FAQs on Back Pain

Back pain can cause sudden, sharp pain that affects mobility. Chronic back pain can cause severe disability and pain. Back pain can be related to spinal arthritis, chronic nerve disease, or from an injury.

Who gets back pain?

As a person gets older, back pain is more likely to occur. People who are likely to get back pain include:

  • Adults age 30 years of age and older
  • Overweight individuals
  • People who have demanding jobs
  • Smokers
  • Anyone who has poor physical fitness

What causes back pain?

Mechanical problems can affect the back. Additional causes include:

  • Disc breakdown
  • Ruptured discs
  • Muscle spasms
  • Spinal arthritis
  • Spinal stenosis
  • Scoliosis
  • Spondylolisthesis
  • Fibromyalgia
  • Kidney stones
  • Pregnancy

How common is back pain?

The prevalence of chronic back pain has risen significantly over the past 15 years. According to a recent study, the rate went from 3.9% in 1992 to 10% in 2006. The increase has been noted for all adult ages, in both men and women, and among all races.

Can back pain be prevented?

The best thing a person can do is prevent back pain. To prevent back pain you can:

  • Exercise frequently to make back muscles strong.
  • Maintain a healthy weight, lose weight, and take calcium/vitamin D supplements.
  • Avoid heavy lifting, and keep your back straight when lifting.

How is back pain diagnosed?

To diagnose back pain, the doctor will ask you questions (medical history) and conduct an examination (physical). Certain tests are used to assess for the underlying cause of pain, such as:

  • X-rays
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan
  • Laboratory tests

What is the difference between acute and chronic back pain?

Acute back pain lasts less than six weeks. This occurs from some type of injury, such as falling, hit during sports, or car accident. Chronic low back pain lasts for longer than three months.

How is back pain treated?

Treatment for back pain depends on the underlying cause. Acute back pain often subsides without treatment. For chronic back pain, options include:

  • Physical therapy – The physical therapist may use heat packs or cold packs during therapy sessions. In addition, exercises are used to strengthen back muscles.
  • Medications – For chronic pain, the specialist may prescribe anti-inflammatory agents, topical analgesics, muscle relaxants, and certain antidepressants. The Food and Drug Administration (FDA) does not recommend the use of muscle relaxants and narcotic analgesics long-term.
  • Epidural steroid injection – This involves inserting a small needle into the epidural space along the spine and injecting a steroid agent and anesthetic.
  • Facet joint injection – The doctor can inject the tiny facet joints of the spine with a steroid and anesthetic.
  • Transcutaneous electrical nerve stimulation (TENS) – This involves use of mild electrical current to interfere with pain sensations. According to a recent study involving patients with back pain, the TENS had an 82% success rate.
  • Surgery – A discectomy is performed to relieve pressure on nerves. This involves removal of one disc. For serious spinal conditions, the doctor may perform spinal fusion, which connects two or more bones of the spine. Vertebroplasty is where cement is injected into the bone to fix a compressed vertebrae.
  • Osteopathic manipulation – This involves manipulative therapies to realign and adjust the spine.
  • Alternative therapies – These include massage therapy, acupuncture, relaxation, and mind-body practices.
  • Spinal cord stimulation – After failed back surgery, and when treatments fail, the pain specialist may recommend spinal cord stimulation. This involves inserting a tiny device into the body and wires that connect to electrodes along the spine. According to a large review of clinical studies, at 97 months follow up, SCS had a 74% success rate. Almost 95% of patients reported good pain relief using the device, however.

Resources

Freburger JK, Holmes GM, Agans RP, et al. (2009). The rising prevalence of chronic low back pain. Archives of Internal medicine, 169(3), 251-258.

Lee AW & Pilitsis JG (2006). Spinal Cord Stimulation: Indications and Outcomes. Neurosurgical Focus, 21(6).

Rigoard P, Delmotte A, D’Houtaud S (2012). Back Pain: A Real Target for Spinal Cord Stimulation? Neurosurgery, 70(3), 574-585.