What to Do When You Encounter Back Pain


Ouch my back hurts, you moan, reaching for your sore, pinched, or strained backside. This is an all-too common scenario for many of us. More than 65 million Americans suffer from back pain every year. It is the most frequent complaint from people seeking medical care.

Advances in medicine have created many treatment options for people seeking back pain relief. Alternative treatments have increased in number and availability as well. However, there is still no miracle cure able to rid the world of back pain once and for all. Since the intensity, causes and specific conditions vary with each patient, you need to discuss treatment options with a health care professional in order to tailor treatment to your specific condition.

Patients have an almost daunting number of choices of medications, some of which alleviate not only back pain but reduce inflammation, muscle tension, and spasms too. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) include aspirin, ibuprofen, and a host of prescription medicines. Taken regularly, these medications can significantly reduce inflammation and resulting back pain, and also provide back pain relief when taken during acute episodes. One common side effect of NSAIDs that should be taken into consideration is their propensity for causing gastrointestinal upset.

Acetaminophen comes in many over-the-counter medications. It acts as an analgesic, and is often used to treat acute pain. These medications can be taken alone or in conjunction with NSAIDs. Potential harmful side effects of acetaminophen include liver and kidney damage.

Doctors sometimes prescribe opioids or muscle relaxants for severe pain, but these medications can be habit-forming.

Acupuncture has been used in China for over 2,000 years and was first popularized in the United States in the 1970s. This ancient alternative to traditional Western medicine has received validation by research studies which have documented acupuncture’s beneficial effects on patients, but many within the medical community are wary of relying too heavily on this form of treatment, as modern medicine has not been able to fully explain how acupuncture works.

Another alternative treatment, chiropractic, is based on the understanding that a properly functioning nervous system is essential for good health. The spinal column is quite literally the backbone of the nervous system, because the spinal cord is encased inside it, as well as nerve roots that branch out into the entire body. Chiropractors adjust the spine of patients, aligning the vertebrae and correcting stress-inducing imbalances.

Your doctor may prescribe physical therapy, which helps patients build strength and increase flexibility. Physical therapy combines exercise with massage, heat/cold therapy, ultrasound, and electrical stimulation.

It is essential that you know what is causing your back pain so you can get the right treatment for you. Your doctor plays a crucial role in diagnosing and prescribing treatment for your condition, but in order to achieve the most effective treatment, you must take an active role in your healthcare also.

Back Pain Relief


Different types of back pains have different types of causes, and to gain some relief, the cause rather than the symptom should be addressed. People suffering from back pain are often suggested by friends and relatives to have complete bed rest, which is a misconception. Mere bed rest would not be sufficient to alleviate back pain if there were a serious underlying cause, like bone degeneration, osteoarthritis, or a bone infection. On the other hand, there is nothing as good as having rest for some initial period (though not necessarily bed rest), if the pain has resulted on account of a stress or a strain.

In a case of back pain without a pathology, avoiding physical activity for some time helps relax the nerves and reduce swelling, if any, in the painful area. This can be eased further by using non-drug methods of pain relief like applying hot and cold compresses to the affected area. Cold compresses are recommended for use during the first two to three days, later followed by hot compresses. This technique relaxes the nerves that have become irritated, and allows for restful sleep. Since pains are normally associated with sleeplessness, during phases of sound sleep the body gets time to heal itself.

Another way of traditional pain relief, and probably the most widespread, is the use of painkillers. Almost everyone has his or her favorites among painkillers, and you can use yours. But if the pain persists, and there is no remarkable benefit from the painkillers, it is advisable to consult a doctor and seek advice. However, if the pain has been relieved, normal daily activity should be resumed gradually after two to three weeks.

However bad back pain might be, it needs good, judicious management. In case the pain is not the result of a serious underlying problem, self-help techniques mentioned above, timely use of painkillers, and plain commonsense can go a long way in providing quick relief. Despite these interventions, however, if the acuteness of the problem gives way to a chronic, unmanageable situation, expert medical help should be immediately sought.

