Back pain is one of the most common ailments among Americans. At least 80% of adults will have some severe low back pain episode in their lifetimes, according to a study published in the Archives of Internal Medicine. Of those who suffer from back pain, about 8% of adults experience persistent or chronic back pain, according to the same study.
In fact, back pain is one of the most common reasons people miss work in the United States, says Dr. Jonathan Rasouli, a neurosurgeon and director of complex and adult spinal deformity surgery at Staten Island University Hospital with Northwell Health System in New York City.
Most people with chronic back pain have a history of repeated episodes of acute pain.
“Usually, it’s a cumulative effect,” says Dr. Neel Anand, an orthopedic surgeon and director of the spine center at Cedars-Sinai Medical Center in Los Angeles.
Back pain can range from mild discomfort to lifestyle-disrupting, leaving many in search of relief for lower back pain.
[SEE: Top Medications for Back Pain.]
Risk Factors for Back Pain
Several factors put certain individuals at higher risk for developing back pain or injury. This includes:
— Aging.
— Chronic disease.
— Genetics.
— High-intensity physical activity.
— Job-related risks.
— Weight.
— Smoking.
Aging
Unfortunately, arthritis
typically progresses as people age and there’s really no way to avoid it from happening.
“As we age, our spine — just like other joints in our bodies — also develop arthritic changes,” Rasouli says. “Arthritis of the spine can lead to back pain.”
Usually, people start developing age-related arthritis between ages 50 to 60, he says.
Chronic disease
Diabetes, for example, is another risk factor for back pain.
“If you have a lot of blood sugar in your bloodstream for a prolonged period of time, the sugar can react to the bone and discs and can cause an acceleration of arthritic changes in the spine,” Rasouli says.
Rasouli says he encourages patients with diabetes to ensure they’re managing their blood sugar well to avoid back pain-related complications.
Genetics
In some cases, back pain can be hereditary.
Often, it’s not known why some people’s backs degenerate and cause pain faster than others.
“Some of that is a familial trend in people,” Anand says. “If people have bad backs in their families, they’re more likely to have a bad back.”
High-intensity physical activity
People who do high-performance sports and activities — such as gymnastics, weightlifting and CrossFit — are also at risk of injuring their backs due to the nature of their sport.
Lower back pain after an intense workout can occur for several reasons. Injury due to improper form or muscle strain from overuse are common causes in high-intensity sports and calls for rest.
Running is another common workout notorious for lower back pain. The repetitive, hard impact of your foot on the pavement could lead to a pinched nerve, which causes shooting pains in your back, or weak core muscles could cause you to overextend while exercising, which may lead to chronic lower back pain.
Job-related risks
Being in a very physical job that requires you to bend, twist or deal with heavy objects in certain ways for prolonged periods of time can put you at higher risk, Rasouli says.
For example, manual laborers like construction workers or warehouse workers that are repeatedly lifting heavy loads over 50 pounds would fall under this category. In these cases, wearing a lumbar support device can help support your back and stabilize it while you do your job. However, outside of this setting, they’re not recommended for regular use.
To keep your muscles active, you want to keep firing them and using them.
“We could not stand up and walk if our back muscles were not firing,” Anand says. Wearing a brace won’t help you “fire” those muscles, and you will actually lose tone in the muscles in your back, which only makes your back pain worse, he says. Therefore, chronic use of a brace for everyday life isn’t a good idea.
Alternatively, desk jobs that require prolonged sitting — especially if you have poor posture — can cause injury or irritation in the spine.
Weight
Being at a higher body weight can put added stress on your spine, causing lower back pain.
“If you have a significant amount of body weight that puts a lot of stress on the joints — the ligaments on the discs of the spine — that can lead to spinal problems down the road,” Rasouli says.
Body mass index is one indicator that trained health care providers may use to screen for a healthy body weight. There is no specific BMI that opens some up to back pain, but a BMI between 25.0 and 29.9 is considered overweight, and a BMI at 30.0 and above is considered obese. BMI doesn’t account for other factors like muscle mass, so it’s merely used as a screening method rather than a diagnostic tool.
Smoking
Smoking is particularly harmful to the spine.
“If you’re smoking for a very long time, it can cause atherosclerosis, or hardening of the blood vessels that feed your spine,” Rasouli says.
Atherosclerosis occurs when plaque builds up in the inner lining of an artery. When that occurs, the discs and ligaments can slowly become atherosclerotic and then cause problems in the spine, Rasouli says.
[What Not to Say to People With Chronic Pain.]
Common Causes of Back Pain
There are many different causes of low back pain. The most common causes include:
— Muscle sprain or strain, typically from lifting something heavy, using the wrong lifting technique, trauma due to a sport or lifting heavy objects over a prolonged period of time.
— Inflammatory conditions, like arthritis in the back. This often occurs as people age.
— Weak muscles, particularly your core muscles, which are important for supporting your spine.
— Poor posture, which puts unnecessary strain on your neck and back muscles.
— Bone fractures, which are often caused by osteoporosis — when there’s a decrease in bone mineral density and bone mass — or trauma or injury to the spine.
