Less Common Causes Of Low Back Pain
Inflammation of the joints of the spine sometimes causes back pain. Osteoarthritis is the common form of arthritis and usually occurs in older people. Ankylosing spondylitis is another form of arthritis that can occur in young adults and which causes pain and stiffness in the lower back. Rheumatoid arthritis may affect the spine but you are likely to have other joints affected too.
Various uncommon bone disorders, tumours, infection and pressure from structures near to the spine occasionally cause low back pain .
The rest of this leaflet is mainly about nonspecific low back pain – the common type of low back pain.
Surgery For Lower Back Pain
Because the vast majority of patients recover from their low back pain with little help from a doctor, the rationale behind choosing surgery must be convincing. Eighty percent of patients with sciatica recover eventually without surgery.
Severe progressive nerve problems, bowel or bladder dysfunction and the cauda equina syndrome make up the most clear-cut indications for back surgery. Back surgery will also be considered if the patients signs and symptoms correlate well with studies such as MRI or electromyogram .
In the most serious cases, when the condition does not respond to other therapies, surgery may well be necessary to relieve pain caused by back problems. Some common procedures include:
- Discectomy, such as a or removal of a portion of a
- a bone graft that promotes the vertebrae to fuse together
- removal of the lamina to create more space and reduce irritation and inflammation
References and useful links
- 1, 2. Excerpted from Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health
- Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health. Reviewed, July 26, 2003.
- Deyo RA, Weinstein JN, Low Back Pain, N Engl J Med, Vol 344, No. 5, Feb 1, 2001, pp 363-370.
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When To Call A Healthcare Provider
It can be easy to assume back pain will go away, especially if you’ve had it in the past and treated it successfully with pain relievers, ice packs, and rest.
However, if your back pain is not responding to treatment, gets worse over time, and/or goes on longer than six weeks, you should talk to your healthcare provider.
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What Are The Symptoms Of Back Spasms
A back spasm may feel mild like a dull ache or twitch, or it can get so sharp and painful that its debilitating.
If you experience any of the following symptoms in addition to back spasms, you should see your healthcare provider right away:
- Loss of bladder or bowel control.
- Muscle weakness in arms or legs.
- Odd sensations, numbness or weakness on one side of your body.
- Loss of balance and coordination.
- Loss of a sense of feeling in a limb/limbs.
Signs Your Back Pain Might Be An Emergency
In our 20s and 30s, normal back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.
In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.
Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.
Approximately 80% of adults will experience back pain in their lives, so its important to be able to identify the severity of your symptoms and track how long the pain lasts.
If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, its usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
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What Is Back Pain
Symptoms of back pain linked to lung cancer may overlap with those of back pain that is caused by other conditions, such as ruptured disc, arthritis, and osteoporosis. If the cancer has metastasized to the spine, symptoms can mimic those of an upper back injury.
However, back pain caused by lung cancer also has distinct differences. These may relate to how and where the cancer causes pain, both directly and indirectly. Lung cancer-related back pain may feel dull like a muscle ache, or it may seem sharp like a pinched nerve.
Red flags that suggest back pain may be due to lung cancer include:
- Back pain that is present at rest
- Back pain that is worse at night
- Back pain that happens without any activity
- Back pain that worsens the longer you lie in bed
- Back pain that gets worse when you take a deep breath
- Back pain that doesn’t respond to physical therapy or other treatment
The back pain may come with other telltale lung cancer signs like a cough that won’t go away or shortness of breath. Unintentional weight loss, chronic fatigue, or coughing up blood may further suggest lung cancer.
A condition called malignant spinal cord compression may develop in some people who have lung cancer that spreads to the spine. These symptoms include worsening back pain, weakness in the legs, and sometimes loss of urinary or bowel control. This is a medical emergency, and immediate treatment is needed to prevent complications such as paralysis.
Back Pain From Cancer
Rarely, it may be the first manifestation of cancer, says a paper in the Journal of General Internal Medicine .
The study authors point out that out of 1,975 walk-in patients at a clinic, only 13 were found to have cancer as a cause of their back pain.