How to Test for Back Pain


Medical Evaluation and Diagnostic Testing procedures should be performed prior to beginning any treatment in order to determine the treatment process that will be most effective. The following describes some of the evaluation testing procedures that can be performed to help confirm the cause of back pain.

The causes of back pain can be very complex, and there are many structures in the lower back that can cause pain. The following are used to test for the cause pain:

X-RAYS An X-Ray provides an image that can be used to evaluate bones, joints and degenerative lesions in the spine.
CAT SCAN (CT) Used primarily when problems are suspected in the bones or when a patient cannot obtain an MRI
MAGNETIC RESONANCE IMAGING (MRI) The most common test to evaluate the lumbar spine. Evaluates: *Vertebral bones * Discs * Joints * Nerves * Soft tissues
MYELOGRAM where dye is injected into the spinal column and then the area is flexed and x-rayed.
DISCOGRAPHY Discography is a diagnostic procedure used to determine the level of the painful disc.
EMG The EMG/Nerve Conduction Study is a useful test to study the nerves in the arms and legs.
BONE DENSITY Bone density testing is fast, painless, and noninvasive. During a test, patients lie fully clothed on a padded treatment table while the machine scans one or more areas of bone. The entire test normally takes only minutes.

A Bone scan in Nuclear Medicine is a procedure which involves two steps:

The patient is asked to arrive 3 hours before their actual scan to receive an injection of a small amount of radioactive tracer that is “tagged” to a calcium like material. Usually the tracer is injected in a vein in the arm of the patient. In some instances, other sites of injection are used especially for those patients that had difficult veins to find. The “radiopharmaceutical” has no side effects and because of this, the patient can be released from the department for 3 hours to give the calcium time to circulate and be taken up by the bone. There are no dietary restrictions so the patient may eat before and after the injection.

After the three hours has elapsed, the patient returns to the Nuclear Medicine department for their scan. The patient is placed on a table a head to toe scan is performed by a “gamma camera”.

The Various Causes of Back Pain


Back pain can be caused by many different diseases and conditions. Some of these conditions can be very serious but fortunately they are for the most part uncommon. These serious conditions include; cancer, tumors, neoplasm, inflammatory arthritis and infection. Several common conditions that can cause back pain are listed below.

Fractures and Dislocations

Fractures and dislocations can occur anywhere in the body. The vertebral bodies which help support the weight of the upper body can break resulting in a compression fracture. These types of fractures can be very painful and even disabling.

It is important for the physician to determine the nature of these fractures. Some fractures can be caused by dangerous or serious conditions such as cancers, malignancies, or advanced osteoporosis. These are called pathological fractures. Other types of fractures may occur through traumatic events.

A dislocation is a term used to describe a condition where a joint has been disrupted and has separated to the point where the two adjacent bones are no longer aligned or touching. When a joint is dislocated the spine becomes unstable and is unable to protect the spinal cord or nerves.

Degenerative Disc Disease

Degenerative Disc Disease (DDD) is a natural condition of the body that causes deterioration of the intervertebral discs. This is a gradual process that may compromise the spine. Although DDD is relatively common, its effects are usually not severe enough to warrant significant medical intervention. The intervertebral disc is one structure prone to degenerative changes associated with aging. Long before Degenerative Disc Disease can be seen radiographically, biochemical and histologic (structural) changes occur. Over time the collagen (protein) structure of the annulus fibrosis weakens and may become structurally unstable. Additionally, water and proteoglycans(PG) content decreases. PGs are molecules that attract water. These changes are linked and may lead to the disc’s inability to handle mechanical stress.

Herniated Disc

Herniation of the nucleus pulposus (HNP) occurs when the nucleus (gel-like substance) breaks through the annulus fibrosis (tire-like structure) of an intervertebral disc (spinal shock absorber). Injury to the disc may result in pain, numbness, tingling or loss of muscle strength. Disc injuries in the neck region may affect the arms or hands while disc injuries in the low back may affect the legs or feet. People between the ages of 30 and 50 appear to be vulnerable because the elasticity of the disc and water content of the nucleus decreases with age.

