Back pain, stiffness, and limited movement can disrupt your life and work. Knowing what is causing your pain can help you relieve discomfort, move better, and participate in activities you enjoy. At Pain Physicians NY Clinic, our board-certified and experienced pain relief specialist, Dr. Leon Reyfman and Dr. Boleslav Kosharskyy, are ready to treat and prevent recurring back pain. They work with you to diagnose your back and spine condition using the most advanced tools and approaches. Dr. Leon Reyfman and Dr. Boleslav Kosharskyy take a comprehensive and individualized approach to treating your back pain and combine their expertise and experience to make you feel better and regain mobility and function.
Lower back pain is very common. Most of us experience it at some point in our lives. It may result from a strain to muscles or tendons in your back, age, or work-related problems or it may be a sign of some medical condition. For most people, it is temporary, but long-lasting or chronic pain is also common and affects a wide population worldwide.
Back pain can range from mild to severe. It usually gets better with rest, physical therapy, and medication. However, in extreme cases, back pain can make it difficult or impossible to walk, sleep, work, or carry out everyday chores.
Read on to learn more about back pain, what causes it, and what remedies and treatments can help you manage it successfully and prevent it from coming back.
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Causes of Back Pain
The human back is a complex structure of muscles, ligaments, tendons, and bones that work together to support the body and enable movement. Problems with any one of these structures can cause back pain.
Common causes of back pain include:
- Strained muscles or ligaments
- A muscle spasm
- Muscle tension
- Spinal damage
- Arthritis
- Injuries, fractures, or falls
The segments of the spine are cushioned with cartilage-like pads called discs. Any problem with these components can also result in back pain. However, in some cases, the causes of back pain remain unclear.
Activities that can lead to strains or spasms include:
- Lifting something improperly
- Lifting a heavy abject
- Making an abrupt, awkward movement
Structural Problems That Cause Back Pain
Sometimes structural problems can also result in back pain. They include:
- Ruptured discs – Each vertebra in the spine is cushioned by discs. If the disc ruptures, there is more pressure on the nerve, which results in back pain.
- Bulging discs – When the inner portion of a disc begins to protrude from the outer wall of the disc, it can cause pressure on a nerve.
- Sciatica – Injury to or pressure on the sciatic nerve can cause sharp and shooting pain from the buttocks and down the back of the leg. It occurs when a bulging or herniated disc presses on a nerve or when a muscle pushes specifically on the sciatic nerve.
- Arthritis – Osteoarthritis can cause problems with the joints in the hips, lower back, and other areas of the body.
- Spinal stenosis – The space around the spinal cord narrows, which puts pressure on the spinal cord and nerves that travel through the spine, causing pain and discomfort.
- Unusual curvature of the spine – An unusually curved spine can lead to back pain.
- Osteoporosis – It is a condition that weakens the bones, including the spine. They become brittle and porous, which increases the risk of fractures and pain.
- Kidney problems – Stones in the kidney or infections can cause back pain.
Read more: 10 Tips For Dealing With Lower Back Pain
Movement and Posture
Slouching and slumping are bad for the spine. Sitting in a hunched position while using a computer for long hours can lead to increased back and shoulder problems in the long run.
Back pain can also result from some everyday activities or poor posture, such as:
- Twisting at an odd angle
- Coughing or sneezing in a way that stretches or tears the muscles
- Overstretching
- Bending awkwardly for long periods
- Pushing, pulling, lifting, or carrying something
- Standing or sitting for long periods
- Straining the neck forward, such as when driving or using a computer
- Driving for lengthy periods without taking a break, even when not hunched
- Sleeping on a mattress that does not support the body or keep the spine straight
Other Causes
Some medical conditions that can cause back pain include:
- Cauda equina syndrome – It occurs when the nerve roots in the lumbar spine are compressed, cutting off sensation and movement. Symptoms include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. It can also cause bowel and bladder function disturbances.
- Cancer of the spine – A tumor on the spine compressing against a nerve can cause back pain. The structural damage to the bone can also be painful when there are tumors or metastasis to the bone.
- Infection of the spine – An infection can result in fever, a tender, warm area on the back, and pain.
- Sleep disorders – People who suffer from sleep disorders can experience back pain.
- Shingles – It is an infection that affects the nerves and may cause back pain. The location of pain depends on the nerve that is affected. A rash will follow the pain.
At times, pelvic inflammatory disease and kidney or bladder infections can also cause back pain.
Read more: How Can I Relieve Pain in My Neck?
