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.
Is Lower Right Or Left Back Pain Worrisome
Pain on one side of the back is not particularly more worrisome than central pain. There are three main kinds of one-sided back pain:
Most of the anatomy of the low back and abdomen is symmetrical. Some of the guts are not symmetrical, and only some of those is a plausible cause of back pain on one side. Heres some of the key anatomy to consider:
The side of the pain on its own doesnt tell us much, and most of the one-sided sources of pain are viscera that usually cause abdominal pain instead of back pain, or in addition to it. In other words, the only reason to worry about right or left lower back pain is if it is otherwise worrisome: if you have other red flags or significant non-back symptoms.
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What Is The Outlook For People With Lower Back Pain
The outlook depends on the cause of pain. Most people with back strains and sprains recover and do not have long-term health issues. But many people will have another episode within a year.
Some people have chronic back pain that doesnt get better after several weeks. Older people with degenerative conditions such as arthritis and osteoporosis may have symptoms that get worse over time. Surgery and other treatments are effective at helping people with a range of injuries and conditions live pain-free.
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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.
Whenback Pain Is Likely Spinal Stenosis
Spinal stenosis is one of themost common causes of spinal pain not related to injury. This narrowing of thespace around the spinal cord puts pressure on the nerves. If you have thefollowing symptoms, spinal stenosis may be to blame:
- A heavy feeling in the legs, which may lead to trouble walking.
- Increased pain going downhill.
- Symptoms that get worse with activity.
- Relief from the grocery cart position bending forward like youre leaning on a shopping cart.
However, Dr. Khalaf notes howcommon false positives are. Around 21% of asymptomatic people over age 60will show signs of spinal stenosis on an MRI, she says. And sometimes spinalstenosis and peripheral arterial disease co-exist. Thats why you need aphysical exam, and possibly other tests, to get a clear diagnosis.
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The Tricky One: Cancer As A Cause Of Low Back Pain And The Necessity Of Testing Just In Case When The Symptoms Justify It
Sorry I have to use the C word I know its kind of a bummer. But C happens.
A few cancers in their early stages can be hard to tell apart from ordinary back pain a bone cancer in the vertebrae, for instance and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient just in case. And yet the possibility cannot be dismissed, either! This is an unsolveable problem.
Most cancers and ominous problems will inevitably start to cause other, distinctive, ominous symptoms, and it wont be long before someone catches on that theres more going on than just back pain. So it truly is an extraordinary circumstance for back pain to be ominous without causing other symptoms that raise the alarm.
For example, in 2017, the New England Journal of Medicine reported on a creepy case of slowly growing neurological deficit caused by a very stealthy cancer, which took a lot of diagnostic effort to solve.25shudder So sneaky cancers happen but they are crazy rare.
This is an unholy combination of factors: the exact same symptoms can have either an extremely rare but serious cause, or an extremely common but harmless cause that can be greatly aggravated by excessive alarm!
My favourite epitaph: I told you I was sick!
What Home Remedies For Lower Back Pain Actually Work
Unless youve had a major injury, such as a fall or car accident, you probably dont need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.
Avoid bed rest. When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain and recovered more slowly than patients who stayed fairly active
Use ice and/or heat. Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you dont injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury then you can try a combo of ice and heat.
Try over-the-counter remedies. Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.
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Which Lifestyle Factors Contribute To Lower Back Pain
There are three major lifestyle factors that may affect your chances of developing lower back pain:
- Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
- Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
- Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.
Back Pain Expert Philip Sell On The Questions To Ask
We asked Philip Sell, consultant orthopaedic and spinal surgeon, what he would want to know if he was suffering from back pain.
What is the cause of my back pain?In 85% of cases, were unable to be precise about why people have back pain. This can be frustrating. It may be more helpful to think about what you can do to make your back better quicker. Research has shown that occupational factors or physical factors only play a small part in back pain. Your genes are probably the most significant factor in back pain.
When should I visit my GP with back pain?See your GP as soon as possible if the back pain is combined with difficulty in passing urine or numbness between the legs or around the bottom. For people over the age of 55 with new back pain, a previous history of cancer surgery or loss of weight should also be medically checked as soon as possible.