Facet Syndrome

Facet syndrome is a common spinal disorder affecting the posterior joints that results in pain, stiffness and inflammation. Increased stress at the facets results in stretching of the ligamentous capsule, deterioration of the smooth cartilaginous surfaces and increased friction at the joint. In facet syndrome, the symptoms of pain, discomfort and weakness frequently localize to the spine, nonetheless a small percentage may be felt in the extremities or other body areas.

Foraminal Stenosis

The spinal nerves pass through openings on the side of the spine called intervertebral foramen. Foraminal stenosis occurs when these openings are smaller than normal. This condition can be the result of injury, degenerative change or congenital anomaly. The smaller opening may result in compression of the nerve. This irritation often causes symptoms of numbness, weakness, burning or tingling in the involved extremity. Long standing or severe stenosis may result in a functional loss. Spinal Stenosis

Spinal stenosis is a condition where the size of the spinal canal is reduced. This may lead to compression of the spinal cord. Symptoms often include pain, numbness, tingling and weakness. Severe cases may actually cause loss of function and may even lead to disability. Spinal stenosis is more common in patients over fifty years of age. Many factors can cause stenosis including injury and degenerative change.


Fibromyalgia is a chronic disorder associated with widespread soft tissue pain, tenderness and fatigue. A person with fibromyalgia will experience pain when up to 18 specific areas called tender points are pressed. Pushing carefully on these specific points during an examination causes discomfort or pain. The pain of fibromyalgia is more than normal muscle aches common after physical exertion. Fibromyalgia often can be severe enough to disrupt a person’s daily work and activities. The cause of fibromyalgia is not known.


Osteoporosis is commonly called the “fragile bone disease.” It is due to loss of bone density caused by a deficiency in such bone-building nutrients as calcium, vitamin D and other vitamins and minerals. The most common complication of osteoporosis is compression fracture. In people with advanced osteoporosis, compression fractures can occur as the result of simple daily activities such as bending, carrying heavy loads, or a minor fall.

Osteoarthritis (DJD)

Osteoarthritis, also called degenerative joint disease (DJD), is the most common type of arthritis. OA can occur in almost any joint of the body but most commonly occurs in the fingers, hips, knees and spine. Over time changes occur within the smooth cartilaginous surfaces of the joint. These changes lead to a loss of elasticity and the cartilage becomes stiff or brittle making it susceptible to injury. This will lead to stiffness, pain and crepitation at the joint. Advanced cases may actually result in significant damage to the bone itself.


Spondylolisthesis occurs when one vertebrae slips forward (translation) in relation to the adjacent vertebrae. Stability is inversely proportional to the degree of translation. The ability of a vertebrae to ÒslipÓ in relation to its neighbor can be caused by many factors, including facet or disc degeneration, trauma or a defect in a region of the vertebrae called the pars interarticularis. Severe cases may result in spinal cord or nerve compression and can require surgical intervention.


Sprains and strains are two of the most common causes of back pain. They can be caused by trauma, overuse, lack of conditioning, and improper body mechanics. The term sprain is used when this injury occurs in a ligament. Conversely, strain is used when the affected tissue is muscle or tendon. Typically, patients will complain of increased pain with activity and relief at rest. Treatment will often include a period of rest followed by a therapeutic exercise program to increase flexibility and strength.

Compression Fracture

Compression fractures can occur in any vertebra (spinal bones) and is described as a collapse of the vertebra.

Symptoms – The first symptom of a compression fracture may be sudden and severe back pain that remains in one local area. Some persons may experience numbness/tingling, or weakness in the arms or legs if the spinal cord or nerves leading away from the fracture have been compressed. If multiple fractures occur in an area of the back, the person will develop a forward hump-like curvature to the back.