Symptoms of Back Pain
The main symptom of back pain is ache and discomfort anywhere in the back and sometimes down to the buttocks and legs. Some back issues can cause pain in other parts of the body, depending on the nerves affected.
Back pain can have many symptoms, including:
- Unexplained weight loss
- Fever
- Inflammation or swelling on the back
- Persistent back pain and lying down or resting does not help
- Pain down the legs
- Pain that reaches below the knees
- A recent injury, blow, or trauma to the back
- Urinary incontinence
- Difficulty urinating
- Fecal incontinence, or loss of control over bowel movements
- Numbness around the genitals, anus and buttocks
Most back pain goes away without treatment. However, if you experience any of these symptoms, call your doctor as they may be a sign of some underlying medical condition.
When to See a Specialist for Your Back Pain?
If your back pain does not subside after a few days of rest and over-the-counter treatment, you should seek medical help.
Call and schedule an appointment with a specialist if:
- Your back pain is a result of an injury or fall
- You have numbness in the legs
- You have weakness and backache
- You develop a fever
- Your back pain is accompanied by unexplained weight loss
- You are having problems moving, standing or sitting
Treating Back Pain
Mild to moderate back pain can be treated with rest, home remedies, and a little patience, but if your back pain worsens or lasts more than 6 weeks, medical treatment is necessary. Your doctor will recommend treatment depending on the causes and intensity of your pain.
Home treatments
You can take over-the-counter pain relief medications to ease mild to moderate discomfort. They include nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics that make you feel better if your back pain is not serious.
Applying a hot compress or an ice pack to the affected area can also reduce pain. Avoiding activities that cause pain and rest can help, but moving around can ease stiffness, alleviate pain, and prevent muscles from weakening.
Read more: How to Relieve Shoulder Pain When Lifting Your Arm
Medication
If your back pain does not respond well to OTC medications, your doctor may prescribe an NSAID to relieve your pain. It is essential to stick to the recommended dosage of medications as they may have severe side effects if taken incorrectly.
Your doctor may recommend topical rubs, ointments, and antidepressants to ease pain. Muscle relaxants are also prescribed if you experience muscle spasms alongside pain. Opioids are the last option that act as stronger pain medications. They are prescribed for more severe pain. If you have kidney problems or stomach ulcers, tell your doctor before starting any medication.
Physical therapy
Physical therapy focuses on alleviating the pain by introducing some flexibility exercises that soothe tight muscles and strengthen the back and abdominal muscles so they can support your spine better.
Exercises included in physical therapy also help with posture, alignment, and body mechanism as well as muscle release techniques that focus on muscle health. It is necessary to practice physical therapy techniques regularly, even after the pain is gone, to prevent it from coming back.
Cortisone injections
If your pain is resulting from certain conditions and does not go away with medications, you may benefit from cortisone steroid injections. Cortisone is an anti-inflammatory drug and reduces inflammation around the nerve roots. The injections numb the areas thought to be causing the pain. They are injected into the epidural space, around the spinal cord.
Botox
Research shows that Botox reduces pain by paralyzing sprained muscles in spasms. These injections are effective for up to 4 months.
Traction
Your doctor may recommend this treatment if you have a herniated or displaced spinal disc. Pulleys and weights stretch the back and move the herniated disc back into place. It can relieve pain but only while traction is applied.
Cognitive behavioral therapy
Your doctor may refer you for CBT for managing chronic back pain. Cognitive behavioral therapy is an effective way to deal with the problems you are facing and breaks them down into smaller parts. It includes relaxation techniques and ways of maintaining a positive attitude, which helps you become more active, focus on exercise, encourage new ways of thinking, and lower the risk of back pain recurrence.
Read more: 10 Tips For Dealing With Lower Back Pain
Surgery
If nothing else works and your back pain persists, your doctor may recommend surgery, although it happens rarely. Herniated discs and nerve compression usually require surgery, especially when there is constant pain and nerve compression, which can lead to muscle weakness.
Surgical procedures in such cases include:
- Fusion – Two vertebrae are surgically joined, and a bone graft is inserted between them. The vertebrae are splinted together with metal plates, screws, or cages. However, this can increase the risk of arthritis in the adjoining vertebrae.
- Artificial disc – An artificial disc replaces the cushion between two vertebrae.
- Discectomy – It is the surgical removal of the damaged portion of a herniated disk in the spine if it is irritating or pressing against a nerve and causing pain.
- Partial removal of a vertebra – A small section of a vertebra is removed if it is pinching the spinal cord or nerves.
