Back Pain Causes and Treatments

Although back pain is fairly common, the symptoms and causes vary considerably. The back is made up of multiple muscles, ligaments, tendons, bones, and discs, all working together to keep us upright, mobile, and active. When one area of the back is injured, whether due to a strain, poor posture, or an ongoing health issue, it can sometimes cause debilitating pain and make it difficult for us to perform daily activities.

To help you better understand the potential sources of your back pain, we outline the most common causes and discuss some rare, yet serious reasons you may be experiencing pain in this area.

Common Causes

In most cases, back pain is acute, meaning that it has been going on for less than four weeks, and these cases gradually improve over time. This type of back pain is can often be caused by straining the back muscles. Chronic back pain describes pain that has lasted longer than twelve weeks. These can sometimes be due to a structural issue in the back, such as a herniated disc or osteoarthritis.

Dr. Miho Tanaka, orthopedic surgeon says, “While many conditions can lead to back pain, minor aches and strains are very common and can affect most people at some point in their lives. Increased stress on the back can contribute to this. Therefore, maintaining flexibility and strength of the muscles that support the spine can be helpful in minimizing the risk of back pain, particularly as we age.”

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Muscle Strains and Sprains

A strained back muscle typically occurs from a sudden force or stress on the muscles.  These injuries are typically caused by misuse or overuse of the muscles and can lead to inflammation, pain, muscle spasms, and tightness.

When torn muscles in the back stiffen, this is the body’s way of protecting the back from further injury. This tightening, however, can lead to immobility and severe pain. 

Strains can be caused by the following:

• Poor posture or spinal misalignment: Maintaining a curved spine for a long period of time when sitting or standing causes unnatural stress to the spine. These positions put pressure on the muscles in the back and can lead to tension and pain. Resting on a sagging mattress that sinks excessively can also cause the spine to strain.
• Incorrectly lifting heavy objects: Heavy lifting or incorrect lifting technique can place increased strain on the muscles in the back.
• Sports or exercise injuries: Activities that include twisting, bending, or other abrupt, awkward movements can strain the muscles.

Bulging or Herniated Disc

Cartilage discs between the vertebrae work to absorb shock and lubricate the joints. Due to aging, these discs deteriorate over time, causing them to bulge outward. This may also occur as a result of trauma. Although these changes are fairly common in the lumbar spine, it can happen in the upper back as well.

In some cases, a disc that protrudes from the spinal column can tear or rupture. This is called a herniated disc, which is considered a part of degenerative disk disease. In this case, the contents of the disc (nucleus pulposus) can sometimes compress nerves that exit the spine, leading to a sharp pain that often radiates down the back into the buttocks and legs. If the sciatic nerve is compressed, it can lead to sciatica, which causes shooting pain that can run from the base of the spine down to the legs.

A ruptured disc in the upper back may cause pain that runs down the shoulders and into the arms and hands. A herniated disc can also lead to neurological symptoms such as weakness, numbness, and a tingling sensation in the limbs.

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Spinal Osteoarthritis

Osteoarthritis occurs when the protective cartilage between bones becomes thin, dry, and brittle. When this happens, there is a decreased cushion between the bones that can cause joints to rub against each other during movement. In some cases, bone spurs often develop near the source of the pain, which can press on nerves and cause tingling or numbness.

Spinal osteoarthritis is the breakdown of the cartilage between the vertebrae of the spine. This may cause stiffness, immobility, and pain when bending or moving.

In addition to aging, excess weight can put stress on the joints along the spine, contributing to symptomatic spinal osteoarthritis.

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Sciatica

A bulging or ruptured disc or bone spur can often lead to sciatica. This occurs when the sciatic nerve, which runs from the base of the spine down through the buttocks and legs, is compressed. Muscle spasms in the buttocks, called piriformis syndrome, can also cause sciatica.

When this nerve becomes compressed, it can lead to intense lower back pain that radiates down through the legs and often to the feet. Sciatic pain often occurs on one side of the body and is accompanied by nerve pain, such as tingling and numbness.

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Spinal Stenosis

Spinal stenosis occurs when the spinal canal gradually becomes narrow and compresses the nerves. This is often due to osteoarthritis or injury to the spine and can lead to pain or nerve damage. In some cases, scoliosis and Paget’s disease, conditions that affect the structure of the spine, stenosis may also occur.

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Osteoporosis

Osteoporosis causes the bones to become brittle, weak, and prone to fracture. In severe cases, sudden, sharp pain in the back could be caused by a compression fracture of the vertebrae. Depending on the brittleness of the bones, this could be brought on by a traumatic injury or by simple everyday tasks. In most cases, fracture pain in the vertebrae takes place in the lower or middle part of the back. It can also be a fairly common cause of back pain in elderly people.

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Vertebrae Stress Fractures

Spondylolysis is a stress fracture to one or more spinal vertebrae. This condition typically occurs in athletes due to strenuous and repetitive activities. Stress fractures can also be the result of injury or deterioration due to aging.

When a stress fracture is left untreated, it can put pressure on the stability of the vertebrae, causing it to weaken and slip. This condition is called spondylolisthesis and can result in lower back stiffness and pain. Slipped vertebrae that press against a nerve may also cause pain that radiates down the arms or legs.

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Rare Causes

Back pain brought on by a serious health issue is less common, but should also be considered. The following are causes of back pain that are connected to diseases that affect the whole body.

Cancer

Certain types of cancers can cause tumors to develop on or around the spine. Additionally, tumors elsewhere in the body, such as the lungs, can spread to the bone of the spine and put pressure on the nerve roots or cause weakening of the bones in the back.

Ankylosing Spondylitis (AS)

Ankylosing Spondylitis (AS) is a chronic inflammatory disease of the spine that can lead to the fusing of the vertebral joints. This condition is hereditary often causes lower back pain, stiffness, and a limited range of motion.