Causes – There are many possible causes of compression fractures. Car accidents, falls, and weakening of the bone due to pathology (i.e. cancer), or Osteoporosis are common.

Diagnosis – The diagnosis is based on observation of the aforementioned symptoms and x-rays of the spine. Additional tests (i.e. bone scan, blood tests) may be needed to diagnose the actual cause of the compression fracture.


If you have severe back pain, it is natural to wonder whether or not the pain might be a sign of cancer. Tumors in the spinal column may cause pain from expansion of the bone or from weakening the bone, which in turn can result in spinal fractures, compression (pinching) of the nerves, or spinal instability.


Discitis, or disc space infection, is an inflammatory lesion of the intervertebral disc that occurs in adults but more commonly in children. Its cause has been the subject of debate, although most authors believe it to be infectious. The infection probably begins in one of the continguous end plates, and the disc is infected secondarily. Severe back pain that begins insidiously is characteristic of the disease.

Discitis in Children
Although most children will continue to walk in spite of the pain, young children may refuse to ambulate. The characteristic finding is extension of the spine and the child’s complete refusal to flex the spine. Children with discitis usually are not systemically ill. They rarely have an elevated temperature and their white blood cell count is frequently normal. However the erythrocyte sedimentation rate is usually increased. Lateral radiographs of the spine usually will reveal disc space narrowing with erosion of the vertebral end plates of the contiguous vertebrae. bone scanning may be helpful in localizing a lesion that is difficult to diagnose clinically. Some bone scans are falsely negative, so the diagnosis of disc space infection should not be excluded simply because the bone scan is normal. Magnetic resonance imaging (MRI) seems to be helpful in identifying a disc space infection.


Kyphosis is the abnormal forward bending of the spine. In kyphosis, the curve of the spine is abnormal, forming a hump.

What is going on in the body?

The normal spine rounds slightly in the chest area, with arching in the lower back and neck regions. Excessive kyphosis can occur mainly in the chest area of the spine, causing the roundness of the back to appear exaggerated.

What are the signs and symptoms of the condition?

Symptoms are usually minimal, unless the deformity is severe. In that case, the back may ache or, rarely, nerve problems may arise. The hamstrings, or muscles at the back of the thigh, may also be tight.

What are the causes and risks of the condition?

Kyphosis is generally caused by an abnormal posture. Other possible causes include: á a significant fracture of the vertebra, which can cause the back to angle forward á spinal surgery á Scheuermann’s disease, which results in wedging of the vertebrae. This disease is usually seen in teenage boys, and its cause is unknown. Pott’s disease, which refers to kyphosis due to collapse of the vertebra when tuberculosis infects the spine á osteoporosis in elderly women, which causes a type of kyphosis known as dowager’s hump á spinal tumors, or surgery to remove them á nerve disorders


Lordosis is a disorder defined by an excessive inward curve of the spine. It differs from the spine’s normal curves at the cervical, thoracic, and lumbar regions, which are, to a degree, either kyphotic or lordotic. The spine’s natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.

Lordosis can be found in all age groups. It primarily affects the lumbar spine, but does occur in the neck (cervical). When found in the lumbar spine, the patient may appear swayback, the buttocks more prominent, and in general an exaggerated posture. A lumbar lordosis can be painful sometimes affecting movement.

Certain disease processes can adversely affect the structural integrity of the spine and contribute to lordosis. Some common causes include achondroplasia, discitis, kyphosis, obesity, osteoporosis, and spondylolisthesis.

Ligamentous Hypertrophy

Ligaments run up and down the spinal column. Hypertrophy of the ligaments in the vertebral canal (the posterior longitudinal ligament — runs up and down along the back side of the vertebral bodies, and the ligamentum flavum — runs up and down under the posterior bone ring made up of the lamina and spinous process) can increase their mass enough that they narrow the canal (stenosis) sometimes to the point that the spinal cord and/or nerve roots running through the canal are compressed. When the posterior longitudinal ligament in front and ligamentum flavum behind the spinal cord hypertrophy the cord is almost “circumferentially” surrounded and compressed). Hypertrophy of the ligamentum flavum laterally near the facet joint can also contribute to foraminal narrowing (stenosis) with potential nerve compression (pinching).


