Definition & Overview
Back problems are some of the most common complaints worldwide. In the United States alone, it is estimated that 80% of Americans have experienced back pains at least once in their lives. According to the World Health Organization (WHO), lower back pain is included in the list of top 10 diseases and injuries that result in lost years due to disability, ill health, or early death; otherwise referred to as disability-adjusted life year (DALY).
Back problems affect people of all ages, gender, and race. However, statistics show that the condition is more prevalent in adults, especially those between the ages of 35 to 55. The risk of experiencing such conditions also increases when people get older due to the natural deterioration of intervertebral discs.
Back pain and other back problems cause limited mobility, which results in missed workdays. As such, back problems place a huge strain on economies, individuals, and families.
Cause of Condition
The human back is made up mostly of muscles, tissues, and the spinal column that houses the spinal cord, which act as the main communication line between the brain and the rest of the body. Back problems can occur in one or more of these areas. Some of the most common causes are strained muscles and ligaments, arthritis, osteoporosis, ruptured discs, and irregularities in the skeletal system.
Injuries are also common causes of back problems. Back injuries can be a result of something as simple as improper posture to activities, such as sports and work duties. Injuries that involve only the muscles and soft tissue are easier to treat while injuries to the spinal column require more complex treatment methods. In some cases, the injury may result in permanent disability, such as paralysis.
While the symptoms of back problems vary, some of the most common are muscle and stabbing pain that radiates to the legs as well as a temporary or permanent reduction in mobility.
Many back problems display symptoms that are associated with other serious conditions such as bowel or bladder problems accompanied by fever. If the back pain is also accompanied by a tingling sensation or numbness in the legs and unexplained weight loss, you should contact your doctor as soon as possible.
Who to See & Types of Treatment Available
If you’re experiencing back problems that have not significantly reduced your mobility or ability to function, you should consult your primary care physician or a general practitioner. However, if the back problem is due to an injury, such as a blow to the spinal column, you should proceed to a hospital’s emergency department immediately or call emergency services for assistance.
If you believe that your spinal column may have been injured, it’s best to avoid moving to minimize the risk of damaging the spine further. Paramedics and other medical personnel trained in providing emergency medical services will be able to decide how you should be taken to a medical facility.
In non-emergency cases, the doctor will assess your condition, including your ability to stand, walk, sit, and lift objects. The doctor will also need a history of the problem and other medical conditions you have already experienced. The information will help the doctor determine if the back problem is associated with a more serious condition that requires the services of a specialist.
Your doctor or specialist will likely perform several tests, including blood exams and imaging tests, such as an x-ray, CT-scan, and MRI. If the doctor suspects that the back problem is caused by a bone disorder, a bone scan will be performed. If the problem is likely contained within the muscles, the doctor may request an electromyography (EMG) that measures the electrical impulses of the nerves.
Once the exact cause of the problem has been determined, you’ll need to undergo treatment as soon as possible to prevent the condition from worsening. Treatment will largely depend on the cause.
Acute back pains that are not caused by damage to the bones are usually treated with pain relievers. Doctors will normally not recommend bed rest for these types of problems. In fact, doctors recommend performing regular activities as much as possible. However, activities that may result in severe pain should be avoided.
Other than pain relievers, doctors may recommend medications such as narcotics, antidepressants, and muscle relaxants.
If the condition is serious, doctors typically recommend physical therapy to help the person manage the condition and regain some degree of mobility. If the back problem is severe and involves the skeletal structure, surgery may be the only option.
If surgery is required, it will usually be one of the following procedures:
- Discectomy – removing a portion of a disc
- Fusion – joining two vertebrae together
- Artificial disk – inserting an artificial disk
- Partial removal of a vertebra – usually performed when a portion of the vertebra is affecting the spinal cord or nerves.
Some back problems that result in back pains may be treated using alternative forms of medicine, such as acupuncture, chiropractic, and osteopathy. These forms of treatments are recommended by the National Health Service (NHS) in the United Kingdom for the relief of back pains and to help patients relax.
Another common form of treatment is through a transcutaneous electrical nerve stimulation (TENS) machine. This device delivers small electrical pulses that encourage the production of endorphins, which block or prevent the transmission of pain signals to the brain. However, it’s important to note that the results of this form of treatment vary widely. It is effective in some people, but produces no results in others. Additionally, if you have any other medical condition, you should avoid undergoing this type of treatment without the approval of your attending physician.
Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.
Walker BF, French SD, Grant W, Green S. Combined chiropractic interventions for low-back pain. Cochrane Database Syst Rev. 2010;(4). Review.