What Causes Backache?
Lower back pain, also called lumbago, is not a disorder. It’s a symptom of several different types of medical problems.
It usually results from a problem with one or more parts of the lower back, such as:
- the bony structures that make up the spine, called vertebral bodies or vertebrae
It can also be due to a problem with nearby organs, such as the kidneys.
According to the American Association of Neurological Surgeons, 75 to 85 percent of Americans will experience back pain in their lifetime. Of those, 50 percent will have more than one episode within a year.
In 90 percent of all cases, the pain gets better without surgery. Talk to your doctor if you’re experiencing back pain.
This diagram shows which muscles in the lower back may be causing you pain.
Many individuals will not need extensive treatment for back pain. Over-the-counter pain medications are often sufficient.
In more severe cases, stronger treatments may be necessary, but they’re typically provided under close supervision from your doctor.
The majority of back pain episodes are relieved by treatment with nonsteroidal anti-inflammatory medications (NSAIDs), such as:
Pain relievers, or analgesics, such as acetaminophen (Tylenol), are also an option, though they don’t have the anti-inflammatory properties.
Be careful with medications like ibuprofen if you have kidney problems or stomach ulcers.
Never take more than the recommended dose of over-the-counter medications without talking to a doctor, as even these medications may have severe side effects if taken incorrectly.
Other medication options include:
Topical rubs and ointments
Topical products may be highly effective at reducing back pain. Many of these contain ingredients like ibuprofen and lidocaine, which have been found to work better than a placebo when it comes to pain relief.
Opioids are stronger pain medications that can be prescribed for more severe pain. These medications, such as oxycodone (OxyContin) and a combination of acetaminophen and hydrocodone (Vicodin), act on the brain cells and body to reduce pain.
Opioids should be used with caution, however, due to a risk of addiction.
Muscle relaxants can also be used for low back pain, especially is muscle spasms are occurring alongside pain. These medicines act on the central nervous system to reduce pain.
Antidepressants and other medications can sometimes be used off-label for the treatment of back pain.
If your back pain is severe, your doctor may prescribe amitriptyline, a tricyclic antidepressant, because it focuses on different parts of the pain response. This antidepressant may also work better for nerve-related pain.
Your doctor might also recommend cortisone steroid injections for severe back pain. However, pain relief from steroid injections usually wears off by around three months.
Surgery is a last resort treatment and is rarely needed for back pain. It’s usually reserved for structural abnormalities that haven’t responded to conservative treatment with medicines and therapy.
- severe, unremitting pain
- nerve compression that causes muscles to become weak
Spinal fusion is a surgery in which painful vertebrae are fused into a single, more solid bone. It helps eliminate painful motion of the spine.
Surgery to partially remove and replace disks and vertebrae may be done to relieve pain caused by degenerative bone diseases.
Alternative therapies that may help relieve back pain include:
Be sure to talk to your doctor before undergoing any alternative or complementary treatment. If you’re experiencing back pain, these lower back pain treatment options might be helpful.
Many home remedies can be used with traditional back pain treatments. If you have questions about these, talk with your doctor.
Ice packs may relieve discomfort and help lessen inflammation in acute phases of back pain. Note: Don’t apply the ice directly to your skin. Wrap it in a thin towel or gauze to prevent damage to your skin.
Warm compresses may also relieve pain when inflammation has subsided. Consider alternating between heat and cold.
Exercises to improve posture and strengthen the muscles of the back and abdominal muscles — called the core muscles — are a treatment option that should be strongly considered.
This treatment often involves:
- improving posture
- using proper lifting techniques
- strengthening core muscles
- stretching muscles to improve flexibility
A physical therapist can teach you how to perform these types of exercises at home.
Research suggests lavender essential oil or ointments made with capsaicin may help decrease pain.
Capsaicin is the ingredient in peppers that make them hot. These ingredients may desensitize the nerves in the impacted area and decrease the pain you feel.
A hot bath can do wonders for aching muscles, but while you’re soaking, give the water an added boost for your back with Epsom salt. Your body can absorb the minerals from the salt bath, and they can help ease aching muscles.
Home remedies may be highly effective at reducing back pain. Learn more about how to use them and how they work.
The most common causes of lower back pain are strain and problems with back structures.
Strained muscles often cause back pain. Strain commonly occurs with incorrect lifting of heavy objects and sudden awkward movements.
Strain can also result from over-activity. An example is the sore feeling and stiffness that occurs after a few hours of yard work or playing a sport.
Vertebrae are the interlocking bones stacked on top of one another that make up the spine. Disks are areas of tissue that cushion the space between each vertebra. Disk injuries are a fairly common cause of back pain.
Sometimes these disks can bulge, herniate, or rupture. Nerves can get compressed when this happens.
Herniated disks can be very painful. A bulging disk pressing on the nerve that travels from your back down your leg can cause sciatica or irritation of the sciatic nerve. Sciatica can be experienced in your leg as:
Spinal osteoarthritis is also a potential cause for back pain. It’s caused by damage and deterioration in the cartilage of joints in your lower back.
