Complications
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Prognosis
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Images
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Risk factors|
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risk
factor is something that increases your chances of having back pain. Having
more risk factors means you have a higher chance of having back pain.
Anyone can develop back pain, even children
and teens. Research has yet to prove what contributes to back pain. However,
these factors might put you at greater risk of developing back pain:
Age. Back pain is more common as you get older, starting around age 30
or 40.
Lack of exercise. Weak, unused muscles in your back might lead to back pain.
Excess weight. Carrying too much weight puts extra stress on your back.
Diseases. Some types of arthritis and cancer can contribute to back pain.
Improper lifting. Using your back instead of your legs can lead to back pain.
Psychological conditions. People prone to depression and anxiety appear to have a greater
risk of back pain.
Smoking. This can keep your body from delivering enough nutrients to the
disks in your back.
Risk factors you can change with lifestyle changes
Doing a job or other activity that requires
long periods of sitting, heavy lifting, bending or twisting, repetitive
motions, or constant vibration, such as using a jackhammer or driving certain
types of heavy equipment
Smoking. People who smoke are more likely than people who don't smoke to
have low back pain.
Being overweight. Excess body weight, especially around the waist, may put strain on
your back, although this has not been proved. But being overweight often also
means being in poor physical condition, with weaker muscles and less
flexibility. These can lead to low back pain.
Having poor posture. Slumping or slouching on its own may not cause low back pain. But
after the back has been strained or injured, bad posture can make pain worse.
"Good posture" generally means your ears, shoulders, and hips are in
a straight line. If this posture causes pain, you may have another condition
such as a problem with a disc or bones in your back.
Being under stress. Stress and other
emotional factors are believed to play a major role in low back pain,
particularly chronic low back pain. Many people unconsciously tighten their
back muscles when they are under stress.
Diagnosis|
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The causes of low back pain can be complex,
and there are many structures in the spine that can cause pain. Doctors will
ask patients to describe the location, severity and type of pain, in addition
to the history of the pain: when the patient started to feel it, and any
activities or positions that make the pain better or worse.
Classification
A diagnosis will typically classify the
patient’s condition as one of three types of pain.
Axial low back pain. This is the most common type
of back pain, is confined to the lower back and does not travel into the
buttocks or legs. The pain can be sharp or dull, and can be severe enough to
limit everyday activities, such as standing and walking. It usually worsens
with certain activities (such as sports) or physical positions (such as sitting
for long periods) and is relieved by rest. Most low axial back pain is acute –
meaning it is short-lived and heals within six to 12 weeks – but can last
longer and become chronic.
Lumbar radiculopathy
(sciatica). It’s the second most common type of
pain caused by a lower back problem. Caused by conditions that compress the
nerve roots of the sciatic nerve, the pain is more severe in the leg than in
the back. Symptoms are pain, numbness and/or weakness that is felt in the lower
back (if at all) and on only on one side of the lower body, affecting the
buttock, leg, foot, or the entire length of the leg.
Low back pain with
referred pain. This is pain in the lower back that
also radiates to the groin, buttock and upper thigh, but rarely below the knee.
Patients describe the pain as dull and achy with varying intensities. Low back
pain with referred pain is similar to axial pain and is managed with similar
treatments.
Tests
If there is reason to suspect a specific
condition may be causing your back pain, your doctor may order one or more
tests:
X-ray. These images show the alignment of
your bones and whether you have arthritis or broken bones. These images alone
won't show problems with your spinal cord, muscles, nerves or disks.
MRI or CT scans. These scans can generate
images that may reveal herniated disks or problems with bones, muscles, tissue,
tendons, nerves, ligaments and blood vessels.
Blood tests. These can help determine
whether you have an infection or other condition that might be causing your
pain.
Myelogram. Allows identification of problems
within the spine, spinal cord and nerve roots. An injection of contrast dye
illuminates the spine prior to an x-ray or CT scan
Bone scan. In rare cases, your doctor may
use a bone scan to look for bone tumors or compression fractures caused by
osteoporosis.
Nerve studies
(electromyography, or EMG). This test measures the
electrical impulses produced by the nerves and the responses of your muscles.
This test can confirm nerve compression caused by herniated disks or narrowing
of your spinal canal (spinal stenosis).
