Back Pain

It’s normal for people to experience back pain from time to time. But if the pain becomes severe, disrupts your daily life, or is accompanied by swelling, redness, or warmth, it’s wise to see a doctor.

At Complete Orthopedics, our team of back specialists offers a range of treatments for back pain, including surgery when needed. We have locations in New York City and Long Island and operate in six hospitals, providing top-notch surgical and orthopedic care. To make an appointment with one of our surgeons, you can either book online or call us.

Learn about the common causes of back pain and the treatments available, including when surgery is the best option.

Overview

Low back pain is the most common cause of absence from work loss of man hours at work. Back pain affects a younger and active population and happens to 80% population as some point of their life with a high recurrence rate.

Mostly it is due to bad posture or mechanical causes and hence is labelled as mechanical back pain. Such patients are usually treated with short period of rest followed by stretching and strengthening exercises of the lower back. The patient may also need to use ice or heat along with the medications.

X-ray of the Lumbar Spine.

X-ray of the Lumbar Spine.

Some patients may also present with radiating pain with or without tingling and numbness to the leg called Lumbar radiculopathy or Sciatica. These patients most likely have a disc herniation in the lumbar spine and need an advance imaging to confirm.

Most patients can be treated conservatively using medications, and physical therapy and various modalities, though some may need invasive treatment in the form of injection or surgical procedure. Surgical procedure in lower back may range from microdiscectomy to fusion surgery with use of screws and rods depending on the disease and patient characteristics.

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Recovery from lumbar spine surgery usually involves gradual rehabilitation and physical therapy and may take 1 to 4 months or more to return to normal activities of daily living. Bone weakening, or osteoporosis is another cause of back pain in elderly population Other rare causes of back pain can be tumors, disorders of aorta, kidneys, ovaries, prostrate, gastrointestinal system etc.

Risks factors for mechanical back pain include:

  • Age – elder people are more susceptible
  • Behavioral disorders such as anxiety and depression
  • Stress
  • Conditions such as pregnancy
  • Gender – more common in females as compared to males
  • Obesity
  • Poor posture
  • Smoking
  • Arduous physical work
  • Sedentary lifestyle

 

Red Flags

The patients who have back or neck pain with any of these following conditions should seek medical attention as soon as possible.

  • Cancer, neoplasia or malignancy.
  • Unexplained weight loss of more than 10 pounds in the last 6 months.
  • Immunocompromised comorbidities like on chemo or radiotherapy or having disease like HIV or AIDs or being on prolonged corticosteroid therapy.
  • IV drug users.
  • Urinary tract infection.
  • Fever of more than 100 degrees centigrade.
  • Significant trauma from a fall or accident.
  • Bowel or bladder involvement in the form of incontinence or retention.
  • Weakness in the major joint of arm or leg.

 

Causes of Back Pain

Muscle or Ligament Strain: Heavy lifting, sudden awkward movements, or poor physical condition can lead to muscle or ligament strain. Repeated stress can cause painful muscle spasms.

Bulging or Ruptured Disks: Disks act as cushions between the vertebrae in your spine. When the soft material inside a disk bulges or ruptures, it can press on a nerve, leading to pain.

Arthritis: Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.

Osteoporosis: Bones can become porous and brittle, leading to painful fractures in the spine’s vertebrae.

Infections and Tumors: Although rare, infections and tumors can cause back pain. Conditions like osteomyelitis (infection of the spine) or cancer can lead to significant discomfort.

 

Symptoms of Back Pain

  • Muscle Ache: A common symptom is a dull, constant ache in the back.
  • Shooting or Stabbing Pain: This type of pain can radiate down the leg (sciatica) and is usually caused by nerve compression.
  • Limited Flexibility or Range of Motion: Difficulty bending or standing up straight can occur.
  • Pain Worsening with Activity: Specific movements or activities, such as lifting or bending, can exacerbate the pain.

 

Diagnosis

To diagnose the cause of back pain, healthcare providers typically start with a thorough medical history and physical examination. Imaging tests, such as X-rays, MRIs, or CT scans, can help identify structural problems or injuries. In some cases, blood tests may be necessary to check for infections or other medical conditions.

 

Treatment and Management

Non-surgical Treatments

Physical Therapy: Exercises tailored to your condition can help strengthen your back muscles and improve flexibility. Physical therapy may include stretching, strength training, and aerobic exercises.

Medications: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. In some cases, muscle relaxants, topical pain relievers, or prescription medications may be necessary.

Heat and Cold Therapy: Applying heat or ice packs can reduce inflammation and relieve pain.

Lifestyle Changes: Maintaining a healthy weight, practicing good posture, and avoiding activities that strain the back are crucial.

Alternative Therapies: Acupuncture, massage therapy, and chiropractic care can provide relief for some individuals.

Surgical Treatments

Surgery is typically considered a last resort when other treatments have failed, and the pain is debilitating. Surgical options may include:

  • Diskectomy: Removal of the herniated portion of a disk to relieve nerve pressure.
  • Laminectomy: Removal of part of the vertebra to relieve pressure on the spinal cord or nerves.
  • Spinal Fusion: Joining two or more vertebrae to stabilize the spine.

