What Causes Extreme Back Pain

Other Reading On Painsciencecom About Back Pain

• 6 Main Causes of Morning Back Pain Why is back pain worst first thing in the morning, and what can you do about it?
• 34 Surprising Causes of Pain Trying to understand pain when there is no obvious explanation.
• Dont Worry About Lifting Technique The importance of lift with your legs, not your back to prevent back pain has been exaggerated.
• Chronic Low Back Pain Is Not So Chronic The prognosis for chronic low back pain is better than most people realize especially for Australians in Australia!
• Spinal Subluxation Can your spine be out of alignment? Chiropractics big idea has been misleading patients for more than a century.
• Back Pain & Trigger Points A quick introduction to the role of trigger points in back pain

And the big one

• Complete Guide to Low Back Pain Everything on one mighty page: an extremely detailed guide to the myths, controversies, the nature of the beast and the highlight dozens of detailed, evidence-based reviews of treatment and therapy options. This huge tutorial also focusses on a topic I think is neglected: the role of muscle in back pain.

How Does My Back Work

To understand your back pain, its helpful to know a little about how your back works.

Your back is a complex structure that provides support for your pelvis, legs, ribcage, arms and skull. The spine is made up of bones called vertebrae that are stacked together to form a loose S-shaped column.

Each vertebra is cushioned by spongy tissue called intervertebral discs. These discs act as shock absorbers and give your spine its flexibility. Vertebrae are joined by pairs of small joints known as facet joints. A mesh of connective tissue called ligaments holds the spine together.

Complex layers of muscle provide structural support and allow you to move. Your spinal cord runs through the centre of the vertebral column and connects your brain to the rest of your body.

Mechanical Lower Back Pain

Because it represents 97% of cases, mechanical low back pain deserves to be discussed first. To determine the factors that bring out the pain, the doctor will consider the following causes of mechanical low back pain:

• Muscle strain.
• Spondylolisthesis .
• .
• Osteoarthritis .
• Spinal stenosis .

Low back pain that gets worse with sitting may indicate a herniated lumbar disc . This is because certain positions of the body can change the amount of pressure that an out-of-place disc can press on a nerve. This is one reason we suggest to people with low back pain to periodically get up and stretch or walk around rather than continually stay sitting. Acute onset, that is, pain that comes on suddenly, may suggest a herniated disc or a muscle strain, as opposed to a more gradual onset of pain, which fits more with osteoarthritis, spinal stenosis, or spondylolisthesis.

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What Are The Most Common Lower Back Surgery Procedures

Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:

Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.

Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.

Types Of Low Back Pain

There are many ways to categorize low back pain two common types include:

• Mechanical pain. By far the most common cause of lower back pain, mechanical pain is pain primarily from the muscles, ligaments, joints , or bones in and around the spine. This type of pain tends to be localized to the lower back, buttocks, and sometimes the top of the legs. It is usually influenced by loading the spine and may feel different based on motion , activity, standing, sitting, or resting.
• Radicular pain. This type of pain can occur if a spinal nerve root becomes impinged or inflamed. Radicular pain may follow a nerve root pattern or dermatome down into the buttock and/or leg. Its specific sensation is sharp, electric, burning-type pain and can be associated with numbness or weakness . It is typically felt on only one side of the body.

  See Radiculopathy, Radiculitis and Radicular Pain

There are many additional sources of pain, including claudication pain myelopathic pain, neuropathic pain, deformity, tumors, infections, pain from inflammatory conditions , and pain that originates from another part of the body and presents in the lower back .

It is also possible for low back pain to develop with no definitive cause. When this happens, the primary focus is on treating the symptoms and the patients overall health.

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Medical Conditions That Cause Back Pain

Conditions that can cause back pain include:

• a slipped disc this can cause back pain and numbness, tingling and weakness in other parts of the body
• sciatica this can cause pain, numbness, tingling and weakness in the lower back, buttocks, legs and feet
• ankylosing spondylitis this causes pain and stiffness that’s usually worse in the morning and improves with movement
• spondylolisthesis this can cause lower back pain and stiffness, as well as numbness and a tingling sensation

These conditions are treated differently to non-specific back pain.