According to the American Obesity Association (AOA) 64.5 percent of adult Americans (about 127 million) are categorized as being overweight or obese (1). The unfortunate truth is that obesity is becoming a global epidemic affecting adults and children.

Connection to Back Pain
Most people know that obesity contributes to the development of coronary heart disease, diabetes, high blood pressure, and colon cancer. However, did you know that obesity is a contributing factor to back pain? It is true. Being overweight or obese can significantly contribute to symptoms associated with osteoporosis, osteoarthritis (OA), rheumatoid arthritis (RA), degenerative disc disease (DDD), spinal stenosis, and spondylolisthesis.

The spine is designed to carry the body’s weight and distribute the loads encountered during rest and activity. When excess weight is carried, the spine is forced to assimilate the burden, which may lead to structural compromise and damage (e.g. injury, sciatica). One region of the spine that is most vulnerable to the effects of obesity is the low back; the lumbar spine. Lack of exercise and bodily conditioning leads to poor flexibility and weak muscles in the back, pelvis, and thighs. This can increase the curve of the lower back causing the pelvis to tilt too far forward. Further, this is detrimental to proper posture and as posture weakens, other regions of the spine (neck) may become painful.

You may try to dismiss the cause of some of these spinal disorders to the process of normal aging. It is true that with age body tissues can cause changes to spinal anatomy (2). However, if you are overweight or obese, chances are you have, or will have, back pain.


Trauma to the spine refers to injury that has occurred to bony elements, soft tissues and/or neurological structures. The two things that surgeons are most concerned about, in the case of spinal trauma, are instability of the vertebral column and actual or potential neurological injury.

Stability to the spinal column can be compromised when bony elements are injured or there is disruption to soft tissues such as ligaments. Instability causes the back to become unable to successfully carry normal loads, which can lead to permanent deformity, severe pain and in some cases catastrophic neurological injuries. Most often the instability comes from a fracture in one of the bony parts of the vertebra, specifically the vertebral body, the lamina or the pedicles.

In the case of trauma, dislocations and fractures happen simultaneously and can result in a very unstable spinal column. They can occur in any region of the spine and are associated with a degree of neurological injury. A surgeon needs to restore the mechanical stability of the spine to try and prevent more neurologic injury, progressive deformity or prolonged incapacitation pain.

Back pain in pregnancy

Introduction to back pain during pregnancy
For pregnant women, back pain during pregnancy is not a trivial matter. If not addressed, it can have a negative impact on your daily lifestyle, cause missed time from work, and make your delivery more difficult. Back pain in the course of your pregnancy can also create problems that will continue for an extended period after delivery.

Addressing back pain during pregnancy
While it is fairly common, back pain during pregnancy should definitely not be accepted as just part of the process. To help make your pregnancy as pleasant as possible and facilitate an easier delivery, back pain should be always be addressed as quickly as possible and managed throughout your pregnancy.

Low back pain of long duration (several weeks or months) during pregnancy is a predictor for post partum back pain (pain after birth). For this reason, pregnant women are encouraged to seek appropriate treatment for back pain during pregnancy.

Likewise, any post partum pain that lasts longer than six to eight weeks should be treated in order to avoid chronic or recurring back problems.


lumbar radiculopathy, which refers to pain in the lower extremities in a dermatomal pattern. A dermatome is a specific area in the lower extremity innervated by a specific lumbar nerve. This pain is caused by compression of the roots of the spinal nerves in the lumbar region of the spine. Diagnosing leg and back pain begins with a detailed patient history and examination.


