Back Problems & Injuries

Most people will have a minor back problem at one time or another. Our body movements usually do not cause problems, but it is not surprising that symptoms develop from everyday wear and tear, overuse or injury. Back problems and injuries often occur during sports or recreational activities, work-related tasks or home projects.

Back pain can cause problems anywhere from the neck to the tailbone (coccyx). The back includes:

• The bones and joints of the spine (vertebrae)
• The discs that separate the vertebrae and absorb shock as you move
• The muscles and ligaments that hold the spine together

Back injuries are the most common cause of back pain. Injuries frequently occur when you use your back muscles in activities that you do not do very often, such as lifting a heavy object or doing yard work. Minor injuries may also occur from tripping, falling a short distance or excessive twisting of the spine. Severe back injuries may result from car accidents, falls from significant heights, direct blows to the back or top of the head, a high-energy fall onto the buttocks or a penetrating injury such as a stab wound.

Although back pain is often caused by an injury to one or more of the structures of the back, it may have another cause. Some people are more likely to develop back pain than others. Things that increase your risk for back pain and injury include getting older, having a family history of back pain, sitting for long periods, lifting or pulling heavy objects and having a degenerative disease such as osteoporosis.

Slumping or slouching alone may not cause lower back pain. But after the back has been strained or injured, bad posture can make pain worse. Good posture generally means your ears, shoulders and hips are in a straight line. If this posture causes pain, you may have another condition such as a problem with a disc or bones in your back.

Lower back pain may occur in children and teenagers, but children and teens are less likely to see a doctor for lower back pain. Although most back problems occur in adults 20 to 50 years old, back problems in people younger than 20 and adults older than 50 are more likely to have a serious cause.

Pain from an acute injury may be sudden and severe. Bruising and swelling may develop soon after the injury. Pain from an acute injury does not usually last longer than six weeks. Acute injuries include:

• An injury to the ligaments or muscles in the back, such as a sprain or a strain.
• A fracture or dislocation of the spine. This can cause a spinal cord injury that may lead to permanent paralysis. It is important to immobilize and transport the injured person correctly to reduce the risk of permanent paralysis.
• A torn or ruptured disc. If the tear is large enough, the jellylike material inside the disc may leak out (herniate) and press against a nerve. 
• An injury that causes the compression of nerves in the lower back (cauda equina syndrome).

You may not remember a specific injury, especially if your symptoms began gradually or during everyday activities. These injuries most often occur from improper movement or posture while lifting, standing, walking, sitting or even while sleeping. Symptoms can include pain, muscle spasms and stiffness. The pain often goes away within four weeks without any treatment.

Back pain or problems may not be related to an injury.

Conditions that weaken the spine, such as ankylosing spondylitis, osteoarthritis, osteoporosis, spinal stenosis or Paget's disease, can cause back pain. These conditions are most common in older adults. In rare cases, tumors or infections can develop in or around the spine.

Some medical conditions can cause pain to spread to the back from other parts of the body (referred pain). Many health problems that can cause back pain have nothing to do with the bones, joints, muscles or ligaments of the back.

Spinal deformities such as scoliosis, kyphosis (Scheuermann disease) and spondylolisthesis can cause back pain.

Chronic pain syndrome caused by a previous injury or degenerative disease with aging can cause back pain.

Most back pain will get better and go away by itself in one to four weeks. Home treatment will often help relieve back pain that is caused by minor injuries. It is usually a good idea to continue your regular activities while your back is healing. Avoid heavy lifting and activities that make your back problems worse.

Other treatments for a back problem or injury may include first aid measures, physical therapy, manipulative therapy (such as chiropractic), medicine and, in some cases, surgery. Treatment depends on:

• The location, type and severity of the injury
• Your age, health condition and activities (such as work, sports or hobbies)

Check symptoms to decide if and when to see a doctor.