What is causing this pain in my back? Lower back pain

Causes

Problems with the spine such as osteoporosis can lead to back pain.

The human back or lumbar spine is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around. The spinal segments of the spine are cushioned with cartilage-like pads called disks.

Problems with any of these components may lead to back pain and in some cases of back pain, its cause remains unclear.

Damage can result from strain, medical conditions, and poor posture, among others.

Strain

Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are:

• strained muscles or ligaments
• a muscle spasm
• muscle tension
• damaged disks
• injuries, fractures, or falls

Activities that can lead to strains or spasms include:

• lifting something improperly or incorrectly
• lifting something that is too heavy
• making an abrupt and awkward movement maximum time of day

Structural problems

A number of structural problems may also result in back pain.

• Ruptured disks: Each vertebra in the spine are moved/cushioned by disks. If the disk ruptures or slips there will be more pressure on a nerve, resulting in back pain.
• Bulging disks: In much the same way as ruptured disks, spondylolisthesis disk, a bulging disk can result in more pressure on a nerve.
• Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg to phalanges, caused by a bulging or herniated disk pressing on a nerve.
• Arthritis: Osteoarthritis can also cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows, and this is known as spinal stenosis.
• Abnormal curvature of the spine: If the spine has abnormal curvature in an unusual way, back pain can result. An example is a scoliosis, in which the spine curves to the side.
• Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, or osteoporosis makes compression fractures more likely.
• Kidney problems: Kidney stones or kidney infections can also cause back pain.

Movement and posture

Adopting a very hunched sitting position when using computers can result in increased back and shoulder problems over time.

Back pain can also result from some everyday activities or poor posture in your office, workplace, or traveling

Examples include:

• twisting
• coughing or sneezing
• muscle tension, or pulled muscle
• over-stretching, or bending
• bending awkwardly or for long periods of time
• pushing, pulling, lifting, or carrying something in abnormally
• standing or sitting for long periods of time
• straining the neck forward bending, such as when driving or using a computer
• long driving sessions without a break, even when not hunched
• sleeping on a mattress uneven surface that does not support the body and keep the spine straight

Other causes

Some medical conditions can lead to back pain.

• Cauda equina syndrome: The cauda equine is a bundle of spinal nerve fiber roots that arise from the lower end of the spinal cord. Symptoms include a dull pain in the lower back, right left, and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes lead bowel and bladder function disturbances.
• Cancer of the spine: A tumor on the spinal cord may press against a nerve, resulting in back pain.
• Infection of the spine: A fever and a tender, warm around the back area on the back could be due to an infection of the spine.
• Other infections: Pelvic inflammatory disease, osteomyelitis, bladder, or kidney infections may also lead to back pain.
• Sleep disorders: Individuals with sleep disorders or abnormal sleep are more likely to experience back pain, compared with others.
• Shingles: it is an infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.

Risk factors

The following factors are linked to a higher risk of developing low back pain:

• occupational activities
• pregnancy
• a sedentary lifestyle
• poor physical fitness
• older age
• obesity and excess weight
• smoking
• strenuous physical exercise or work, especially if done incorrectly
• genetic factors
• medical conditions, such as arthritis and cancer

Back pain also tends to be more common in women than in men, possibly due to hormonal factors stress, anxiety, and mood disorders that have also been linked to back pain.

The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way radiate down to the buttocks and legs.

Some back issues can cause pain in other parts of the body, around the back depending on the nerves affected.

In most cases, the pain often goes away without treatment, but if it occurs with any of the following people should see their doctor:

• weight loss
• fever
• inflammation or swelling on the back
• persistent back pain were 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
• numbness around the anus
• numbness around the buttocks
• that does not improve with the rest
• after an injury or fall
• with numbness in the legs
• with weakness
• with fever
• with unexplained weight loss

Diagnosis

A doctor will usually be able to diagnose back pain after asking about symptoms and carrying out a physical examination.

An imaging scan and other tests may be required if:

• back pain appears to result from an injury
• there may be an underlying cause that needs treatment
• the pain persists over a long period

An X-ray, MRI, or CT scan can give information about the state of the soft tissues in the back.

