By Birgitta Kautz

Back Pain

What is back pain?

Back pain is one of the most common medical problems. According to Bone and Joint Canada, up to 80% of people experience it at least once in their lifetime. Back pain can affect people of any age. However, the risk increases when getting older.

Back pain can develop anywhere from the neck down to the lower spine. The pain can range from a dull aching to a sudden stabbing sensation. It can also radiate down the leg.

It can occur suddenly after an injury or lifting something heavy. But the pain can also develop slowly from wear and tear.

Back pain is not a disease diagnosis but a symptom. The pain can be caused by many reasons, sometimes even by a combination of more than one factor. However, it happens often that no specific cause can be found.

Different types of back pain

Our back and spine can be divided into regions: the cervical or neck region, the upper back or thoracic region, and the lower back or lumbar spine. The area between the ribs and the hips is also referred to as the middle back.

Often, the different types of pain are categorized by their location:

Neck pain is prevalent today, also because of poor posture when using technology.    

Upper back pain can often be felt between the shoulder blades and is less common as neck or lower back pain.

Middle back pain is often caused by muscle strains or accidents as the thoracic spine is involved in most upper body movements.    

Lower back pain (LBP) makes it hard to move. According to the WHO, LBP is the number one cause of disability worldwide. LBP is often subclassified as specific or non-specific.

Specific LBP

Sometimes, lower back pain causes are known, such as certain diseases or problems in the spine. If this is the case, the resulting pain in the lower back is called specific.

For specific low back pain relief, the focus is on treating the underlying condition that causes the pain.

Non-specific LBP

If no specific cause can be found, the low back pain is defined as non-specific. The vast majority of LBP cases fall under this category. 

Most guidelines for non-specific low back pain relief recommend physical exercise. Suggested exercises for lower back pain relief include walking, Pilates, yoga, and physical therapies.

Acute vs. chronic back pain

Back pain can also be classified by how long it lasts.

Acute pain lasts less than six weeks. Causes are most often a sudden injury and heavy or wrong lifting. Most people recover from acute pain relatively quickly with simple treatments.  

Subacute pain lasts between six to twelve weeks and is less common than acute pain. A thorough diagnosis is vital to prevent subacute pain from becoming chronic. This applies especially to those who are recovering slowly.       

Chronic back pain lasts over 12 weeks and occurs daily. The pain is often experienced at multiple sites and parts of the body. Severe chronic pain can hinder mobility and disrupt life. The causes are underlying conditions rather than injuries.  

Most people with acute and subacute low back pain begin to improve within the first 6 weeks. However, in some patients, pain can transition from acute to chronic.

What causes back pain?

A broad range of causes can trigger backache in adults and children.

Mechanical back pain

Most of the time, people experience either nonspecific or so-called mechanical back pain.

The term “mechanical” means that the pain is generated by the spine and its supporting structures. This includes the spinal disks, bones, joints, and surrounding soft tissues.

Common causes include

• spinal stenosis (a narrowing of the spinal canal)
• herniated discs (also called slipped discs, it occurs when the jelly-like center of a spinal disk leaks)
• vertebral fractures (a fracture of one or more of the backbones)
• muscle strain
• pinched or compressed nerve roots (often as a result of a herniated disk or osteoarthritis)
• spondylosis (osteoarthritis of the spine)

But, prolonged poor posture from too much sitting or weight gain in pregnancy can also trigger pain in the back.

Inflammatory back pain

This pain is less common and is caused by an underlying inflammation. Several types of spinal arthritis are known that cause the joints of the spine to become inflamed.

Pain caused by other medical conditions

Other conditions can also trigger a backache. These include osteoporosis, infections, kidney stones, and, in rare cases, tumours.

Some people can experience back pain as a side effect of certain medications.

Can back pain be prevented?

The best way to reduce the risk of back pain is to address some of the known risk factors.

Exercise
Staying physically active is important for your back. Regular gentle exercise programs can help improve muscle strength and maintain healthy body weight.   

Diet
Getting enough calcium and vitamin D from our diet is vital for bone health. A balanced diet also helps to manage body weight.

Smoking
Stop using any tobacco products as they can restrict blood flow and circulation. This in turn can damage spinal structures, such as your spinal discs.

Workplace
Try to keep your back straight when standing or sitting. An ergonomic office chair can help you maintain good posture.

Lifting
Learn to lift with your legs instead of using your back. For extremely heavy items, see if someone can help you with lifting.

Sleep
Make sure you get enough good quality sleep. Also, choose a mattress that offers good support and pressure relief.

How to relieve back pain?

You should always keep in mind that the cause of your back pain determines the treatment.

If you suffer from mechanical back pain, the following tips can help you feel better:

1. Heat pad: A heat pad or a warm bath can help relax muscles and ease pain or stiffness in your back.
2. Ice packs: Ice packs can help with pain and swelling. You can also try alternating between heat and ice packs to see what works best for you.
3. Gently stretching: Doing gentle yoga or Pilates to stretch and strengthen your muscles can help your back feel better. You can also try knee-to-chest stretches for lower back pain.
4. Light exercise: Low-impact activities such as walking or swimming can be one of the most effective treatments for pain.
5. Massages: Gentle massages promote blood flow. They can also reduce stress and muscle tension. Applying herbal creams such as arnica or comfrey cream to the affected area can further help with pain relief.
6. Acupuncture & physiotherapy: Acupuncture can help decrease your pain, while physiotherapy is good for improving strength and getting more flexible.  
7. Nutrition: A healthy diet in combination with exercise helps to manage body weight. If you are overweight, losing weight will decrease the strain on the back. Also, foods rich in antioxidants can help reduce inflammation and pain.
8. Sleep: Avoid sleeping on your stomach. Putting a pillow under your knees can help relieve pressure on your back. 

When should you see a doctor?

Most back pain gets better within a few weeks. You should see a doctor if your pain does not improve. If you suffer from chronic low back pain, you may need prescription drugs such as muscle relaxers or pain medication.  

Also, see a healthcare provider if you experience any of the following symptoms along with your back pain:

• Your pain is severe or persistent.
• You feel numbness, weakness, or tingling in your legs.
• Your pain occurs after a fall or back injury.
• You have problems with passing urine.
• You have a high temperature or fever.
• Your pain is paired with unintended weight loss.

These symptoms should be clarified as they could indicate a serious medical problem.

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