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Back pain

Back pain (also known "dorsalgia") is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine.

The pain may be have a sudden onset or it can be a chronic pain, it can be felt constantly or intermittently, stay in one place or refer or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may be felt in the neck (and might radiate into the arm and hand), in the upper back, or in the low back, (and might radiate into the leg or foot), and may include symptoms other than pain, such as weakness, numbness or tingling. In about 85% of back pain cases, the origin of the pain is unknown, and imaging studies usually fail to determine its cause. Disk disease, spinal arthritis, and muscle spasms are the most common diagnoses. Other problems can also cause back pain, however.

Different Types of Pain:
The origin of some pain is neuropathic, while other pain is nociceptive. This is important to know because different treatments work better for each type of pain.

Neuropathic pain is caused by damage to nerve tissue. It is often felt as a burning or stabbing pain. One example of neuropathic pain is a "pinched nerve."

Nociceptive pain is caused by an injury or disease outside the nervous system. It is often an ongoing dull ache or pressure, rather than the sharper, trauma-like pain that is characteristic of neuropathic pain. One example of nociceptive pain is arthritis pain.

Some people experience mixed pain, which is a combination of neuropathic and nociceptive pain.

Chronic versus Acute Back Pain
Chronic back pain is commonly described as deep, aching, dull or burning pain in one area of the back or traveling down the legs. Patients may experience numbness, tingling, burning, or a pins-and-needles type sensation in the legs. Regular daily activities may prove difficult or impossible for the chronic back pain patient. They may find it difficult or unbearable to work, for example, even when the job does not require manual labor. Chronic back pain tends to last a long time, and is not relieved by standard types of medical management. It may result from a previous injury long since healed, or it may have an ongoing cause, such as nerve damage or arthritis.

Acute back pain is commonly described as a very sharp pain or a dull ache, usually felt deep in the lowerpart of the back, and can be more severe in one area, such as the right side, left side, center, or the lower part of the back. Acute pain can be intermittent, but is usually constant, only ranging in severity.

Sometimes, acute back pain can be caused by injury or trauma to the back, but just as often has no known cause. Patients with acute back pain, even when it's severe, will typically improve or completely recover within six to eight weeks.

Approximately half of all back pain patients have acute pain caused by trauma. A contusion, torn muscle, or strained joint resulting from a back injury can cause acute pain. Patients with any of these conditions typically exhibit pain, muscle spasms, and decreased functional activities. Treatment of acute back pain is short-term and usually successful. With physical therapy, follow-up treatment, and prevention practices, these patients typically return to full functionality in a few weeks. Occasionally, these patients will re-injure themselves and have to return for a short course of treatment. Patients with acute pain occurring more than three times in one year or who experience longer-lasting episodes of back pain that significantly interfere with functional activities (e.g., sleeping, sitting, standing, walking, bending, riding in or driving a car) tend to develop a chronic condition.

Mechanical back pain—a form of acute pain—is aggravated by movement and worsened by coughing. This type of pain is usually alleviated with rest. Mechanical back pain is typical of a herniated disc or stress fracture. For patients with this condition, forward movements of the spine usually cause pain. In addition, posture, coughing, sneezing, and movement can all influence pain coming from the spine.

When acute back pain is severe and travels down both legs, it could be caused by lumbar disc disease—the most common cause of true sciatica, another form of acute pain.


Your back is an intricate structure composed of bones, muscles, ligaments, tendons and disks. Disks are the cartilage-like pads that act as cushions between the segments of your spine. Back pain can arise from problems with any of these component parts. In some people, no specific cause for their back pain can be found.

Causes of Back Pain

Lumbar Muscle Strain
Muscle strains are the most common cause of low back pain. Patients may or may not remember the initial event that triggered their muscle spasm, but the good news is that most episodes of back pain from muscle strains resolve completely within a few weeks.

Ruptured Disc
A ruptured intervertebral disc, also called a herniated disc, is another common cause of back pain. How to treat the back pain from a herniated disc depends on the particular individual and situation.

Discogenic Back Pain
Discogenic back pain is thought to be a common cause of low back pain. Discogenic back pain cis the result of damage to the intervertabral disc, but without disc herniation. Diagnosis of discogenic back pain may require the use of a discogram.


Spinal Stenosis
Spinal stenosis causes back pain in the aging population. As we age, the spinal canal can become constricted, due in part to arthritis and other conditions. If the spinal canal becomes too tight, back pain can be the result.

Spondylolisthesis causes back pain because adjacent vertebra become unstable and begin to "slip." The most common cause of spondylolisthesis is due to degenerative changes causing loss of the normal stabilizing structures of the spinal column. If the spine becomes unstable enough, back pain can become a problem.

Lumbar Spine Arthritis
Arthritis most commonly affects joints such as the knees and fingers. However, arthritis can affect any joint in the body, including the small joints of the spine. Arthritis of the spine can cause back pain with movement.

Osteoporosis can cause a number of orthopedic problems and generalized discomfort. Back pain from osteoporosis is most commonly related to compression fractures of the vertebra. Osteoporosis causes weak bones and can lead to these fractures.

Symptoms of back pain

Simple back pain is often in your lower back (lumbar region), and may also spread to your buttocks and thighs. It's often described as a dull pain and can come and go at different times, depending on your level of activity. The pain can begin suddenly or come on gradually if you strain your back over time.

Simple back pain usually only lasts a few days and gets better on its own.

However, you should see your GP as soon as possible if, as well as back pain, you have:
fever (high temperature)
redness or swelling on your back
pain down your legs and below your knees
numbness or weakness in one or both legs or around your buttocks
loss of bladder or bowel control (incontinence)

Some symptoms are called "red flags" and may indicate that you require treatment for an underlying condition. You should see your GP if:
your pain is the result of an injury
you're under 20 or over 55 and the pain lasts for more than a few days
you have had or currently have cancer in any part of your body
you have HIV/AIDS
you have been taking steroid medicines for more than a few months

Diagnosis of back pain

Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history.

If your pain lasts longer than six weeks, or if your GP suspects there is some underlying cause of your pain, he or she may recommend more tests such as:

  1. X-rays
  2. CT scans - a CT scan uses X-rays to make a three-dimensional image of the body/or part of the body
  3. MRI - an MRI scan uses magnets and radio waves to produce images of the inside of your body
  4. blood tests

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