Overview
Back pain is the most common cause of workplace disability worldwide. About 80% of adults experience back pain at some point in their lives. Most cases resolve on their own within 1-2 weeks; some may become chronic and last for months.
Back pain is classified as acute (less than 6 weeks), subacute (6-12 weeks), or chronic (longer than 12 weeks).
Symptoms
- Burning, aching, or stabbing pain in the lower back
- Pain radiating to the leg (sciatica)
- Numbness or tingling in the leg or foot
- Muscle tension or spasm
- Limited range of motion
- Difficulty bending, lifting, or walking
- Pain that may decrease or increase with rest
Causes
Mechanical causes (most common):
- Muscle or ligament strain
- Herniated disk
- Spondylolisthesis
- Scoliosis
- Osteoarthritis of the spine
- Spinal stenosis (narrowing of the spinal canal)
Other causes:
- Compression fracture related to osteoporosis
- Infection
- Tumor (rare)
- Rheumatic diseases such as ankylosing spondylitis
- Kidney stones, kidney infection
- Gynecological problems in women
Risk Factors
- Age: Most common between 30-50
- Sedentary lifestyle, weak core muscles
- Excess weight
- Heavy lifting, improper technique
- Prolonged sitting (desk work)
- Smoking
- Stress and depression
- Pregnancy
- Genetic predisposition
When to See a Doctor
Seek emergency care for:
- Loss of bladder or bowel control
- Progressive weakness or numbness in the legs
- Severe pain after trauma
- Back pain with fever
- Back pain with unexplained weight loss
- Severe pain waking you at night
- New back pain after age 50
- New back pain in patients with a history of cancer
Diagnosis and Treatment
Diagnosis: Physical examination may be enough. X-ray, MRI, CT, and nerve conduction tests may be done when needed.
Treatment:
- First step: Short rest, hot/cold therapy, simple pain relievers
- Physical therapy and exercise: Very effective
- Medications: Muscle relaxants, NSAIDs, neuropathic pain medications when needed
- Injections: Epidural steroid, facet joint injection
- Surgery: Only for advanced cases (disk herniation, spinal cord compression)
About 90% of cases improve without surgery.
Prevention
- Exercise regularly (walking, swimming, pilates)
- Strengthen your abdominal and back muscles
- Maintain proper sitting and standing posture
- Lift heavy loads by bending your knees
- Maintain a healthy weight
- Quit smoking
- Create an ergonomic work setup
- Do not stay in the same position for too long