Scoliosis is defined as a side-to-side deviation from the normal frontal axis of the body. Although traditional, this definition is limited since the deformity occurs in varying degrees in all three planes: back-front; side-to-side; top-to-bottom. Scoliosis is a descriptive term and not a diagnosis. As such, a search is made for the cause. In more than 80% of the cases, a specific cause is not found and such cases are termed idiopathic, i.e., of undetermined cause. This is particularly so among the type of scoliosis seen in adolescent girls. Conditions known to cause spinal deformity are congenital spinal column abnormalities, neurological disorders, genetic conditions and a multitude of other causes. Scoliosis does not come from carrying heavy things, athletic involvement, sleeping/standing postures, or minor lower limb length inequality.

In managing AIS, the judgment of the surgeon and the participation of informed patients and families are as important in determining treatment outcome as surgical techniques. Decision-making in the management of AIS remains complex despite the availability of data on natural history, prognosis of different curve patterns, brace treatment factors, and surgical innovations.

The management of AIS includes several steps and treatment options:

  • screening and early detection of deformity,
  • observation of changes in deformity over time with informed judgment regarding prognosis, orthotic and non-operative interventions,
  • surgical planning and operating.


This is a condition which causes pain down the back of one or both thighs. Inflammation of the sciatic nerve (which is the largest nerve in the body-about the diameter of your little finger) can be either constant or intermittent. Success in solving this problem is directly correlated to the diagnosis. Sciatica can be caused by a pinched nerve as it exits the low back spine or it can be caused by prostatic cancer. Odds are usually that the cause is some structural imbalance, but there are so many potential causes, some serious and some benign, it is better to at least know that there may be a grave cause to the symptoms.

This doesn’t mean that you shouldn’t immediately incorporate a strategy to eliminate any structural imbalances. In most cases, this will resolve the problem. If the problem doesn’t respond to these basic efforts, then professional assistance may be needed. The first effort in relieving sciatic symptoms should be to review Hip Pain.

Trigger points can accumulate in the piriformis muscle forcing a contraction and strangulation of the sciatic nerve. The tennis ball exercise should be incorporated to help to relax the piriformis muscle. Stretching may be beneficial, but that is more of a “try an see” exercise.

If there are no improvements with this approach, refer to Low Back Pain to better understand the relationship between the sciatic nerve and the low back spine. Seeking help from a chiropractor or orthopedist may be indicated if the solution can’t be found at home.

The Anatomy of the Human Back


The spinal column (or vertebral column) extends from the skull to the pelvis and is made up of 33 individual bones termed vertebrae. The vertebrae are stacked on top of each other group into four regions:

Term # of Vertebrae Body Area Abbreviation
Cervical 7 Neck C1 Ð C7
Thoracic 12 Chest T1 Ð T12
Lumbar 5 or 6 Low Back L1 Ð L5
Sacrum 5 (fused) Pelvis S1 Ð S5
Coccyx 3 Tailbone None

The cervical spine is further divided into two parts; the upper cervical region (C1 and C2), and the lower cervical region (C3 through C7). C1 is termed the Atlas and C2 the Axis. The Occiput (CO), also known as the Occipital Bone, is a flat bone that forms the back of the head.

Atlas (C1)

The Atlas is the first cervical vertebra and therefore abbreviated C1. This vertebra supports the skull. Its appearance is different from the other spinal vertebrae. The atlas is a ring of bone made up of two lateral masses joined at the front and back by the anterior arch and the posterior arch.

Axis (C2)

The Axis is the second cervical vertebra or C2. It is a blunt tooth?ike process that projects upward. It is also referred to as the ?ens?(Latin for ?ooth? or odontoid process. The dens provides a type of pivot and collar allowing the head and atlas to rotate around the dens.

Thoracic Vertebrae (T1 PT12)

The thoracic vertebrae increase in size from T1 through T12. They are characterized by small pedicles, long spinous processes, and relatively large intervertebral foramen (neural passageways), which result in less incidence of nerve compression.

