Back pain is an extremely common ailment, and most people have experienced it at some point in their lifetime. Any form of back pain is usually a symptom of a larger medical issue like whiplash or other car accident injuries– it is not a disorder or a diagnosis itself. However, it can still be a debilitating issue that causes a decrease in quality of life or leads to other serious issues when untreated. Luckily, most back pain can be treated without invasive options like surgery.
Treating back pain is sometimes particularly complex due to the nature of the back, which usually refers to the spine and connecting muscle tissue. Moreover, the spine impacts the rest of your body through the nervous system, so back pain can be a sign of much larger issues. The best thing you can do is take steps to prevent back pain from ever occurring- but when it does, understanding the spine and how it works can be helpful in making decisions about the right treatment.
The spine is technically one area of the body, but it is made up of many smaller vertebrae and it spans the entire torso. That means that different areas of the spine may react differently to injury or disease. While we may think of it all as “back pain,” the area of the back that is impacted can make a big difference in diagnosis and treatment.
The portion of your spine that makes up the neck is known as the cervical spine- right below that, your thoracic spine begins. The thoracic spine is more resilient than the cervical spine and lower back, but its sturdiness can still be overcome to back pain. This area begins right under the neck and is comprised of 12 vertebrae, labeled T1 through T12, which go down the back and end around the bottom of the rib cage. Unlike the rest of the spine, this area is fairly stiff and immobile, as the ribs and sternum connect the vertebrae, leaving them less room to operate independently.
Pain in the upper and mid-back usually occurs for one of two reasons:
Muscular irritation can happen in the large muscles that attach to the shoulder blade, as they are prone to strains and tightness that may be painful and difficult to relieve. Most commonly, this is a result of an overuse injury from repetitive motions or a severe lack of muscle strength.
Joint dysfunction is the other primary cause of thoracic back pain and can result from either a sudden injury or age-related degeneration that leads joints to become dysfunctional and painful.
When upper and mid-back pain becomes bad enough to limit your activity, most people describe the pain as a sharp, burning pain that is localized to one spot, or a general achiness that flares up and spreads across the shoulder and neck.
The lumbar region of your spine begins underneath vertebrae T12, below the ribs, and ends at your tailbone. Unlike the thoracic spine, this area is very mobile and is a complex structure that interconnects a number of tissues with the 5 vertebrae, making it much more prone to injury or disorder. The lower spine also supports the weight of the entire body, providing mobility and the ability to do simple things like walk or sit comfortably. Nerves in this region also provide sensation to the lower half of the body.
Most acute pain in the lower back is the result of injuries to the muscles, ligaments, joints, and discs in that area. These can also become quickly inflamed in response to a disturbance, which can cause significant pain in the region. Because of the interconnected nature of the lumbar spine, it is not always easy to identify the exact root cause of the pain, and symptoms can vary widely. Time and treatment are usually important to understand the root cause of your pain and properly address that cause.
While many things can lead to back pain, there are some general categories of common causes. Knowing these can help you understand your risk for back pain or what activities may be contributing to your discomfort.
Often a result of incorrect lifting or sudden awkward movements, a strained muscle is a common cause of back pain. Your entire back has muscles, so this can occur in any location, or even multiple at one time. Over-activity is another way that muscles can become strained. If you notice soreness and stiffness in the time following strenuous activity, a sprain may be the culprit.
The spine is composed of vertebrae, interlocking bones that stack on top of each other. Each vertebra is separated by discs made of a cushion-like tissue to create space between the vertebrae and prevent friction. When these discs are injured, moved, or degenerate over time, it can lead to severe back pain. Discs can herniate, meaning they may bulge or even rupture, compressing nerves in the nearby area, leading to pain and numbness or tingling.
Conditions like arthritis of the spine, which causes damage or deterioration to the cartilage of joints, can lead to pack pain, especially as we age. A loss of bone density known as osteoporosis can also lead to small fractures in the vertebrae, which cause severe pain.
There are many other causes of back pain, though some are very rare. Any regular back pain is a reason to see your doctor to identify the root cause of your discomfort.
Back pain itself is a symptom, so when you seek treatment, the goal will be first to identify a diagnosis that can be treated. This can usually be achieved through a physical examination and discussion with your doctor. You will likely be asked about your symptoms and medical history, in addition to a series of physical tests to assess your ability to stand and walk, range of motion, reflexes, and strength.
If your doctor can’t identify a diagnosis or suspects a serious condition, you may be sent for tests and diagnostic imaging. Blood or urine samples may be taken in addition to x-rays, CAT scans, or MRIs to get a better view of any issues.
The identified cause of your back pain will heavily influence what kind of treatment method you are prescribed. Most back pain can be addressed with chiropractic care, physical therapy, and simple home remedies like rest and over-the-counter medications. However, in more serious cases of illness or where typical treatment is not working, surgery or similarly invasive procedures may become necessary to prevent further damage from occurring.
Ideally, you would never experience back pain in the first place. There are some ways you can take care to not injure your back- and if it does happen, the same simple tips can prevent you from worsening an existing problem.
A lot of pain comes from carrying heavy objects like briefcases, backpacks, or suitcases, which strain your back. Reducing what needs to be carried and using bags with wheels can keep pressure off your back.
Poor posture is a heavy risk factor for pain and damage over time. Regular reminders to roll back your shoulders and sit upright will make a huge difference.
Exercise is always good for you, but strength training, in particular, can help your back muscles be stronger and less prone to damage. Focusing on your core is also important. In addition to exercises, stretching throughout the day helps keep your muscles alert and less prone to strains, while also improving circulation.