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Back pain


Disease: Back pain Back pain
Category: Bones, joints, muscles diseases
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Disease Definition:

Back pain is a very common complaint, and it’s one of the most common reasons people miss work or go to the doctor.

Surgery is rarely needed to treat back pain and most back pain can be prevented. However, in case of the failure of prevention, simple home treatment and some proper body mechanics can heal the back within a few weeks and keep it functional for the long run.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes




Composed of bones, muscles, tendons, ligaments and disks that are cartilage-like pads and act as cushions between the segments of the spine, the back is a complex structure. When problems occur in any of these component parts, back pain will occur. However, in some cases, no specific cause for back pain is found.

Sometimes a muscle spasm can cause back pain, but most often it is caused by strained muscles and ligaments, from heavy or improper lifting, or after a sudden and awkward movement.

In some cases, back pain could be caused by these structural problems:

When bones become permeable and brittle, compression fractures of the spine’s vertebrae occurs.

Sciatica is a sharp, shooting pain through the buttock and back of the leg. It occurs when a bulging or herniated disk presses on the main nerve that travels down the leg.

Skeletal irregularities:
The upper back could look abnormally rounded or the lower back could arch excessively when the natural curves in the spine become exaggerated. When the spine curves to the side, a condition known as scoliosis occurs, leading to back pain. In general, when the spine curves in an abnormal way, it causes back pain.

Bulging or ruptured disks:
Disks act as cushions between the vertebrae in the spine, so, in some cases, when the soft material inside a disk bulges out of place or ruptures and presses on a nerve, it causes back pain. However, many people experience no pain even though they have bulging or herniated disks.

In some cases, arthritis in the spine might lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis. However, the most commonly affected joints by osteoarthritis are the hands, hips, lower back and knees.

Some of the rare but serious conditions that back pain could be related to include:

Infection of the spine:
Infection could be the cause of back pain, in case a fever and tender, warm area accompany the pain.

Cancer in the spine:
Back pain could be caused by a tumor on the spine pressing on a nerve.

Cauda equina syndrome:
This syndrome is a serious neurological problem that affects a bundle of nerve roots serving a person’s lower back and legs. It can cause weakness in the legs, loss of bowel or bladder control, and numbness in the groin area.






Within a few weeks of home treatment and careful attention, most back pain gets better. Although a short period of bed rest is okay, however, more than a couple of days of rest does more harm than good. In some cases, a regular schedule of over-the-counter pain relievers could be all that is needed. A person with back pain may be suggested stronger medications or other therapy when home treatment doesn’t work.

To reduce pain, a variety of treatments could be applied to the back muscles and soft tissues, such as ice, heat, ultrasound, electrical stimulation and muscle-release techniques. The physical therapist can teach the patient specific exercises as the pain improves, to increase their flexibility, strengthen their back and abdominal muscles and improve their posture. To prevent pain from coming back, the patient should use these techniques regularly.

In order to relieve mild to moderate back pain that doesn’t get better with over-the-counter pain relievers, the patient may be prescribed muscle relaxants or NSAIDs.
Low doses of tricyclic antidepressants, such as amitriptyline, relieve chronic back pain, independent of their effect on depression.
Hydrocodone, codeine or other narcotics could be used for a short period of time with close supervision by the doctor.

If the pain radiates down the patient’s leg, and if other measures don’t relieve it, he/she will be injected an anti-inflammatory medication called cortisone into the space around the spinal cord, called epidural space. Even though the cortisone injection helps decrease inflammation around the nerve roots, however, the pain relief will last less than six weeks.

The patient may also be injected a numbing medication into or near the structures believed to be causing the pain, such as botulism toxin, which early studies show that it could help relieve back pain by paralyzing strained muscles in spasm. Within three or four months Botox injections usually wear off.

No effective surgical techniques are available for muscle-and-soft-tissue-related back pain. Very few people ever need surgery for back pain, and it’s usually reserved for pain caused by a herniated disk. A person may benefit from surgery in case they have unrelenting pain or progressive muscle weakness caused by nerve compression.
Some of the kinds of back surgery are:

Disk replacement:
During this surgery, the patient’s disk is replaced with an artificial one as a replacement cushion between two vertebrae. This type of surgery is an alternative to fusion.

During this surgery, two vertebrae are joined together to eliminate painful movement. A bone graft is inserted between them, which may be splinted together with metal plates, screws or cages. However, this surgery increases the chances of arthritis developing in adjoining vertebrae.

Partial removal of a vertebra:
A small section of the offending vertebra could be removed to open up the passage in case the spine has developed bony growths that are pinching the spinal cord or nerves.

Partial removal of disk:
In case a disk material is pressing or squeezing a nerve, a portion of the disk that’s causing the problem could be removed.



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