• X-rays – can show the alignment of the bones and detect signs of arthritis, injury, or broken bones, but they may not reveal damage in the muscles, spinal cord, nerves, or disks.
• MRI or CT scans – can reveal herniated disks, bulging disks, or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles, and bones.
• Bone scans can detect bone tumors or compression fractures in the spine caused by osteoporosis. A radioactive substance or tracer is injected into a vein or vascular malformation of the spine. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera.
• Electromyography or EMG – measures the electrical impulses produced by nerves in response to muscles action. This can confirm nerve compression, a fracture that may occur with a herniated disk, or spinal stenosis.
• A chiropractor test – will diagnose through touch, or palpation, and a visual examination of the spine in the lumber region. Chiropractic is known as a direct approach to the spine, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of x-ray imaging scans and any blood and urine tests.
• An osteopath – also diagnosed through palpation and visual inspection. Osteopathy composes slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.

Chronic or acute pain?

Back pain is categorized into two types:

• Acute pain starts suddenly and lasts for up to 6 weeks or less.
• Chronic or long-term pain develops over a longer period, lasts for over 3 months more, and causes ongoing problems.

If a person has both occasional bouts of more and more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.

Treatment

Back pain usually resolves with rest and home remedies, but sometimes medical treatment is necessary.

Home treatments

Traction: Pulleys and weights are used to stretch the back. This may result in a herniated disk, PLID moving back into position. It can also relieve pain, but only while traction is applied.

Cognitive-behavioral therapy (CBT): CBT can help manage chronic back pain by encouraging new ways of thinking. It may include relaxation techniques and ways of maintaining a positive attitude. Studies have found that patients with CBT tend to become more active and do exercise, resulting in a lower risk of back pain recurrence.

Physical therapy: Applying heat, ice, ultrasound, Irr, SWD, MWT, traction, and electrical stimulation — as well as some muscle-release techniques to the back muscles and soft tissues — may help alleviate pain. As the pain improves, the physical therapist may introduce some flexibility and strength types exercises for the back and abdominal muscles. Techniques for improving posture may also help. The patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent or help back pain recurrence.

Complementary therapies

Complementary therapies may be used alongside conventional therapies or on their own.

Chiropractic, osteopathy, shiatsu, and acupuncture may help relieve back pain, as well as encourage the patient to feel relaxed.

• An osteopath specializes in treating the skeleton and muscles.
• A chiropractor treats joint, muscle, and bone problems. The main focus is the spine.
• Shiatsu, also known as finger pressure therapy, 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.
• Acupuncture originates from China. It consists of inserting fine needles and specific points in the body. Acupuncture can help the body release its natural painkillers — endorphins — as well as stimulate nerve and muscle tissue.
• Yoga involves specific poses, movements, and breathing exercises. Some may help strengthen the back muscles and improve posture. Care must be taken that exercises do not make back pain worse.

Studies on complementary therapies have given mixed results. Some people have experienced significant benefit, while others have not. It is important, when considering alternative therapies, to use a well qualified and registered therapist.

Transcutaneous electrical nerve stimulation (TENS) is a popular therapy for patients with chronic back pain. The TENS machine delivers small electric pulses into the body through electrodes that are placed on the skin.

Experts believe TENS encourages the body to produce endorphins and may block pain signals returning to the brain. Studies on TENS have provided mixed results. Some revealed no benefits, while others indicated that it could be helpful for some people.

A TENS machine should be used under the direction of a doctor or health professional.

It should not be used by someone who is:

• is pregnant
• has a history of epilepsy
• has a pacemaker
• has a history of heart disease

TENS is considered “safe, noninvasive, inexpensive, and patient-friendly,” and it appears to reduce pain, but more evidence is needed to confirm its effectiveness in improving activity levels.

Medications

If home treatments do not relieve back pain, a doctor may recommend the following medication, physical therapy, or both.

• NSAIDs –  pain relief medication, usually nonsteroidal anti-inflammatory drugs (NSAID), such as ibuprofen, aceclofenac, can relieve discomfort. Applying a hot compress or an ice pack to the painful area may also reduce pain. Resting from strenuous activity can help, but moving around will ease or soothe stiffness, reduce pain, and prevent muscles from weakening.
• Over-the-counter (OTC) NSAIDs – Back pain that does not respond well to OTC painkillers may require a prescription NSAID like naproxen, etodolac. Codeine or hydrocodone, which are narcotics types of drugs, maybe prescribed for short periods. These require close monitoring by the doctor. In some cases, muscle relaxants may be used.
• Antidepressants –  such as amitriptyline, pregabalin, or gabapentin may be prescribed, but research is ongoing at to their effectiveness, and the evidence is conflicting.
• Cortisone injections: If other options are not effective, these may be injected into the epidural space carefully, around the spinal cord. Cortisone, triamcinolone injection is an anti-inflammatory drug. It helps reduce inflammation around the nerve roots. Injections may also be used to numb areas thought to be causing the pain.
• Injecting cells to regenerate spine discs: Scientists from Duke University, North Carolina, developed new biomaterials that can deliver a booster shot of reparative cells to the nucleus pulposus, effectively eliminating the pain caused by degenerative disc disease, PLID.
• Botox: Botox (botulism toxin), according to some early studies, is thought to reduce pain by paralyzing sprained muscles in spasms. These injections are effective for about 3 to 4 months.