Scientists have developed a new method of stopping or reversing disability and pain caused by degenerative disc disease in the spine using cell therapies. Injecting a booster shot of reparative cells to the nucleus pulposus can effectively eliminate pain that results from degenerative disc disease.
Complementary Therapies
Complementary therapies are often used alongside conventional therapies or on their own to provide relief from back pain.
They include:
- Osteopathy – It is based on the idea that well-being of an individual depends on their bones, muscles, ligaments, and connective tissues functioning smoothly together. It uses physical manipulation, stretching, and massage to increase the mobility of joints.
- Chiropractic – It focuses on the diagnosis and treatment of neuromuscular disorders. A chiropractor uses their hands to help relieve problems with the bones, muscles, and joints. The main focus is the spine.
- Shiatsu – Also known as finger pressure therapy, it is a type of massage where pressure is applied along energy lines in the body. The shiatsu therapist applies pressure with the fingers, thumbs, and elbows to relieve pain.
- Acupuncture – It is a treatment in which very thin steel needles are inserted into your skin to stimulate specific points throughout your body. It helps the body release its natural pain relievers, and stimulate nerve and muscle tissue.
- Yoga – Yoga is a mind and body practice that can build strength and flexibility. It involves specific physical poses, movements, and breathing exercises that strengthen the back muscles, improve posture, and help to manage pain and reduce stress.
Read more: 8 Tips to Help Ease Your Back Pain
TENS
Transcutaneous electrical nerve stimulation is a popular method of relieving chronic back pain, using a mild electrical current. The TENS machine is a small, battery-operated device that delivers small pulses into the body through sticky pads or electrodes placed on the skin.
It is believed that TENS encourages the body to produce endorphins and blocks pain signals returning to the brain. Although it is considered a safe, non-invasive, and effective treatment method for reducing pain, it may not benefit everyone.
Complementary therapies have given mixed results. Some people experienced instant benefits, while others did not. Consult your doctor before undergoing any new treatment. If you are considering complementary therapy, seek guidance from a trained and qualified therapist for best results.
Risk Factors for Back Pain
The following factors can increase your risk of developing back pain:
- Occupational activities
- Pregnancy
- A sedentary lifestyle
- Incorrect standing or sitting postures
- Older age
- Obesity
- Smoking
- Strenuous physical exercise or work, especially if done incorrectly
- Genetic factors
- Medical conditions such as arthritis and cancer
It has been observed that females experience back pain more than males, possibly due to hormonal factors. Healthcare experts also link back pain with stress, anxiety, and mood disorders. Your mental health can also affect your risk of back pain. You are more likely to have back pain if you have a stressful job or suffer from anxiety and depression.
Diagnosing Back Pain
Your doctor can diagnose back pain after analyzing your symptoms, taking your medical history, and conducting a physical examination.
He may ask for an imaging scan and other tests if:
- Your back pain appears to be a result of an injury
- There is some underlying cause that requires further diagnostics and treatment
- The pain has persisted for a long time
Tests may include:
- X-rays – They show the alignment of the bones and reveal signs of arthritis or broken bones.
- MRI or CT scans – They reveal herniated discs or problems with soft tissues, tendons, nerves, blood vessels, muscles, and bones.
- Bone scans – They help to detect bone tumors or compression fractures that result from osteoporosis. A radioactive substance or tracer is injected into a vein. It collects in the bones and allows doctors to identify bone problems with the aid of a special camera. Bone scans are usually reserved for bone conditions and hard-to-detect fractures.
- Electromyography – It measures the electrical impulses produced by nerves in response to muscles. It can detect nerve compression that may occur with a herniated disc or spinal stenosis.
Your doctor may order a blood test to detect infection or genetic markers for some conditions that cause back pain or a urine test to check for kidney stones, which cause pain in the sides of lower back. As there are many possible causes of low back pain, it may take some time to make an accurate diagnosis.
Read more: 9 Stretches to Relieve Neck Pain
Alternative Diagnostic Methods
- Chiropractic – Chiropractic is a direct approach that focuses on adjusting the spinal joints. A chiropractor can diagnose through touch, palpation, and a visual examination. Your chiropractor may also want to see the results of imaging scans and blood and urine tests.
- Osteopathy – Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles. An osteopath also makes a diagnosis through palpation and visual inspection.
- Physical therapy – It is an effective way to ease back pain through guided exercises. Your physical therapist will focus on diagnosing problems in the joints and soft tissues of the body.
Chronic or Acute Pain – What Is the Difference?