Very rarely, back pain can be a sign of a serious problem such as:

• a broken bone in the spine
• an infection
• cauda equina syndrome
• some types of cancer, such as multiple myeloma

If you see a GP with back pain, they’ll look for signs of these.

Page last reviewed: 14 January 2020 Next review due: 14 January 2023

What Should I Know About Back Pain

Back pain is a very common problem and will affect many of us at some point during our lives.

The good news is that in most cases it isnt a serious problem, and it might just be caused by a simple strain to a muscle or ligament.

As far as possible, its best to continue with your normal everyday activities as soon as you can and to keep moving.

Being active and exercising wont make your back pain worse, even if you have a bit of pain and discomfort at first. Staying active will help you get better. Taking painkillers can help you do this.

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Can You Tell If Your Back Pain Is From Covid

Not necessarily. Back pain is one of the most common medical problems in the U.S., impacting eight out of 10 people in their lifetime, according to Medline Plus. Given how many people struggle with back pain, its tricky to know for sure if your pain is from COVID or one of the many other common causes that can lead to back aches, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York.

The overwhelming number of people that have back pain do not have COVID, Dr. Russo says. But, he adds, its important to look at your back pain in the context of everything else thats going on with your health. If you have symptoms of COVID-19 in addition to back pain that are more common with COVID, such as respiratory tract symptoms and loss of taste and smell, that would be a signal that your back pain could be due to COVID, he says.

He also recommends suspecting COVID if you suddenly develop back pain and you know youve recently been exposed to someone with the virus. But back pain alone, without anything else, should not make you suspect COVID, Dr. Russo says.

Really, the only way to know if your back pain might be linked to COVID is to test yourself, Dr. Russo says. The best thing to do to ease your concerns is to go ahead and get tested, he says. Thats a way to evaluate this more objectively.

How Are Back And Neck Pain Treated

If you experience acute back or neck pain, it may simply improve with some rest. Over-the-counter medicines, such as acetaminophen or ibuprofen, may also help with the discomfort. You should try to move gently during this period, so that you will not become stiff and lose mobility.

If you have chronic pain of your back and neck, you should try several remedies that may be helpful, before seeking surgical options. These include:

• Hot or cold packs

• Specific exercises to strengthen muscles and ease pain, such as stretching and flexing. Your health care provider can provide and demonstrate these exercises.

• Aerobic exercise may be permitted and can help with your overall fitness and strength

• Certain anti-inflammatory medications or muscle relaxants may be used, with your health care providers supervision

• Braces or corsets for extra support

• Injections for pain relief in the area

• Nerve block, which decreases pain signals from the affected nerve

• Acupuncture

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How Common Is Lower Back Pain

Around four out of five people have lower back pain at some point in their lives. Its one of the most common reasons people visit healthcare providers.

Some people are more likely to have lower back pain than others. Risk factors for lower back pain include:

• Age: People over 30 have more back pain. Disks wear away with age. As the disks weaken and wear down, pain and stiffness can result.
• Weight: People who are obese or carry extra weight are more likely to have back pain. Excess weight puts pressure on joints and disks.
• Overall health: Weakened abdominal muscles cant support the spine, which can lead to back strains and sprains. People who smoke, drink alcohol excessively or live a sedentary lifestyle have a higher risk of back pain.
• Occupation and lifestyle: Jobs and activities that require heavy lifting or bending can increase the risk of a back injury.
• Structural problems: Severe back pain can result from conditions, such as scoliosis, that change spine alignment.
• Disease: People who have a family history of osteoarthritis, certain types of cancer and other disease have a higher risk of low back pain.
• Mental health: Back pain can result from depression and anxiety.

Chronic Lower Back Pain

When back pain continues for more than three months, it is considered chronic. Although for most people an episode of back pain is over by that time, in some cases it progresses and can have a major impact on ones ability to function. For some patients, physical therapy with local heat or ice application , combined with a home exercise program and education in proper positions for lifting and other movement techniques can make a major difference. Patients must learn to tolerate a certain degree of pain, or they may allow themselves to become more disabled than necessary. Patients at the Hospital for Special Surgery have had success with graded exercise to work through the pain, gradually increasing the exercise quota at each session so they can learn to tolerate more exercise in spite of the pain, and get back to work and activities. Read more detail on this topic in .

