Lower & Middle Back

Back Pain Overview

Back pain affects 80% of Americans at some time in their lives. It comes in many forms, from lower back pain, middle back pain, or upper back pain to low back pain with sciatica. Common back pain causes include nerve and muscular problems, degenerative disc disease, and arthritis. Many people find relief from symptoms of back pain with pain medication or pain killers. 

What Are the Symptoms of Back Pain?

Most people have experienced back pain sometime in their life. The causes of back pain are numerous; some are self-inflicted due to a lifetime of bad habits. Other back pain causes include accidents, muscle strains, and sports injuries. Although the causes may be different, most often they share the same symptoms. The symptoms for back pain are:

Persistent aching or stiffness anywhere along your spine, from the base of the neck to the hips.

Sharp, localized pain in the neck, upper back, or lower back -- especially after lifting heavy objects or engaging in other strenuous activity.

Chronic ache in the middle or lower back, especially after sitting or standing for extended periods.

Back pain that radiates from the low back to the buttock, down the back of the thigh, and into the calf and toes.

Inability to stand straight without having severe muscle spasms in the low back.

Call Your Doctor About Back Pain If:

You feel numbness, tingling, or loss of control in your arms or legs. This may signal damage to the spinal cord.

The pain in your back extends downward along the back of the leg. You may be suffering from sciatica.

The pain increases when you cough or bend forward at the waist. This can be the sign of a herniated disc.

The pain is accompanied by fever, burning during urination, or strong-smelling urine. You may have a bacterial urinary tract infection.

You have urine or fecal incontinence.

You have dull pain in one area of your spine when lying in or getting out of bed. If you are over 50 you may be suffering from osteoarthritis.


How Is Back Pain Diagnosed?

Before a doctor can begin treating back pain, he or she may do tests to diagnose what is causing the patient's back pain. Unless you are totally immobilized from a back injury, your doctor probably will test your range of motion and nerve function and touch your body to locate the area of discomfort.

Blood and urine tests will make sure the pain is not due to an infection or other systemic problem. X-rays are useful in pinpointing broken bones or other skeletal defects. They can sometimes help locate problems in connective tissue. To analyze soft-tissue damage, computed tomography (CT) or magnetic resonance imaging (MRI) scans may be needed. X-rays and imaging studies are generally used only for checking out direct trauma to the back, back pain with fever, or nerve problems such as weakness or numbness in the arms or legs. To determine possible nerve or muscle damage, an electromyogram (EMG) can be useful.


Be-Your-Own Therapist Home Treatment

What Are the Treatments for Back Pain?

Because back pain stems from a variety of causes, treatment goals are pain relief and restored movement. The basic treatment for relieving back pain from strain or minor injury is rest. An ice pack can be helpful, as can aspirin or another nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and inflammation. After the inflammation subsides, applying heat can soothe muscles and connective tissue.

Long-term bed rest is not only no longer considered necessary for most cases of back pain, it is actually potentially harmful, making recovery slower and potentially causing new problems.

In most cases, you will be expected to start normal, nonstrenuous activity (such as walking) within 24 to 72 hours. After that you should begin controlled exercise or physical therapy. Physical therapy treatments may employ massage, ultrasound, whirlpool baths, controlled application of heat, and individually tailored exercise programs to help you regain full use of the back. Strengthening both the abdominal and back muscles helps stabilize the spine. You can prevent further back injury by learning -- and doing -- gentle stretching exercises and proper lifting techniques, and maintaining good posture.

If back pain keeps you from normal daily activities, your doctor can help by recommending or prescribing pain medications. Over-the-counter painkillers such as Tylenol, aspirin, or ibuprofen can be helpful. Your doctor may prescribe prescription strength anti-inflammatories/pain medicines or may prefer to prescribe combination opioid/acetaminophen medications such as Vicodin or Percocet. Some doctors also prescribe muscle relaxants. But beware, these medications have their main effect on the brain, not the muscles, and often cause drowsiness.

If your primary doctor isn't able to help you control back pain, he/she may refer you to a back specialist or a pain specialist. Sometimes these doctors will use injections of steroids or anesthetics to help control the pain. Some newer treatments have been developed recently to help with the treatment of pain. One of these is radiofrequency ablation, a process of delivering electrical stimulation to specific nerves to make them less sensitive to pain, or by delivering enough electricity to actually destroy the nerve to prevent further pain. A similar type of procedure that delivers heat to a herniated disc can shrink the disc so that it no longer bulging onto the nerve root causing pain. Other medicines such as antidepressants and anticonvulsants are sometimes prescribed to help with pain related to irritated nerves.

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