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Infection

Bacteria or fungal organisms can cause an infection in the spinal column, intervertebral discs, or in the soft tissue surrounding the spine. The most common type of spinal infection is vertebral osteomyelitis, which can occur after other types of infection in the body or from spinal surgery. Spinal infection is typically accompanied by a fever, severe back pain, and chills.

Cauda Equina Syndrome

Cauda Equina Syndrome is a medical emergency that occurs when the nerves at the base of the spinal cord are severely compressed, causing the risk of permanent neurological injury. This is associated with severe back pain and loss of strength and/or sensation in the legs, and incontinence.

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When to See a Doctor

Most of us experience some form of back pain throughout our lives. In most cases, there are simple and easy ways to find pain relief at home. However, if your back pain is accompanied by any of the following symptoms, it is best to seek medical advice before starting a treatment plan.

• Fever, chills, or sweats
• Difficulty using the restroom
• Shortness of breath or difficulty breathing
• Debilitating pain that keeps you at night
• Back pain that continues for longer than 4 weeks

When visiting your doctor, they will diagnose the cause of your back pain with a physical examination or by using imaging tests, such as an x-ray, CT scan, or MRI scan. Together, you and your primary care physician can develop a plan that may involve medication and/or physical therapy.

In some cases, chiropractic care can also help. Chiropractors offer electrical stimulation which stimulates the muscles to ease tension. Chiropractic care can also include spinal manipulation which involves moving and massaging the muscles to reduce pain.

Treatment Options

In addition to meeting with your doctor, there are several lifestyle changes and home remedies that may help you find back pain relief, depending on its cause.

Eat An Anti-Inflammatory Diet

A diet rich in omega-3 fatty acids can naturally reduce inflammation in the body, which can be the cause of some types of pain. Food such as dark leafy greens, nuts and seeds, and cold-water such as salmon all have high omega-3 content.

When trying to reduce inflammation, it is best to avoid high saturated fats and salty, processed foods.

Low-Impact Exercises and Stretching

Low-impact exercises that strengthen the core, such as swimming or walking, can help relieve back pain and facilitate a faster return to activities in many cases. Light stretching can also ease joint stiffness and ease tension in the lumbar area.

You can also try hot and cold therapy post-exercise, or at the end of each day, to ease soreness and prevent new pains.

Replace Your Mattress

As we mentioned earlier, an unsupportive mattress can lead to spinal misalignment, which puts pressure on the back muscles and leads to aches and pains in the morning. The best mattress for back pain will keep the spine resting in a safe, neutral position so the muscles in this area can fully relax and recover.

When considering mattress firmness, you need to know your preferred sleep position. For example, when looking for a mattress for side sleepers, you want to find something with more give to keep the hips and shoulder joints cushioned and protected from pressure points. A soft to medium firmness tends to work best for side sleepers.

A back sleeper is often more comfortable on a medium to medium-firm mattress because this comfort level keeps body weight evenly distributed, so the spine can remain in alignment with the hips and shoulders.

Stomach sleeping is typically not recommended for those with back pain. This position forces the spine to bow, which can increase tension on the joints of the spine and be uncomfortable for some people.

No matter what mattress firmness you choose, it is important to avoid those that cause excessive sinking. When one part of the body sinks too far into the bed, it can force the spine into unnatural positions and cause the back muscles to tighten. That said, most stomach sleepers prefer firm mattresses to avoid pain.

Heavyweight sleepers should avoid mattresses that are too soft, as they may cause uncomfortable sinkage. Lightweight sleepers will naturally sink less, so they may prefer a soft to medium mattress in order to experience adequate contouring.

Massage

Massage is a safe and effective way to release tension and stress in the back muscles and alleviate pain. If you suffer from chronic pain or injury, it is best to discuss this with your therapists beforehand. This will keep them aware of any tender spots, knots, or areas to avoid.

Frequently Asked Questions

Is bed rest good for back pain?

Depending on your condition, your doctor may recommend bed rest. However, in most cases, long periods of inactivity can cause back pain and stiffness to worsen. Physical activity has been shown to facilitate faster recovery, and help loosen and strengthen muscles.

Could back pain be kidney related?

In some cases, back pain can be related to the kidneys. Kidney stones or a kidney infection can cause sharp pains in the mid-back. This is may be accompanied by nausea, vomiting, and fever. If you suspect your back pain is connected to kidney function, it is important to seek medical attention right away.

Are back pains normal during pregnancy?

It is fairly common for women to experience back pain throughout pregnancy. Hormonal changes within the body can contribute to this. Later in pregnancy, the weight of a growing belly can also put pressure on the back and lead to low back pain.

Avoiding heavy lifting, wearing low-heeled shoes, and resting on their side at night can help alleviate back pain in women who are pregnant. A body pillow can also help support the weight of the belly and reduce pressure on the back, especially if paired with a softer mattress for pregnancy.

Does stress cause back pain?

With our busy, active lives, stress and anxiety can lead to chronic tension and pain in the back and shoulder muscles. Stress also affects the muscles that support the neck, upper back, and shoulders, which may sometimes even lead to neurological symptoms, such as tingling or numbness in the arms. Therefore, finding ways to naturally reduce stress, such as physical activity, breathing exercises, and light stretching, can also help to decrease the risk of back pain.

Conclusion

The back is a complex structure of muscles and ligaments. Therefore, a small strain in one area can often lead to pain throughout your entire back. The good news is that most strains do not lead to chronic, long term back pain. With mild exercise and stretching, massage, and self-care, many people can reduce mild discomfort and get back to their normal routine. If not, check-in with your doctor to look for other causes or treatments.