BACKGROUND: According to the Mayo Clinic, about four out of five people in the United States will experience low back pain at least once during their lives. Back pain is the second most common cause of missed work days. It costs us about $90 billion each year.
CAUSES: There are many potential causes of back pain. Some of these include:
- Strains: Strained muscles and ligaments may result from improper lifting or after a sudden, awkward movement.
- Bulging or ruptured disks: Disks act as cushions between the vertebrae in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve.
- Sciatica: If a bulging or herniated disk presses on the main nerve that travels down your leg, it can cause sciatica -- sharp, shooting pain through the buttock and back of the leg.
- Arthritis: The joints most commonly affected by osteoarthritis are the hips, hands, knees and lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord. This is a condition known as spinal stenosis.
- Skeletal irregularities: Back pain can occur if your spine curves in an abnormal way. If the natural curves in your spine become exaggerated, your upper back may look abnormally rounded, or your lower back may arch excessively. Scoliosis, a condition in which your spine curves to the side, may also lead to back pain.
- Osteoporosis: Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle.
RISK FACTORS: Some risk factors for back pain include smoking, being obese, being female, having a physically strenuous job, having a stressful job, being sedentary and experiencing anxiety or depression.
TREATMENTS: Doctors may prescribe nonsteroidal anti-inflammatory drugs or muscle relaxants to relieve mild to moderate back pain that doesn't get better with over-the-counter pain relievers. Low doses of certain types of antidepressants have been shown to relieve chronic back pain as well. Physical therapists can apply a variety of treatments such as heat, ice, ultrasound, electrical stimulation and muscle-release techniques to a patient's back muscles to reduce pain. Doctors may also inject cortisone into the space around a patient's spinal cord. A cortisone injection helps decrease inflammation around the nerve roots. If all of those measures fail, patients may undergo surgery to relieve their pain.