 

Prevention

Preventing back pain involves several proactive steps:

  • Exercise Regularly: Strengthening the muscles, particularly those in the abdomen and back, can help maintain spine health.
  • Maintain a Healthy Weight: Excess weight puts additional stress on the back.
  • Proper Lifting Techniques: Lift with your legs, not your back, to avoid strain.
  • Ergonomic Workspaces: Ensure that your workstation supports good posture and reduces strain.

Special Considerations

Children and Adolescents

Back pain in children and adolescents is less common and often related to specific activities, such as sports. Conditions like scoliosis (curvature of the spine) or Scheuermann’s disease (a condition where the vertebrae grow unevenly) may also cause back pain in younger individuals.

Older Adults

In older adults, degenerative conditions such as osteoarthritis and spinal stenosis are more common. Osteoporosis can lead to fractures and chronic pain.

When to See a Doctor

Seek medical attention if:

  • The pain is severe and doesn’t improve with rest.
  • Pain spreads down one or both legs, especially if it extends below the knee.
  • Causes weakness, numbness, or tingling in one or both legs.
  • It’s accompanied by unexplained weight loss.
  • Occurs after a fall, blow to your back, or other injury.

Back pain is a widespread issue, but with the right approach, it can often be managed effectively. Through a combination of lifestyle changes, medical treatment, and sometimes surgical intervention, most people can find relief and regain their quality of life.

Do you have more questions? 

When should I consider seeing a doctor for my back pain?

You should see a doctor if you experience severe pain, pain that doesn’t improve with rest, or if it’s accompanied by symptoms like numbness, tingling, weakness, or bowel/bladder issues.

How does poor posture contribute to back pain?

Poor posture can strain muscles and ligaments, leading to discomfort and chronic back pain over time. It can also contribute to spinal misalignment.

What lifestyle changes can help prevent back pain?

Maintaining a healthy weight, regular exercise, good posture, and ergonomic adjustments at work can help prevent back pain.

What are the symptoms of a herniated disc?

Symptoms include localized back pain, pain radiating to the legs (sciatica), numbness, tingling, and weakness in the legs.

What is lumbar radiculopathy?

Lumbar radiculopathy, or sciatica, occurs when a nerve in the lower spine is compressed, causing pain, numbness, or weakness in the legs.

Can stress and anxiety cause back pain?

Yes, stress and anxiety can cause muscle tension and exacerbate back pain.

What are the surgical options for treating back pain?

Surgical options include microdiscectomy, spinal fusion, and decompression surgeries, depending on the underlying cause

How effective is physical therapy for back pain?

Physical therapy can be very effective for strengthening back muscles, improving flexibility, and reducing pain.

What role does obesity play in back pain?

Obesity increases the strain on the spine and back muscles, contributing to pain and the development of conditions like herniated discs.

How does smoking affect back pain?

Smoking can reduce blood flow to the spine, impairing healing and increasing the risk of back pain.

What are the risks of prolonged corticosteroid use for back pain?

Risks include weakened bones (osteoporosis), increased risk of infections, and potential hormonal imbalances.

What is osteoporosis and how does it relate to back pain?

Osteoporosis is a condition where bones become weak and brittle, often leading to fractures and chronic back pain.

Are there specific exercises recommended for back pain relief?

Yes, exercises like stretching, strengthening the core, and low-impact aerobic activities are recommended for back pain relief.

How does pregnancy contribute to back pain?

Pregnancy increases weight and changes posture, leading to additional strain on the back muscles and spine.

What are the benefits of using heat or ice for back pain?

Ice can reduce inflammation and numb acute pain, while heat can relax muscles and improve blood flow for chronic pain.

Can poor sleeping habits cause back pain?

Yes, improper sleeping positions or using a non-supportive mattress can contribute to back pain.

What is the significance of “red flags” in back pain assessment?

Red flags indicate serious conditions that require immediate medical attention, such as cancer, infections, or significant neurological deficits.

How does physical work affect back pain risk?

Arduous physical work can strain the back muscles and spine, increasing the risk of injury and chronic pain.

Can back pain be a symptom of other underlying health conditions?

Yes, back pain can be associated with conditions like kidney problems, infections, or tumors.

What is microdiscectomy and when is it used?

Microdiscectomy is a minimally invasive surgery to remove part of a herniated disc that is compressing a nerve, used when conservative treatments fail.

How long does recovery from back surgery typically take?

Recovery can take from 1 to 4 months or more, depending on the type of surgery and individual patient factors.

What role does ergonomics play in preventing back pain?

Proper ergonomics in the workplace and daily activities can help reduce strain on the back and prevent pain.

What is spinal fusion surgery and when is it recommended?

Spinal fusion surgery involves joining two or more vertebrae to stabilize the spine, recommended for conditions like severe degenerative disc disease or spondylolisthesis.

What are the potential complications of back surgery?

Complications can include infection, nerve damage, blood clots, and incomplete pain relief.

Dr Vedant Vaksha

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.