The rib cage is joined to the thoracic vertebrae. At T11 and T12, the ribs do not attach and are so are called “floating ribs.” The thoracic spine’s range of motion is limited due to the many rib/vertebrae connections and the long spinous processes.

Lumbar Vertebrae (L1 PL5)

The lumbar vertebrae graduate in size from L1 through L5. These vertebrae bear much of the body’s weight and related biomechanical stress. The pedicles are longer and wider than those in the thoracic spine. The spinous processes are horizontal and more squared in shape. The intervertebral foramen (neural passageways) are relatively large but nerve root compression is more common than in the thoracic spine.

Purpose of the Vertebrae

Although vertebrae range in size; cervical the smallest, lumbar the largest, vertebral bodies are the weight bearing structures of the spinal column. Upper body weight is distributed through the spine to the sacrum and pelvis. The natural curves in the spine, kyphotic and lordotic, provide resistance and elasticity in distributing body weight and axial loads sustained during movement.

The vertebrae are composed of many elements that are critical to the overall function of the spine, which include the intervertebral discs and facet joints.

Functions of the Vertebral or Spinal Column Include:

  • Spinal Cord and Nerve Roots
  • Many internal organs
Base for Attachment
  • Ligaments
  • Tendons
  • Muscles
Structural Support
  • Head, shoulders, chest
  • Connects upper and lower body
  • Balance and weight distribution
Flexibility and Mobility
  • Flexion (forward bending)
  • Extension (backward bending)
  • Side bending (left and right)
  • Rotation (left and right)
  • Combination of above
  • Bones produce red blood cells
  • Mineral storage

About Upper Back Pain


Upper back pains are not as common as lower back pains; they also do not have the host of causes that trigger lower back pain. But whenever they occur, they are equally painful in nature. Mainly two causes of upper back pain have been identified: muscular irritation in the myofascial region, a region comprising of neck and upper back; and joint dysfunction in this area. This could include an injury sustained by spinal discs in the upper back, but as evidence suggests, such injuries are rare, since this is the strongest and most stable portion of the spine and has no mobility at all. The thoracic region of the spinal column is referred to as the upper back.

Despite its low incidence, upper back pains have been on the rise in the recent times, a trend attributed to the frequent use of computers (and the abnormal sitting postures and strain resulting from computer use) in the workplaces. Even these complaints, however, have mostly pertained to the neck and shoulder regions rather than the thoracic region.

On account of the absence of rare pathological causes, most upper back pains can be managed by such practices as osteopathic or chiropractic manipulation, active and passive physical therapy, massage therapies, and acupuncture. Another benefit is stretching and strengthening exercises, which should be undertaken with the help of an expert physiotherapist. For quick relief, all these therapeutic modalities can be supplemented by use of safe and effective painkillers and anti-inflammatory medicines. Anti-inflammatory medicines help reduce the inflammation that results from muscular irritation and joint dysfunction.

If upper back pain persists for long, then causes such as a degenerated disc or herniated disc in the thoracic region should be investigated.

Back Pain Warning Signs


At some point in our lives, we are likely to experience back pain — 80% of all adults do. Most of the time it is relatively minor but how do we know when it’s time to see a doctor? If you answer yes to any of the following questions, you should consult a spine specialist:

1. Has your low back pain extended down your leg?

If the pain persists and is severe, it is a sign that something is compressing a nerve running from your back to your leg.

2. Does your leg pain increase if you lift your knee to your chest or bend over?

If so, there is a good chance a disc is irritating a nerve.

3. Have you had severe back pain following a recent fall?

A fall may cause damage to your spine. Chances of injury increase if you have osteoporosis.

4. Have you had significant back pain lasting more than 3 weeks?

Often pain will go away with simple treatment. However, if your pain persists you should consult a spine doctor.

5. Have you had back pain that becomes worse when you rest, or wakes you up at night?

If this is accompanied by a fever, it may be a sign that there is an infection or other problem.

6. Do you have persistent bladder or bowel problems?

Bladder and bowel problems may be due to many causes, but some spine problems may cause these symptoms.

