Anything that puts pressure on the back muscles or nerves can cause pain; and any illness or damage to the spine can also cause pain. Though back pain is one of the most common health problems in America, its cause is often unidentified. The majority of acute back pain problems, however, are most likely due to minor strains, sprains, spasms and overuse (National Library of Medicine, 2001; University of Washington Department of Orthopaedics and Sports Medicine, 2002), and can be exacerbated by emotional stress, which slows the rate of recovery (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Muscle strains and spasms are thought to be the most common causes of back pain (Cluett, 2001; National Library of Medicine, 2001). An awkward movement of the back (even when sneezing, coughing, bending to tie a shoe, or incorrectly lifting a heavy object) can cause a muscle spasm. A muscle spasm causes the back to lock up and can cause severe pain. Muscle spasms tend to get better over time; severe cases can be treated with physical therapy and medication (National Library of Medicine, 2001).
Strained muscles, tendons, or ligaments or inflamed joints may cause pain along the spine (Mayo Clinic, 2000). If the back is strained, soreness or stiffness may develop over time or immediate pain may be felt (Mayo Clinic, 1997).
A herniated disc, also called a ruptured invertebral disc or slipped disc, is among the most painful back problems, but is also one of the easiest to identify. Though vertebral discs don’t actually slip, normal wear and tear or strain can cause a disc to bulge or rupture (herniate) into the spinal canal, pressing on the nerve roots.
A herniated disc can cause back pain and muscle spasms, but more often causes sciatic pain - severe pain spreading down one leg and often into the foot (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002). A herniated disc can usually be detected with physical examination alone, but sometimes may require the use of computerized axial tomography (CAT) scan or magnetic resonance imaging (MRI) to confirm diagnosis (see What to Expect During Diagnosis section for more information) (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Compression or inflammation of nerves in the lower back or buttocks can cause sciatica, named after the sciatic nerve that extends down the leg from the hip to the heel. About 10 in 100 people with back pain will experience sciatica. Sciatica may cause pain radiating from the back down through the buttock to the lower leg. Tingling, numbness, or muscle weakness may also accompany nerve compression. Any activity that exerts pain on the spine can worsen sciatica, including sneezing and coughing, but pain usually resolves on its own. Severe nerve compression, however, can cause progressive muscle weakness (Mayo Clinic, 1997).
Overloading, injury, and aging can slowly deteriorate cartilage, the soft, elastic material that covers the surface of vertebral joints and other joints in the body (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002). Discs between vertebrae may become worn narrowing the space between vertebrae, leading to a gradual stiffening of the back and loss of flexibility. Joints may also rub together, compress, and become irregular. When the cartilage becomes worn, pain may result. This wear and pain is known as osteoarthritis. Lower back pain may become worse if osteoarthritis affects the hips or knees.
Osteoarthritis can also directly affect the spine, causing muscles, tendons, or ligaments to become strained, leading to back and/or neck pain (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Osteoporosis is a disease that causes bones to become more porous due to calcium loss, which gradually makes them weaker and more brittle. Healthy bone is dense and strong, able to withstand a great deal of pressure. With osteoporosis, bones become fragile and can break more easily. In particular, osteoporosis contributes to compression fractures, or spinal fractures where the vertebrae become flattened (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
One in three women older than 50 is affected by compression fractures as a result of osteoporosis. Progressive compression of the vertebrae often leads to gradual loss of height, and sometimes structural changes to the spinal column that cause one to have a stooped posture or a dowager’s hump (Mayo Clinic, 1997).
Many back injuries are caused by an unexpected twist or sudden motion (University of Washington Department of Orthopaedics and Sports Medicine, 2002), most often resulting in muscle strain and spasms. Muscle spasms are a common response to injury, and are designed to immobilize the painful area and prevent further damage (Mayo Clinic, 2000). With injury or accident, severe muscle spasms usually last 48-72 hours, followed by days or weeks of less severe pain, and 2-4 weeks for complete recovery from mild back injury. For more severe injury, involving strained ligaments, it could take 6-12 weeks for recovery. Severe back injury involving a fall or other accident may require hospitalization and a longer recovery period (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Source: Health Education Rural Outreach (HERO) is a cooperative effort between Texas Cooperative Extension & Texas A&M University System Health Science Center School of Rural Public Health.Editors: Carol A. Rice, Ph.D., RN & Janet M. Pollard, MPH
Muscle Spasms and Strains
Muscle strains and spasms are thought to be the most common causes of back pain (Cluett, 2001; National Library of Medicine, 2001). An awkward movement of the back (even when sneezing, coughing, bending to tie a shoe, or incorrectly lifting a heavy object) can cause a muscle spasm. A muscle spasm causes the back to lock up and can cause severe pain. Muscle spasms tend to get better over time; severe cases can be treated with physical therapy and medication (National Library of Medicine, 2001).
