What is Back Pain and Sciatica?
What is Back Pain?

Back pain is a common complaint. Most people in the United States will experience low back pain at least once during their
lives. Back pain is one of the most common reasons people go to the doctor or miss work. On the bright side, you can take measures to prevent or lessen most back pain episodes. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul.
Surgery is rarely needed to treat back pain.

Symptoms

Symptoms of back pain may include:

Muscle ache
Shooting or stabbing pain
Pain that radiates down your leg
Limited flexibility or range of motion of your back
Inability to stand straight


Back pain that lasts from a few days to a few weeks is considered acute. Pain that lasts for three months or longer is considered chronic.

In rare cases, back pain can signal a serious medical problem. Contact a doctor if your back pain:

Is constant or intense, especially at night or when you lie down
Spreads down one or both legs, especially if the pain extends below your knee
Causes weakness, numbness or tingling in one or both legs
Causes new bowel or bladder problems
Is associated with pain or throbbing (pulsation) in your abdomen, or fever
Follows a fall, blow to your back or other injury
Is accompanied by unexplained weight loss

Causes

Your back is an intricate structure composed of bones, muscles, ligaments, tendons and disks. Disks are the cartilage-like
pads that act as cushions between the segments of your spine. Back pain can arise from problems with any of these component parts. In some people, no specific cause for their back pain can be found.

Strains

Back pain most often occurs:

From strained muscles and ligaments
From improper or heavy lifting
After a sudden awkward movement

Sometimes a muscle spasm can cause or be associated with back pain.

Structural problems

In some cases, back pain may be caused by structural problems, such as:

Bulging or ruptured disks. Disks act as cushions between the vertebrae in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve. But even so, many people who have bulging or herniated disks experience no pain from the condition.

Sciatica. If a bulging or herniated disk presses on the main nerve that travels down your leg, it can cause sciatica sharp, shooting pain through the buttock and back of the leg.

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

Skeletal irregularities. Back pain can occur if your spine curves in an abnormal way. If the natural curves in your spine become exaggerated, your upper back may look abnormally rounded or your lower back may arch excessively. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain.

Osteoporosis. Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle.

Rare but serious conditions

In rare cases, back pain may be related to:

Cauda equina syndrome. This is a serious neurological problem affecting a bundle of nerve roots that serve your lower back and legs. It can cause weakness in the legs, numbness in the "saddle" or groin area, and loss of bowel or bladder control.

Cancer in the spine. A tumor on the spine can press on a nerve, causing back pain.

Infection of the spine. If a fever and a tender, warm area accompany back pain, the cause could be an infection.

Western Medicine Treatment

Most back pain gets better with a few weeks of home treatment and careful attention. A regular schedule of over-the-counter
pain relievers may be all that you need to improve your pain. A short period of bed rest is OK, but more than a couple of days
actually does more harm than good. If home treatments aren't working, your doctor may suggest stronger medications or
other therapy.

Medications

Your doctor is likely to recommend pain relievers such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others). If mild to moderate back pain doesn't get better with over-the-counter pain relievers, your doctor may also prescribe a muscle relaxant.

Narcotics, such as codeine or hydrocodone, may be used for a short period of time with close supervision by your doctor.

Low doses of certain types of antidepressants particularly tricyclic antidepressants, such as amitriptyline have been shown to relieve chronic back pain, independent of their effect on depression.

Physical therapy and exercise

A physical therapist can apply a variety of treatments, such as heat, ice, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques will help prevent pain from returning.

Injections

If other measures don't relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone an anti-
inflammatory medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease
inflammation around the nerve roots, but the pain relief usually lasts less than a few months.

In some cases, your doctor may inject numbing medication and cortisone into or near the structures believed to be causing
your back pain, such as the facet joints of the vertebrae. Located on the sides, top and bottom of each vertebra, these joints
connect the vertebrae to one another and stabilize the spine while still allowing flexibility.

Surgery

Few people ever need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgical intervention. Otherwise, surgery usually is reserved for pain related to structural anatomical problems that haven not responded to intensive conservative therapy measures.

Types of back surgery include:

Fusion. This surgery involves joining two vertebrae to eliminate painful movement. A bone graft is inserted between the two vertebrae, which may then be splinted together with metal plates, screws or cages. A drawback to the procedure is that it increases the chances of arthritis developing in adjoining vertebrae.

Partial removal of disk. If disk material is pressing or squeezing a nerve, your doctor may be able to remove just the portion of the disk that's causing the problem.

Partial removal of a vertebra. If your spine has developed bony growths that are pinching your spinal cord or nerves, surgeons can remove a small section of the offending vertebra, to open up the passage.


Adopted From mayoclinic.com