Over time, this condition can lead to narrowing of the spinal column, or spinal stenosis.
Loss of bone density and thinning of the bone, called osteoporosis, can lead to small fractures in your vertebrae. These fractures can cause serious pain and are referred to as compression fractures.
Other causes of back pain
There are many other potential causes of back pain, but most of these are rare. Be sure to see your doctor if you experience regular back pain that does not go away.
After ruling out the more common causes of back pain, your doctor will perform tests to determine if you have a rarer cause. These can include:
- displacement of one vertebral body onto another, called degenerative spondylolisthesis
- loss of nerve function at the lower spinal cord, called cauda equina syndrome (a medical emergency)
- fungal or bacterial infection of the spine, such as Staphylococcus, E. coli, or tuberculosis
- cancer or nonmalignant tumor in the spine
- kidney infection or kidney stones
Back pain can have many symptoms, including:
- a dull aching sensation in the lower back
- a stabbing or shooting pain that can radiate down the leg to the foot
- an inability to stand up straight without pain
- a decreased range of motion and diminished ability to flex the back
The symptoms of back pain, if due to strain or misuse, are usually short-lived but can last for days or weeks.
Back pain is chronic when symptoms have been present for longer than three months.
Back pain symptoms that may indicate a serious problem
See your doctor if back pain doesn’t improve within two weeks of developing. There are times when back pain can be a symptom of a serious medical problem.
Symptoms that can indicate a more serious medical problem are:
- loss of bowel or bladder control
- numbness, tingling, or weakness in one or both legs
- onset following trauma, such as a fall or a blow to the back
- intense, constant pain that gets worse at night
- presence of unexplained weight loss
- pain associated with a throbbing sensation in the abdomen
- presence of fever
Let your doctor know if you have any of these symptoms.
A physical exam is typically all that’s needed to diagnose back pain. During the physical exam, your doctor may test your:
- ability to stand and walk
- spine’s range of motion
- leg strength
- ability to detect sensations in your legs
If a serious condition is suspected, your doctor might order other tests, including:
- blood and urine tests to check for underlying conditions
- X-rays of the spine to show alignment of your bones and check for breaks
- computed tomography (CT) scan or magnetic resonance imaging (MRI) to assess your disks, muscles, ligaments, nerves, and blood vessels
- bone scan to look for abnormalities in the bone tissue
- electromyography (EMG) to test nerve conduction
These tips can help ease back pain when it happens. They can also help you prevent back pain in the first place.
Heavy briefcases, laptop bags, suitcases, and purses can add unnecessary stress and strain to your neck and spine.
Try to reduce what you need to carry, and use bags that distribute the weight more evenly, such as a backpack. If you can, use a bag with wheels to keep weight off your back entirely.
Work your core
The muscles in and around your abdomen and back help keep you upright and carry you through your physical activities. Strengthening them can also reduce the chances of pain, strain, or damage to your back.
Plug strength-training workouts with a core focus into your regular fitness routine at least twice a week.
Improve your posture
Poor posture can put unnecessary pressure and strain on your spine. Over time, this can lead to pain and damage.
Regularly remind yourself to roll back rounded shoulders and sit upright in your chair.
High-heeled shoes are likely to cause damage to your back if you wear them frequently. Pick comfortable, low-heeled shoes when you can. One inch is a maximum heel height suggestion.
Doing the same thing every day can leave your muscles fatigued and more apt to strain. Stretch regularly to help improve circulation in those muscles and lower the risk of back pain and damage.
If you think these five tips are helpful for preventing back pain, read five more ways to help reduce your chances of hurting your back.
According to the Mayo Clinic, you’re at an increased risk for back pain if you:
- work in a sedentary environment
- don’t exercise
- engage in high-impact activity without stretching or warming up first
- are older
- have obesity
- are a smoker
- have been diagnosed with a specific condition like arthritis
Your emotional health also has an effect on your risk for back pain. You may be at a higher risk for back pain if you have a stressful job or have depression and anxiety.
Back pain during each trimester of your pregnancy isn’t uncommon — several causes can be to blame. However, you should be sure to talk to your doctor about what you’re experiencing, in the event the pain may be part of a bigger problem.
Here are a few reasons why you may be experiencing back pain during pregnancy:
Shifting center of gravity
As your baby grows, the center of your body’s “gravity” moves outward. Your spine and back arch to make up for the change in balance. This put extra stress on the lower lumbar spine.
Weight gain can be a healthy part of pregnancy, but even the little bit you’re likely to gain during those 9 months can put more stress on your back and core muscles.
As your body prepares to deliver the baby, it releases hormones that loosen the ligaments that stabilize your pelvis and lumbar spine. These same hormones can cause the bones in your spine to shift, too, which may lead to discomfort and pain.