Certain findings correlate to this, but these findings certainly dont automatically mean cancer:
At least 50 years of age
Previous history of cancer
Pain lasting longer than a month
No improvement with conservative therapy
Whats scary is that the paper says that metastatic cancer, when causing back pain, may not always cause other symptoms.
When cancer causes back pain, its more frequently in the lower region. Thus, pain specifically in the middle back, from this disease, would be even rarer.
Quite simply, pain in the back, be it low, middle or upper, has MANY causes including inflammatory bowel disease, irritable bowel syndrome, gastroesophageal reflux disease , fibromyalgia, aortic disease, imminent heart attack, premenstrual syndrome, benign ovarian cysts and overdoing it in a yoga class.
Dr. Psallidas is the main author of many peer-reviewed publications and book chapters in pleural disease and lung cancer.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
Top image: Freepik.com/ shayne_ch13
- Other organs
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How Lung Cancer And Back Pain Are Linked
When we think about back pain, usually the last thing that comes to mind is cancer. Instead, we connect it to things like an injury, such as a muscle strain or ruptured disc. Or we may think its because of a degenerative disease, like arthritis or osteoporosis.
Back pain caused by lung cancer shares some common features with many of these disorders. Yet it also has distinct differences. These may relate to how and where the cancer causes pain, both directly and indirectly.
Some possible ways in which lung cancer can produce back pain include:
- A tumor can place direct pressure on the structure of the back, most often in the mid to upper back rather than lower back.
- A tumor can irritate the nerves that serve the lining of the lungs and chest wall. This may trigger a sharp and sometimes chronic nerve pain.
- Cancer spread from the lungs to the spine and bones happens in some 30% of people with lung cancer.
- Spread of cancer to the adrenal glands occurs in 40% of people with lung cancer, and can cause pain right above the kidney.
Healthcare providers may overlook a possible lung cancer as the cause of back pain, especially in people who have never smoked. However, at the current time, most of the people who develop lung cancer are non-smokers, either never smokers or former smokers. Lung cancer cases are rising in young women and men who have never smoked.
What To Do If You Suspect Something Else
Theres only one major tiphere: See a doctor, whether it is your primary care physician or aspecialist. Each condition that mimics spinal problems comes with its own treatments,but the first step is an accurate diagnosis. For example, a nerve test such aselectromyography can help a doctor spot neuropathy, and a blood-flow testsuch as the ankle-brachial index can distinguish between spinal stenosisand peripheral arterial disease.
Its so important to look atall of your symptoms and history and do a thorough examination, Dr. Khalafsays. Its how we can tell the difference between a back issue and a medicalcondition.
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Find Out How To Spot Red Flags That Can Indicate A Serious Condition
Here’s how to tell if your back pain may be something serious
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In many cases, back pain can be as commonplace as a mild headache, a sneeze here and there, or eye strain. In fact, non-specific low back pain is a frequent ailment. One study reports that the lifetime prevalence of chronic low back pain is as high as 84%, making ones chances of experiencing discomfort at one time or another pretty high.
Then there are those other times, when the back pain just doesnt feel right and your gut is saying that something more is going on. Many people have been known to go to the emergency room when experiencing low back painin 2012, a study found that low back pain accounted for 3.15% of all emergency visits in the United States. When you consider how many conditions can land someone in the ER, that number is fairly substantial.
Lets say that youre experiencing a significant amount of back pain, wondering, How do I know if my back pain is serious? This guide will help you decide if it warrants a trip to your doctor or the emergency room.
What Does Pancreatic Cancer Back Pain Feel Like
Pancreatic cancer is hard to be recognized in its earlier stages as its signs and symptoms may resemble vague gastrointestinal complaints. Pain in the abdomen or back is its common symptom. It is mostly intermittent initially, that is, it comes and goes. But with time, it becomes more frequent. The abdominal pain is most often due to the tumor pressing on the nearby organs. It can be worse when lying down, and you can sometimes feel better when you sit leaning forward. It may worsen after eating. Back pain may arise if the tumor spreads to the nerve surrounding the pancreas and if it has grown so much that it presses on the spine.
