What Is The Outlook
Most of us will have a bout of nonspecific low back pain at some point in our lives. The severity can vary. However, it is difficult to quote exact figures as to outlook . This is partly because it is so common and many people with back pain do not consult a doctor. Roughly, it is thought that:
- Most nonspecific back pains ease and go quickly, usually within a few weeks.
- In about 4 in 10 cases, the pain has completely gone within four weeks.
- In about 7 in 10 cases the pain has completely gone within one year.
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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What Is The Treatment For Chronic Nonspecific Low Back Pain
Initial treatment is similar to sudden-onset attacks. That is, aim to keep as active as possible. Also, painkillers can help. In addition to the painkillers listed above, your doctor may advise a course of an antidepressant medicine in the tricyclic group – for example, amitriptyline. Tricyclic antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including back pain.
Also, a national guideline , referenced below) recommends one or more of the following treatments should be considered. Each of these treatments has some evidence from research trials to suggest that they will help to ease symptoms in some people :
- Structured exercise programme. This means a programme of exercise supervised by a professional such as a physiotherapist. This is likely to be in a group setting. Exercises may include aerobic activity, movement instruction, muscle strengthening, posture control and stretching. It typically consists of up to eight supervised sessions over 8-12 weeks with encouragement to keep on doing the exercises at home between sessions.
- Manual therapy. Typically this includes several sessions of massage, spinal mobilisation and/or spinal manipulation. With spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist moves joints beyond the usual range of movement.
- A course of acupuncture. It is not clear how this may work.
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Less Common Causes Of Low Back Pain
While considerably less common, low back pain may also be caused by:
Infection. Also called osteomyelitis, a spinal infection is rare but can cause severe pain and is life threatening if untreated. It can be caused by surgical procedures, injections, or spread through the blood stream. Patients with a compromised immune system are more susceptible to developing an infection in the spine.
Tumor. Most spinal tumors start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis.
Autoimmune disease. Back pain is a possible symptom associated with autoimmune conditions, such as ankylosing spondylitis, rheumatoid arthritis, lupus, crohns disease, fibromyalgia, and others.
This list includes the more common causes of back pain, but there are many more. Finding the optimal treatment for low back pain usually depends on obtaining a correct clinical diagnosis that identifies the underlying cause of the patients symptoms.
Acute Back Pain Due To Inflammation Of Internal Organs
Pain in your lower back may occur due to the inflammation or irritation of an internal organ or may be a sign of infection. Organs of the mid-back, abdominal, or pelvic regions can cause pain specifically in the right or left side of your lower back or be generalized throughout the area.
Common examples of lower back pain stemming from internal organs include:
- Kidney stones. Acute lower back pain may be felt when a kidney stone moves inside the kidney or the ureter, a thin tube connecting the kidney to the bladder. The pain is typically localized to the left or right side depending on the kidney thatâs affected.
- Kidney infection. Kidney infections usually start as urinary tract infections , causing inflammation and pain on the left or right lower back area, depending on the kidney affected.
- Ulcerative colitis. Persistent inflammation of the large intestine can cause abdominal cramping and sharp back pain on one or both sides of the lower back and abdomen.
- Pancreatitis. A lower left back pain may be due to inflammation of the pancreas, which also causes upper abdominal pain at the same time.
- Appendicitis. An inflamed appendix can cause a sharp pain in the lower right abdomen and back.
Women may develop lower back pain from specific conditions, such as uterine fibroids and endometriosis, and pregnancy.
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Facet Joint Pain And Spinal Arthritis
Facet joints are interconnecting joints located at the back of the spine collectively, they give the spine its integrity by limiting excessive movement. Each spinal level has a right and left facet joint. Facet joints are also known as zygapophysial joints.
Facet joints are often the site where bone spurs and other arthritic changes occur. Such changes tend to be related to wear and tear, and at any given level, may occur on one facet joint, but not the others. So when they develop on the right side, they may cause right side back pain.
Other symptoms include numbness, tingling, electrical sensations and/or weakness that travel down one extremity.
Can I Prevent Lower Back Pain
You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.
To reduce your risk of a back injury, you should:
- Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
- Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
- Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.
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What Does It Mean If Lower Back Pain Is Shooting Into Legs
Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.
If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.
Common Causes Of Chronic Lower Back Pain
“Chronic lower back pain is less likely to be caused by injury to your muscles and ligaments and more likely to be due to issues with the lumbar disks, nerves, joints or vertebrae,” says Dr. Palmer. “There are several potential causes of chronic pain in the lower back.”
In general, osteoarthritis and degenerative disk disease are the underlying cause of many types of chronic lower back pain. However, lower back pain can also be caused by accident-related trauma and acute stress.
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What Are The Symptoms Of Serious Back Injury
Any of the following symptoms could indicate a severe back injury. You should see a doctor right away if you have:
- difficulty breathing or shortness of breath
- problems with urinating or passing stool
- numbness or pins and needles to the arms, legs, hands or feet
- blood in the urine
Seek medical assistance immediately by calling an ambulance on triple zero . Do not move the person unless they are in danger and advise the person to not move their back. Support their head, neck and spine and prevent twisting or bending movements.