Surgery

Surgery for back pain is very rare. If a patient has a herniated disk surgery may be an option, especially if there is persistent pain and nerve compression which can lead to muscle weakness.

Examples of surgical procedures include:

• Fusion: Two vertebrae are joined together, with a bone graft inserted between them and fixed the spine. The vertebrae are splinted together with metal plates, screws, or cages. There is a significantly greater risk for arthritis to subsequently develop in the adjoining vertebrae.
• Artificial disk: An artificial disk is inserted by surgery; it replaces the cushion between two vertebrae.
• Diskectomy: A portion of a disk may be removed if it is irritating or pressing against a nerve root.
• Partially removing a vertebra: A small section of a vertebra may be removed if it is pinching the spinal cord or nerves root.

Prevention

Steps to lower the risk of creating back torment comprise fundamentally of tending to a portion of the gamble factors.

• Work out: Regular exercise assists develop fortitude and controlling body weight. Directed, low-sway oxygen-consuming exercises can support heart wellbeing without stressing or jolting the back. Prior to beginning any activity program, converse with a medical services proficient. There are two principal sorts of activity that individuals can do to decrease the gamble of back torment: Core-reinforcing practices work the stomach and back muscles, assisting with fortifying muscles that safeguard the back. Adaptability preparing targets further developing center adaptability, including the spine, hips, and upper legs.
• Diet: Make sure your eating regimen incorporates enough calcium and vitamin D, as these are required for bone wellbeing. A restorative eating regimen additionally assists in the control of body weight.
• Smoking: An essentially higher level of smokers have back torment occurrences contrasted with non-smokers of a similar age, stature, and weight.
• Bodyweight: The weight individuals convey and where they convey it influences the gamble of creating back torment. The distinction in back torment hazard among large and typical weight people is extensive. Individuals who convey their weight in the stomach region versus the bottom and hip region are likewise at a more serious gamble.
• Act while standing: Make sure you have a nonpartisan pelvic position. Stand upstanding, head looking ahead, back straight, and equilibrium your weight uniformly on the two feet. Keep your legs straight and your head in accordance with your spine.
• Pose while sitting: A decent seat for working ought to have great back help, armrests, and a turn base. While sitting, attempt to keep your knees and hips level and keep your feet level on the floor, or utilize a stool. You ought to in a perfect world have the option to sit upstanding with help in the little of your back. Assuming you are utilizing a console, ensure your elbows are at right points and that your lower arms are flat.
• Lifting: When lifting things, utilize your legs to do the lifting, rather than your back. Keep your back as straight as possible, keeping your feet separated with one leg somewhat forward so you can keep up with balance. Twist just at the knees, hold the weight near your body, and fix the legs while changing the place of your back as little as could be expected.
• Bowing your back at first is unavoidable – yet when you twist your back make an effort not to stoop, and make certain to fix your stomach muscles with the goal that your pelvis is pulled in. Generally significant, don’t fix your legs prior to lifting, or you will utilize your back for the vast majority of the work.
• Try not to lift and contort at a similar time: If something is especially weighty, check whether you can lift it with another person. While you are lifting continue to gaze directly ahead, not up or down, so that the rear of your neck resembles a persistent straight line from your spine.
• Getting things: It is better for your back to push things across the floor, utilizing your leg strength, rather than pulling them.
• Shoes: Flat shoes put to a lesser degree a strain on the back.
• Driving: It is critical to have appropriate help for your back. Ensure the wing mirrors are appropriately situated so you don’t have to curve. The pedals ought to be decisively before your feet. Assuming you are on a long excursion, have a lot of breaks. Escape the vehicle and stroll around.
• Bed: You ought to have a sleeping cushion that keeps your spine straight, while simultaneously supporting the heaviness of your shoulders and bum. Utilize a pad, however not one that powers your neck into a precarious point