Back pain

You can feel back pain in different parts of the spine, which may be severe or chronic, affecting physical and emotional well-being. Most people experience back pain at some point in their lives.

Sometimes, the back pain is short-term, lasting for only a few weeks or even less and may be triggered by a sharp, awkward movement or heavy lifting. Back pain may reoccur over a longer period, accompanied by shooting pains, limited range of movement, stiffness or muscle spasms.

Your doctor can make the right diagnosis and treatment for back pain relief. In some cases, patients get a referral for rehabilitation or physiotherapy.

If your back pain is due to a structural problem in the spine or the surrounding muscular structure, your doctor may recommend an X-ray or a more extensive scan like MRI or CT.

Causes of back pain

Back pain may occur from different factors. Sometimes, these factors may be present at once or interact to cause chronic low back pain. These may include structural or mechanical problems with the spine, inflammatory conditions or other medical issues. The healthcare professional may not identify a specific cause of back pain.

Structural or mechanical problems

Structural or mechanical problems in the spin, tendons, ligaments, muscles and discs in the back or a compressed nerve can cause back pain.

• Sprain – This is an injury to the ligaments supporting the spin. The ligaments connect different bones. Sprains often occur from lifting or twisting improperly.
• Strain – This is an injury to the tendon or muscle.
• Degenerative disc disease – Ageing can cause the disc between the spine’s vertebrae to break down. This condition occurs with other degenerative changes in the spine, such as spinal stenosis or arthritis.
• Ruptured or Herniated discs – A disc may become compressed and irritate nearby nerves. This usually occurs at the lumbar level but can also affect the cervical spine.
• Spondylolisthesis – A vertebrae in the spin gradually shift from alignment.
• Spinal stenosis – This is the narrowing of the spinal canal that places pressure on the nerves or spinal cord.
• Fractured vertebrae
• Scoliosis or other congenital spine changes
• Myofascial pain – This is pain or tightness of the muscles supporting the spine, resulting from damage to the muscle or the nerve input to the muscles originating from the spine.

Inflammatory conditions

These include:

• Ankylosis spondylitis – a type of arthritis of the spine
• Other inflammatory arthritis of the spine

Other medical conditions

• Endometriosis – uterine tissues in areas outside of the uterus
• Osteoporosis resulting in painful vertebrae fractures
• Kidney infections or stones
• Pregnancy
• Tumours – in rare cases, tumours develop on the spine and other areas of the back
• Infections affecting the disc between the bones of the spine or infection in these bones
• Fibromyalgia – a condition causing fatigue and muscle pain

Symptoms

An ache in the back is the main symptom of back pain. Sometimes, the ache may occur in the buttocks and legs. Back pain can cause pain in other body parts, depending on the affected nerves. The pain usually subsides without treatment. However, if the following accompanies the pain, contact your doctor.

• Fever
• Unexplained weight loss
• Pain reaching the legs
• Swelling or inflammation on the back
• Pain that reaches below the knees
• Persistent pain that remains intense when resting or lying down
• Urinary incontinence
• A recent blow, trauma or injury to the back
• Numbness around the buttocks
• Numbness around the anus
• Numbness around the genital
• Faecal incontinence or losing control over bowel movement

Tests for back pain

Your healthcare professional may recommend undergoing some tests if:

• They suspect an underlying cause of the pain
• You sustained an injury in your back, like a bad fall
• The pain is chronic

A computerised tomography (CT) or magnetic resonance imaging (MRI) scan may be necessary in these cases.

X-rays aren’t common for back pain diagnosis because back pain often results from problems with soft tissues, such as muscles and ligaments, which X-rays cannot identify. However, X-rays can identify changes in the spin occurring from spondylosis. These changes are common and affect everyone, but some people do not experience pain or any problems when the changes occur, so X-rays aren’t always helpful.

Sometimes, a thorough investigation cannot diagnose the exact cause of back pain.