Should I be resting?You may feel its the wrong thing to do, but keep mobile and active. Resting, bed rest in particular, can prolong the duration of an episode of back pain. Most acute episodes of back pain will settle on their own, often within days rather than weeks. Taking pain relief and keeping active will stop stiffness setting in and keep muscles in good condition.
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Severe Lower Back Pain When Sitting Or Bending
Lower back pain may occur while sitting or standing for a prolonged period of time. Pain may also occur when there is active spinal movement, such as attempting to stand up and/or bend down.
While in most cases the underlying cause of the pain can be identified, sometimes back pain may be non-specific with no identifiable cause.1
Here are a few possible causes for severe low back pain in such situations.
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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All The Red Flags For Ominous Causes Of Back Pain
Red flags are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing even when there really is something serious going on and sometimes they are a false alarm.24 Check off all that apply hopefully none or few or only the least alarming of them!
Some of these red flags are much less red than others, especially depending on the circumstances. For instance, weight loss is common and often the sign of successful diet! Obviously, if you know of a harmless reason why you have a red flag symptom, it isnt really a red flag . But every single actual red flag in combination with severe low back pain thats been going on for several weeks is definitely a good reason to get yourself checked out.
Most people who check off an item or two will turn out not to have an ominous cause for their low back pain. But why not check?
When Should I See A Doctor If I Have Lower Back Pain
In many cases lower back pain stops on its own. But if it doesnt, here are some guidelines on when you may want to start seeking professional help:
- If the pain lasts four weeks or longer
- If the pain keeps getting worse as time goes by
- If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.
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Who Should I See For Lower Back Pain
Your primary care physician knows you best and should be your first contact for lower back pain. If he or she is unable to diagnose or treat the issue, you may get referred to a specialist, such as a rehabilitation physician . These specialists practice a comprehensive approach to lower back pain, and can diagnose and treat a variety of conditions that have lower back pain as a symptom.
Later, you may get referred to a physical therapist, a chiropractor or another practitioner depending on the nature of your back pain. The good news is that surgery is rarely needed for lower back pain. Only about one in ten patients needs lower back surgery, Chhatre says.
Herniated Disk In The Lower Back
The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.
Rarity: Common
Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness
Urgency: Primary care doctor
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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.
The Universal Guide To Lower Back Pain: Everything You Ever Wanted To Know Straight From The Experts
In This Article: | | | | | | | | | |
If youve ever had lower back pain stop you from doing what you want, youre not alone. Lower back pain is one of the most common medical problems in the world. It is a leading reason why people visit a doctor, affecting more than 80% of adults at some point in their lives. According to the Global Burden of Diseasea significant study published in the Lancet medical journallower back pain is also a leading cause of disability.
While severe lower back pain can cause worry, pain severity is not always an indication something is seriously wrong. Photo Source: Shutterstock.
You may not be able to prevent lower back pain, especially as you age and your back loses some strength and resilience. Fortunately, there are many ways you can get relief, no matter the cause of your back pain.
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Chronic Low Back Pain Is Serious But Rarely Ominous
Back pain can suck the joy out of your days for week, months, even years. It can definitely be serious even when its not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.
Ominous is medical jargon for truly scary. Cue Jaws theme music. Low back pain is ominous when it is caused by something that can cripple or kill you. Such causes are rare, fortunately. But awful things do happen, even the best doctors can miss them .
Ordinary back pain can be fierce & awful but not dangerous. Its bark is almost always much louder than its bite.
Preventing Back Pain In Children
Back pain in secondary-school-age children has been linked to heavy schoolbags and ill-fitting classroom seating. Nearly half of all teenagers in the UK have experienced occasional backache from poor posture, carrying overloaded bags, and an unhealthy lifestyle.
The best schoolbag for your child is a well designed backpack. This should be worn over both shoulders to balance out the weight. A heavy satchel or shoulder bag can put stress on your childs spine.
Encourage your child to exercise regularly, or plan joint activities, such as a walk in the countryside or a trip to a swimming pool.
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