Strained muscles, tendons, or ligaments or inflamed joints may cause pain along the spine (Mayo Clinic, 2000). If the back is strained, soreness or stiffness may develop over time or immediate pain may be felt (Mayo Clinic, 1997).
Herniated Disc
A herniated disc, also called a ruptured invertebral disc or slipped disc, is among the most painful back problems, but is also one of the easiest to identify. Though vertebral discs don’t actually slip, normal wear and tear or strain can cause a disc to bulge or rupture (herniate) into the spinal canal, pressing on the nerve roots.
A herniated disc can cause back pain and muscle spasms, but more often causes sciatic pain - severe pain spreading down one leg and often into the foot (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002). A herniated disc can usually be detected with physical examination alone, but sometimes may require the use of computerized axial tomography (CAT) scan or magnetic resonance imaging (MRI) to confirm diagnosis (see What to Expect During Diagnosis section for more information) (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Sciatica
Compression or inflammation of nerves in the lower back or buttocks can cause sciatica, named after the sciatic nerve that extends down the leg from the hip to the heel. About 10 in 100 people with back pain will experience sciatica. Sciatica may cause pain radiating from the back down through the buttock to the lower leg. Tingling, numbness, or muscle weakness may also accompany nerve compression. Any activity that exerts pain on the spine can worsen sciatica, including sneezing and coughing, but pain usually resolves on its own. Severe nerve compression, however, can cause progressive muscle weakness (Mayo Clinic, 1997).
Osteoarthritis
Overloading, injury, and aging can slowly deteriorate cartilage, the soft, elastic material that covers the surface of vertebral joints and other joints in the body (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002). Discs between vertebrae may become worn narrowing the space between vertebrae, leading to a gradual stiffening of the back and loss of flexibility. Joints may also rub together, compress, and become irregular. When the cartilage becomes worn, pain may result. This wear and pain is known as osteoarthritis. Lower back pain may become worse if osteoarthritis affects the hips or knees.
Osteoarthritis can also directly affect the spine, causing muscles, tendons, or ligaments to become strained, leading to back and/or neck pain (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Osteoporosis (compression fractures)
Osteoporosis is a disease that causes bones to become more porous due to calcium loss, which gradually makes them weaker and more brittle. Healthy bone is dense and strong, able to withstand a great deal of pressure. With osteoporosis, bones become fragile and can break more easily. In particular, osteoporosis contributes to compression fractures, or spinal fractures where the vertebrae become flattened (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
One in three women older than 50 is affected by compression fractures as a result of osteoporosis. Progressive compression of the vertebrae often leads to gradual loss of height, and sometimes structural changes to the spinal column that cause one to have a stooped posture or a dowager’s hump (Mayo Clinic, 1997).
Injuries and Accidents
Many back injuries are caused by an unexpected twist or sudden motion (University of Washington Department of Orthopaedics and Sports Medicine, 2002), most often resulting in muscle strain and spasms. Muscle spasms are a common response to injury, and are designed to immobilize the painful area and prevent further damage (Mayo Clinic, 2000). With injury or accident, severe muscle spasms usually last 48-72 hours, followed by days or weeks of less severe pain, and 2-4 weeks for complete recovery from mild back injury. For more severe injury, involving strained ligaments, it could take 6-12 weeks for recovery. Severe back injury involving a fall or other accident may require hospitalization and a longer recovery period (University of Washington Department of Orthopaedics and Sports Medicine, 2002).
Source: Health Education Rural Outreach (HERO) is a cooperative effort between Texas Cooperative Extension & Texas A&M University System Health Science Center School of Rural Public Health.Editors: Carol A. Rice, Ph.D., RN & Janet M. Pollard, MPH
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