical examination to determine the cause of your back pain. They may order tests to provide an accurate diagnosis and appropriate treatment, which could include:

• Blood tests look for signs of infection, inflammation, or arthritis.
• Bone scans detect fractures, infection, cancer, or bone disorders.
• Electromyography (EMG) tests muscles and nerve signals.
• Imaging tests such as computerized tomography (CT), magnetic resonance imaging (MRI), and X-rays take detailed pictures of the spine and surrounding tissues to look for abnormalities.
  

When to See a Healthcare Provider 

Most back pain improves on its own over time. OTC medications, rest, and home treatments (e.g., stretching) may relieve pain. Contact your healthcare provider if your back pain does not improve after three to four weeks, or you have back pain with one or more of the following symptoms:

• Fever
• Loss of bladder and bowel control 
• Numbness, tingling, or weakness in the leg(s) 
• Pain spreads to the leg(s) and feet
• Unintentional weight loss 
• Worsening pain that does not improve with rest
  

Summary 

Back pain is a common condition caused by injury, structural problems, inflammatory disease, and other medical conditions. It can be relieved with medication, specific therapies, and in severe cases, surgery. Talk to your healthcare provider if you experience back pain lasting longer than three to four weeks.

A Word From Verywell

Living with acute or chronic back pain can be challenging. Daily stretching, regular physical activity, and maintaining a healthy weight can help reduce the risk of future episodes of back pain. Talk to your healthcare provider if back pain interferes with your daily life. They can determine the cause of your back pain and provide the necessary treatments.