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Can I Prevent Neck And Back Pain

The following may help to prevent back and neck pain:

• Practice correct lifting techniques: avoid heavy lifting when you do lift something, bend your legs, keep your back straight, and then slowly lift your body and the object.

• Properly use telephones, computers, and other equipment.

• Maintain correct posture while sitting, standing, and sleeping.

• Exercise regularly. Learn specific back-strengthening exercises to keep your back muscles strong. Warm up with stretching exercises before doing back exercises.

• Do exercises that improve your balance.

• Avoid smoking.

• Reduce emotional stress, which may cause muscle tension.

• Make sure you have enough Vitamin D and calcium in your diet.

When Should I See My Healthcare Provider About Lower Back Pain

Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.

See your provider if you have:

• Pain that doesnt get better after about a week of at-home care.
• Tingling, numbness, weakness or pain in your buttocks or legs.
• Severe pain or muscle spasms that interfere with your normal activities.
• Fever, weight loss, bowel or bladder problems or other unexplained symptoms.

A note from Cleveland Clinic

Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.

Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.

References

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Pain Intensifies When You Move

You had a recent fall, but you didnt think your back would hurt this much! If you had a traumatic injury, like a heavy object lands on your back or you slip on the ice and fall with your back striking the edge of a step, you can break a vertebral bone or a rib, notes Dr. Tien. The pain can be moderate to severe, but it will get worse when you move. Talk to your doctor, especially after any bad injury.

Back Pain Culprit: Chronic Conditions

Several chronic conditions can lead to low back pain.

• Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
• Ankylosing spondylitis inflames the joints of the spine, and sometimes the shoulders, hips, ribs, and other areas too. It causes chronic back pain and stiffness. In serious cases, spinal vertebrae start to fuse .
• Fibromyalgia causes widespread muscle aches, including back pain.

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What Is Back Pain

Back pain refers to pain that you may feel in your back or spine. It is a very common problem: 1 in 6 Australians report having back problems, and 4 out of 5 experience it sometime in their life. While both men and women report that they experience back problems, it is more commonly reported by people 25 years and older.

Back pain can be grouped into different categories. Lower back pain refers to pain felt in the lower part of the spine . Back problems can also affect the upper back , the neck as well as the tailbone .

People experience back pain in different ways. Some people say it feels like a sharp pain other people report aches or spasms. You may feel stiff, or find it hard to turn or bend in certain directions. In some cases, such as sciatica, pain can travel down one or both your legs.

Back pain can impact you physically and mentally. People suffering from back pain may feel irritable or short-tempered. They may worry about whether the pain will control their life and may experience feelings of helplessness.

Whats New In This Article

Fourteen updates have been logged for this article since publication . All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. moreWhens the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are fine print, but more meaningful than most of the comments that most Internet pages waste pixels on. I log any change to articles that might be of interest to a keen reader. Complete update logging of all noteworthy improvements to all articles started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles.See the Whats New? page for updates to all recent site updates.

2020 Minor science update, added a citation to a cancer case study.

2020 Added information about back pain as a symptom of COVID-19.

2018 Cited Premkumar et al on red flag reliability .

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Home Remedies Vs When To Call A Doctor

Home remedies for these conditions and other back pain may include over-the-counter medications, ice or heat, or a combination of both. Often, walking or easy movement is recommended for some conditions. In some instances, however, limiting activity and resting may be just what the doctor ordered.

The pain management specialists at National Spine & Pain Centers encourage women to make an appointment to see a provider anytime the back pain you experience lasts more than two weeks and is not improving with these home remedies. Additionally, if the pain is causing numbness, weakness, a sudden spike in pain, loss of bladder function, fever, weight loss, or is chronically affecting your quality of life on an everyday basis. Your healthcare provider will run necessary tests to determine the cause of your pain and recommend treatment, which may include lifestyle changes, physical therapy, or pain medication. If the condition persists, the specialist may discuss surgical options to improve your pain.