— Disc herniation, also known as a ruptured or slipped disc.
An infection or cancer can also lead to back pain, but those are very rare causes, Rasouli adds.
[SEE: How to Describe Medical Symptoms to Your Doctor.]
How to Relieve Back Pain
For most people who develop low back pain, the pain either resolves on its own over time or responds well to conservative interventions. The following are ways to reduce the severity of back pain:
— Anti-inflammatory medications.
— Exercise.
— Physical therapy.
— Rest.
— Heat or ice.
— Lifestyle modifications.
Anti-inflammatory medications
Over-the-counter anti-inflammatory medications
like ibuprofen or acetaminophen can provide some relief, depending on what’s causing your pain. OTC anti-inflammatories are best for reducing pain caused by swelling and inflammation in muscles and the surrounding nerves, or discs, in your back.
Sometimes your doctor will prescribe a muscle relaxant or prescription-strength anti-inflammatory medication, but most providers avoid prescribing opioid or narcotic painkillers for routine back pain. Opioids or narcotics not only can result in dependence and misuse, but they’re also unlikely to be more effective than non-opioid therapies.
Exercise
Pain in your back is sometimes due to muscle stiffness. Maintaining regular, light activity can help loosen and stretch your muscles, providing much-needed lower back pain relief.
Core-training exercises, in particular, are key for improving lower back pain. Core muscles help support your spine, and without a strong core, your body may rely on other structures like soft tissue ligaments and tendons in your back to support your spine, causing strain in your back.
Exercises such as yoga or Pilates not only strengthen your core, but also provide overall health benefits as well.
Physical therapy
Sometimes, general exercise is not enough, or you may benefit from more targeted exercises. Physical therapy is most often used for acute back pain. Physical therapists will focus on individualized manual therapy to help you feel better, followed by self-care exercise routines to use at home.
The goal of physical therapy is to reduce pain and help prevent the recurrence of acute back pain episodes. It’s important to note that exercises should be improving your pain, not worsening it. A trained physical therapist will guide you and ensure you’re performing exercises correctly.
Rest
Alternatively, the simple remedy of resting can help limit strain on affected muscles in your back, particularly if your pain is due to muscle overuse.
Heat or ice
Many cases of back pain are due to muscle strain. Therefore, applying heat or ice to the affected area may help loosen up the muscles and reduce swelling.
Hot baths, steamed towels or heat wraps can be applied to help reduce muscle stiffness.
Lifestyle modifications
Aiming for an overall healthier lifestyle may improve or slow your symptoms over time.
Having good metabolic markers like making sure your blood pressure, blood sugar and weight are all within healthy normal parameters is important, Rasouli says.
Avoiding smoking is also important, as it’s been associated with back pain. Talk with your doctor about smoking cessation programs that might help you kick the habit.
Though lifestyle modifications can’t cure you, they can certainly slow some of the natural age-related arthritic changes that develop in our spine, Rasouli says.
When It’s Time to See Your Doctor
The vast majority of people who develop low back pain will experience very satisfactory pain relief with conservative measures, Rasouli says. However, “it’s that small percentage — usually about 10% — who don’t do well with these measures.”
In some cases, conservative measures may have worked for a short period of time and now they’re no longer working; in other cases, maybe nothing worked to begin with. In any case, if your pain persists longer than six to 12 weeks with moderate intervention or worsens, it’s time to see a doctor.
Also, if you’re entirely changing your everyday lifestyle due to the pain — like avoiding going out to dinner — that is a problem and you should seek medical advice, Anand says.
“In that small subset of patients, we will typically get a little bit more advanced imaging,” Rasouli says.
You doctor will typically get an MRI or a CAT scan of your low back and look for any structural issues or structural pathology of the spine in which a surgeon could potentially intervene.
Additionally, there are certain signs or symptoms that mean you should visit your doctor right away if you develop back pain. Contact your doctor immediately if you’re experiencing any of the following symptoms:
— Agonizing back pain.
— Burning or shooting pain down your legs.
— Leg weakness and/or numbness.
— Difficulty walking or functioning.
— Numbness in your genital region.
— Urinary incontinence.
— Difficulty urinating or producing a bowel movement.
— Fever and/or chills.
— Cough.
— Unexpected weight loss.
— Non-healing wounds.
Common Myths and Misconceptions About Back Pain
Many who suffer from back pain believe they’re stuck with it, but the vast majority of patients who have acute back pain will get better with a little bit of time and conservative management.
In certain cases, the condition may require surgery. Although some may believe that spinal surgery is either “unsafe or it could potentially be unhelpful,” Rasouli says, the development of newer technologies — such as the introduction of robotics and image-guided surgery — has made spinal surgery much safer and more effective.
Anand cautions against receiving anecdotal advice from those, especially on the internet, who claim to be a “back expert” and using non-scientific methods to treat pain, as it may actually cause worsening symptoms and lead to chronic back pain.
Instead, it’s important to consult with a neurosurgeon or orthopedic surgeon to find the best treatment option for you.
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Back Pain Relief and Management originally appeared on usnews.com