According to healthcare experts, back pain can be of two types:
- Acute pain
- Chronic pain
Acute pain happens suddenly and lasts for up to 6 weeks, while chronic pain or long-term pain develops over a longer period, lasts for more than 3 months, and can even continue when the illness or injury has been treated.
If you are facing both occasional episodes of intense pain and fairly continuous mild back pain, you need medical treatment. Your doctor may need to perform some tests to determine the source of your discomfort.
How to Prevent Back Pain
You can keep back pain away by lowering the risk of developing it. Addressing some of the risk factors can help you prevent back pain effectively. They include:
Exercise
You can increase strength and endurance in the back and allow the muscles to work better with regular exercises. Controlled, low-impact aerobic activities promote heart health without straining or jerking the back and help to manage body weight. Consult your healthcare professional or a trained therapist before starting any new exercise routine.
You can reduce the risk of back pain with the following:
- Core strengthening exercises that work the abdominal and back muscles, and protect the back
- Flexibility training that focuses on improving core flexibility, including the spine, hips, and upper legs
Diet
Eating a balanced diet is important for managing body weight and preventing deficiencies that can cause diseases and health issues. Your diet should include sufficient amounts of calcium, and vitamins D, K, A, C, and antioxidants as they are essential for bone health and to reduce inflammation when you suffer from back pain.
Avoid too much intake of sugary, processed, and fried foods as they can aggravate back pain.
Smoking
People who smoke suffer from more back pain issues. Quitting smoking can have a positive and immediate effect on your spine health. It improves blood flow, reduces inflammation, and increases your body’s ability to health itself, easing chronic back pain.
Read more: 5 Signs Your Back Pain Might Be an Emergency
Body weight
Being overweight, especially in the upper part or abdominal area, strains back muscles. People with obesity experience back pain more than people with moderate body weight. Maintaining your body weight according to your height can prevent backache.
Posture when standing and sitting
Maintaining a neutral pelvic position is essential when you are standing. Stand straight, with the head facing forward and a straight back, balancing your body weight evenly on both feet. Keep your legs straight and your neck in line with the rest of the spine.
If you have a desk job, get a seat with good back support, armrests, and a swivel base. When you sit, keep your knees and hips level and your feet flat on the floor, or use a footstool in case your feet do not touch the ground. You should be able to sit upright with support in the small of your back. There should be a 90-degree angle between the upper arm and forearm if you are using a keyboard.
Lifting
Make sure to use your legs when you are lifting objects. Keep a long spine and your legs apart, with one leg slightly forward to maintain balance. Bend only at the knees, hold the weight close to your body, and slowly straighten your legs while changing the position of your back as little as possible.
Bending your back seems unavoidable, but when you bend, avoid stooping and focus on drawing lower belly in so your pelvis stays neutral and supported. Do not straighten your legs before lifting, or you will be using your back for most of the work which results in pain.
Avoid lifting and twisting at the same time
If you have to lift a heavy object, get some help and lift it with someone else. As you lift it, keep looking straight. This is important to keep the neck in alignment with the rest of the spine and to prevent injury.
Moving things
Pushing with your back is safe as compared to pulling things and using your upper body force. When you push, you will be using your leg strength.
Shoes
Prefer shoes with a low heel as they place less strain on the back. High heels and sometimes flat shoes with minimal support, such as flip flops, can also lead to back pain.
Driving
Having proper support for your back is important for safe driving and prevents back pain. Make sure the wing mirrors are angled properly so you don’t twist. The pedals should be squarely in front of your feet.
If you have to drive long distances, take several breaks. Get out of the car and walk around to ease the back muscles.
Read more: What Causes Chronic Back Pain? Here Are 7 Potential Culprits
Bed
Get a mattress that keeps your spine properly aligned and supports the shoulder and buttock weight. Make sure your pillow is comfortable and does not force your neck into a steep angle.
It is important to focus on treatment before your back pain worsens and leads to reduced mobility and other complications. You can relieve back pain and improve your quality of life by making some changes to your lifestyle and adopting healthy habits.
Whether your pain results from an accident, sports injury, or some underlying condition, Dr. Leon Reyfman and Dr. Boleslav Kosharskyy can relieve your discomfort using the most advanced treatment modalities. They specialize in treating pain-related issues and comes up with a unique approach to pain relief that is comprehensive, personalized and offer the best results. In addition to traditional treatment, they offer the latest therapies to relieve pain in the upper, mid, or lower back and keep you active and happy. Call Pain Physicians NY Clinic of NYC today for a timely diagnosis of your condition and the best pain management care to prevent further complications and future flare-ups.