7. Do you get numbness or weakness in your legs while walking?

These problems can be caused by a narrowing of the spinal canal. This is called spinal stenosis.

The Facts and Statistics about Back Pain


The epidemic of back pain is enormous: It’s a $44 billion industry, it’s the leading workers’ comp injury, it’s the leading reason for disability for people under the age of 45, it will strike 90% of all American adults, it’s the second-leading surgical procedure, and it’s only getting worse.

1. Up to 85% of the US Population will have back pain at some time in their life.

2. On any given day 6.5 million people are in bed because of back pain.

3. 5.4 million Americans are disabled annually due to back pain.

4. An estimated 93 million workdays are lost each year due to back pain.

5. 5-10% of low back pain becomes chronic.

6. The total number of spine surgeries in the U.S. approaches 500,000 per year.

7. An estimated $45 – 54 billion is spent on the treatment of low back pain per year.

10 Tips for A Healthy Back


Follow these simple guidelines to keep your back in good shape:

1. Standing… keeping one foot forward of the other, with knees slightly bent, takes the pressure off your low back.

2. Sitting… sitting with your knees slightly higher than your hips provides good low back support.

3. Reaching… stand on a stool to reach things that are above your shoulder level.

4. Moving Heavy Items… pushing is easier on your back than pulling. Use your arms and legs to start the push. If you must lift a heavy item, get someone to help you.

5. Lifting… kneel down on one knee with the other foot flat on the floor as near as possible to the item you are lifting. Lift with your legs, not your back, keeping the object close to your body at all times.

6. Carrying… two small objects (one in either hand) may be easier to handle than one large one. If you must carry one large object, keep it close to your body.

7. Sleeping… sleeping on your back puts 55 lbs. of pressure on your back. Putting a couple of pillows under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure.

8. Weight Control… additional weight puts a strain on your back. Keep within 10 lbs. of your ideal weight for a healthier back.

9. Quit Smoking… smokers are more prone to back pain than nonsmokers because nicotine restricts the flow of blood to the discs that cushion your vertebrae.

10. Minor Back Pain… treat minor back pain with anti-inflammatories and gentle stretching, followed by an ice pack.

What to expect while you’re expecting


Half of all pregnant women can expect some back pain. Back pain develops for two reasons. One is simply the added weight caused by the pregnancy. Another may be that the extra weight is carried in the front of the body, shifting your center of gravity forward and putting more strain on the low back. The muscles in your back may have to work harder to support your balance.

How can you minimize the discomfort?

1. Stick with your exercise program. Find out from your doctor what abdominal and back strengthening exercises are safe for you, and how long you can maintain your regular exercise program. Swimming is an excellent way to keep fit and relieve the stress on your back from the extra weight of pregnancy.

2. Lifting. If you have to pick something up, kneel down on one knee with the other foot flat on the floor, as near as possible to the item you are lifting. Lift with your legs, not your back, keeping the object close to your body at all times. Be careful, though – it may be easier to lose your balance while you are pregnant. Whenever possible, get assistance in lifting objects.

3. Carrying. Two small objects (one in either hand) may be easier to handle than one large one. If you must carry one large object, keep it close to your body.

4. Sleeping. Sleeping on your back puts 55 lbs. of pressure on your back. Placing a pillow under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure.

How can you deal with the back pain related to pregnancy?

Fortunately, most back pain related to pregnancy is self-limited and will resolve. In most cases, medication is not a good option. Do not use any medication during pregnancy without permission of your physician. Some treatment options include learning exercises to support muscles of the back and pelvis, using supportive garments that may be helpful with certain causes of back pain in pregnancy and using spot treatments such as heat and cold. If your pain persists despite these measures, or you develop any radiating pain, numbness, tingling or weakness in your legs, you should consult with a spine physician with expertise in women’s health issues and/or pregnancy related disorders. They will be able to assist you in diagnosing and treating your specific problems.