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How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
What Are The Symptoms Of Pancreatitis
Common symptoms of Pancreatitis include:
- Fever and chills: This is because the immune system is involved in the inflammatory process of pancreatitis.
- Sharp upper abdominal pain: This typically happens one to five hours after eating, and can last for several minutes or up to a few hours at a time. The severe pain may radiate to the back, shoulder blade area, or between shoulder blades.
- Nausea and vomiting: This is a common symptom that can result from a number of reasons, but it is a common one in cases of pancreatitis because the digestive enzymes from the pancreas enter the bloodstream.
- Abdominal pain: This severe abdominal pain can be severe pancreatitis and is often described as sharp, constant, and intense. Other symptoms may include constipation or diarrhea.
- Painful joints: This may happen because pain impulses from the abdomen can migrate to other parts of the body.
- Jaundice: Yellowing of skin and eyes caused by high levels of bilirubin in the blood. The patient’s urine might also become dark or murky looking due to liver problems.
In some cases, the patient may also feel very tired and have a high temperature or chills from a drop in their white blood cells.
Pancreatitis can be life-threatening if it is not treated quickly by a doctor. In fact, one out of every 10 people who have pancreatitis will eventually die from it.
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What Causes Back Spasms
There are a number of possible causes for back spasms:
- Not using your muscles enough. If you sit too much, have poor posture, dont exercise or rarely use your back or stomach muscles, those muscles can get weak and spasm.
- Using your muscles too much. Athletes and those who do a lot of heavy lifting may experience back spasms. Such activities can cause a muscle strain, which is a tear, and that can cause inflammation.
- Dietary issues. Back spasms can be caused by too little water, potassium and/or calcium in your diet.
- Mental/emotional health issues. Anxiety and stress can tense up your muscles.
- Trauma. You may injure your back in a fall or car accident.
Sometimes, your back spasms may mean that you have a serious condition, including:
- Epidural abscess.
Symptoms Of Lower Back Pain
Sometimes a pain may develop immediately after you lift something heavy, or after an awkward twisting movement. Sometimes it can develop for no apparent reason. Some people just wake up one day with low back pain.
Although nonspecific back pain is sometimes called simple back pain, simple does not mean that the pain is mild. The severity of the pain can range from mild to severe. Typically, the pain is in one area of the lower back but sometimes it spreads to one or both buttocks or thighs. The pain is usually eased by lying down flat. It is often made worse if you move your back, cough, or sneeze. So, nonspecific low back pain is mechanical in the sense that it varies with posture or activity.
Most people with a bout of nonspecific low back pain improve quickly, usually within a week or so, sometimes a bit longer. However, once the pain has eased or gone it is common to have further bouts of pain from time to time in the future. Also, it is common to have minor pains on and off for quite some time after an initial bad bout of pain. In a small number of cases the pain persists for several months or longer. This is called chronic back pain .
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Onset Of Upper Back Pain Symptoms
Upper back pain symptoms could start any number of ways, including:
- Sudden. Pain could begin immediately after an injury or out of the blue for no apparent reason at all.
- Delayed. Sometimes pain from an injury takes a few hours or longer before it shows up. The reason for this is not always known, but it could be due to an inflammatory process or how pain might be felt in another area of the body before it is noticed in the upper back.
- Gradual. Pain may start out mild and slowly worsen over time.
Sometimes upper back pain comes and goes. Intermittent pain may or may not become worse over time, depending on the cause. Pain could feel worse in the morning and get better during the day, or it might be worse in the evening but feel better after rest.
Treatment If Back Pain Is Severe Or Lasts A Long Time
If your back pain doesn’t get better or is severe, your doctor may recommend:
- Prescription medicines.
These may include:
- Muscle relaxants to help reduce pain and muscle tension and help you move better. These can help with severe muscle spasms that happen when the back pain starts .
- Antidepressants, such as duloxetine. They can help treat long-lasting back pain.
- Prescription pain medicines.
- Steroid shots.
They may help reduce swelling and relieve pressure on nerves and nerve roots. But there is little evidence showing that these shots can help control back pain.
In some cases, a back brace may be used to support the bones in the spine after a fracture.
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