You’re Running A Fever
The flu can definitely make you run a fever and achiness, including in your back. However, if the fever is unresponsive to standard OTC medications, you could have a serious infection that needs treatment immediately. If you go to a doctor and they find an infection, they may prescribe antibiotics and a few days rest.
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Living With Lumbar Strain
Cold reduces swelling. Both cold and heat can reduce pain. Protect your skin by placing a towel between your body and the ice or heat source.
- For the first few days, apply an ice pack for 15 to 20 minutes.
- After the first few days, try heat for 15 minutes at a time to ease pain. Never sleep on a heating pad.
- Over-the-counter medicines can help control pain and swelling. Try aspirin or ibuprofen.
When To See Your Gp
You should speak to your GP as soon as possible if you have back pain and:
- find it difficult to pass or control urine
- feel numbness or altered sensation around your back passage or genitals – such as wiping after the toilet
- have pins and needles around your back passage or genitals – such as wiping after the toilet
If your GP surgery is closed, phone 111.
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Who Gets Back Pain
Anyone can have back pain. You may be more likely to have back pain because of the following:
- Fitness level: Back pain is more common among people who are out of shape. You may also get back pain if you exercise too hard after not being active for a while.
- Obesity: If you are overweight or obese, it can put stress on the back and cause pain.
- Job-related risk factors: Jobs that require heavy lifting, pushing, pulling, or twisting can injure the back. A desk job may also play a role, especially if you slouch or sit all day in an uncomfortable chair.
- Age: You may have more back pain as you get older, particularly after you turn 45.
- Family history: Your genes play a role in some disorders that cause back pain.
Lower Right Back Pain Symptoms
The back provides both strength and stability to the entire body, leaving it vulnerable to many kinds of injury. It’s possible for even severe back pain to be confined to just one side of the back. When the pain is entirely on the lower right side, it may suggest a specific type of injury or illness, and it’s important to have it examined. Low back pain is also called lumbago or sciatica.
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How To Get Out Of Bed
To get out of bed safely:
What Are Common Causes Of Sudden Back Pain
Sudden back pain is a common problem and can have many different causes, ranging from muscle strain to something more severe, such as pneumonia. Very often, the location of the pain can help a medical professional find the source. Diagnostic tests, such as X-rays or blood work, can also help to determine the cause of the pain. Treatment options will depend on the cause of the problem as well as the overall health of the patient.
If the sudden pain is felt in the upper portion of the back, it can sometimes be a symptom of a heart attack. Even though the heart is located in the front of the chest, the pain of a heart attack can sometimes be felt in and around the shoulder blades. Pain in this area of the back can also be due to a muscle strain, caused by pushing, pulling, or lifting. A dislocated or herniated disc in the spine often causes sudden pain in the upper portion of the back as well as in the neck.
Sudden back pain in the middle of the back is often due to problems with one or both kidneys, such as an infection or kidney stone. Problems with the liver and the gallbladder may also cause pain in this area. Once again, problems with the discs found in the spine can also cause middle back pain, as can any type of injury to the muscles in this area.
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Lower Back Pain: What Could It Be
Do you have lower back pain? You are not alone. Anyone can experience lower back pain at any time, even if you dont have a prior injury or any of the risk factors. It is not always serious and can often get better on its own. But in some cases pain is your bodys way of telling you that something isnt right.
Learn more about lower back pain and what causes it from rehabilitation physician Akhil Chhatre, M.D., who specializes in back pain in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
What Is Sudden Lower Back Pain
Lower back pain is experienced in the lower region of the back, which includes the spine, lumbar and lower spinal vertebrae, areas on the left and right side of the spine and the lower portion which is rested when seating. Sudden pain is acute back pain, often felt as sharp, lightning or shooting type, which can sometimes make a person feel weak and unable to stand, bend or continue with the activity.
Sudden lower back pain may be felt with a burning, stabbing sensation and can also be accompanied with numbness and tingling in lower limbs. It may be related to specific activity or may worsen on making further movements. There may be a history of falling, sudden jerking movements, lifting of heavy weights, accidents or sport injuries.
When internal organs are involved pain may be of dull aching type but many conditions also cause sudden lower back pain. Hence proper evaluation is must.
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Living With Back Pain
Living with back pain can be hard however, most people feel better within 6 weeks. Remember to follow your doctors directions. These tips may make it easier for you to manage your pain and recover:
- Add exercises slowly and talk to your doctor about the types of exercises that are best for you or those that you should not do.
- When sitting for a long time, get up, move around, and switch positions frequently.
- Wear shoes that feel good and that have a low heel.
- When driving a long way, try using support behind your back, and stop frequently to stand up and walk around.
- Sleep on your side, and place a small pillow between your knees. If you tend to sleep on your back, place a pillow under your knees. If possible, try to avoid sleeping on your stomach.
- Limit the amount you carry. Instead, make a few extra trips to avoid carrying too much weight.
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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