Back Pain; Symptoms, Diagnosis, and Treatment

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Coping with back pain can be dreadful, as the pain can come and go unexpectedly – and at times, it can be unbearable. Statistically speaking, the majority of people will deal with back pain at a given point in their lives. Concurrently, the number of people suffering from back pain is on the rise, stress being a major contributor to this, but not exclusively. This is primarily why people spend a lot of money on trying to treat back pain efficiently. Unfortunately, many attempts aren’t successful.

It is important to understand where your back pain is coming from – especially if it interferes with the quality of your daily life. This guide encompasses everything you should know on the topic, including symptoms, diagnosis, and treatment. 

Chapter 1: Acute and Chronic Back Pain – A Growing Phenomenon

Back pain is a growing phenomenon, affecting more and more people by the day. The intensity of the pain can range a lot, depending on the degree of body tissue damage. At the same time, the affected area may vary, in the sense that some people cope with upper back pain whereas others deal with lower back pain, the latter being the most common one. When it comes to describing the pain, then we might classify it as being acute or chronic.

  • Acute back pain

For one thing, we have acute back pain. This is the result of body tissue damage. So, you are prone to experience it after a fall, sports injury, car accident, or anything of the kind. The initial phase of acute pain is basically the initial state of the injury, and it is associated with symptoms such as pain, inflammation, tissue damage, and tissue repair. It can last for several weeks – up to twelve weeks depending on the severity of the injury and depending on the individual, of course. When treated accordingly, acute back pain may be subsided entirely.

  • Chronic back pain

On the other hand, we have chronic back pain that lasts for more than 12 weeks. For some people, back pain becomes second nature, as it can last for years or decades. According to the American Physical Therapy Association, back pain affects not only people that spend a lot of time standing but also people that spend most of their day sitting.

As desk jobs are becoming more prevalent, back pain is also more popular. When discussing chronic back pain, Cleveland Clinic indicates that it is a complex disorder that, in some cases, requires a multi-disciplinary approach. Such an approach should consider the psychological, physical and socio-economic aspects of the disorder. 

In lines with this source, back pain is very common, being one of the main reasons why people seek advice from their healthcare providers. When the back pain is chronic, then tissue damage might be the cause. But there are also cases in which there are no actual structural causes. This is what makes back pain challenging to diagnose and treat, leading to frustration and hopelessness.

According to official records, globally, roughly 12 percent of people deal with back pain at a given point. Even if you might feel as if you’re struggling with this issue on your own, back pain is a global phenomenon. There are several studies that analyze the prevalence of back pain, and according to them, people between the ages of 20 to 59 are more likely to report chronic back pain. Concurrently, 24 percent of the people between the ages of 69 and 81 indicated that they experienced chronic back pain in the last year, and it has interfered with the quality of their lives.

These official records showcase one thing: back pain is a global phenomenon. And as this condition is spreading more and more, the medical costs associated with addressing it increase as well. As for the people that suffer from back pain, they struggle with decreased workplace productivity, not to mention that the quality of their lives is affected.

Chapter 2: Back Pain – The Most Common Symptoms

Moving on to the second section of our guide – namely the main symptoms associated with back pain, there are several symptoms that apply in most cases. For one thing, the back has a delicate structure. Whenever you move, ligaments, muscles, discs, tendons, and bones work together harmoniously, supporting the body and allowing you to move as you please. When one of these segments isn’t properly aligned, or it is damaged, this will lead to back pain. As for the symptoms you might experience, these can vary depending on the severity of the injury or discomfort.

Note that physicians analyze the type of back pain depending on the four parts of the back. To that end, there is the neck – cervical region, the upper back – thoracic region, the lower back – lumbar region, and the tailbone – which is the sacral and coccyx regions.

The main symptom of back pain is, evidently, experiencing pain or discomfort anywhere in the back. There are certain back issues that could result in pain in other parts of the body as well, depending on the area that is affected. And while the cause of back pain – be it chronic or acute – can differ, the symptoms are pretty much the same, as following:

  • Constant aching or stiffness along the spine – anywhere from the base of the neck to the tail bone.
  • Sharp, persistent pain in the neck, lower back or upper back, especially after lifting something heavy or after engaging in a demanding, strenuous physical activity. In some isolated cases, experiencing pain in the upper back might be an indicator of a heart attack or another life-threatening condition.
  • Experiencing a chronic ache in the middle or lower back, particularly after sitting or standing for an extended time frame.
  • Back pain radiating from the lower part of the back to the buttock, down to the thigh, reaching the calf and toes.
  • Inability to stand straight without experiencing pain or muscle spasms in the back.
  • Difficulty with standing or sitting in the same position for an extended time frame.
  • Pain targeting one or both legs.
  • Diminished flexibility or range of motion in the lower back and legs.
  • Experiencing difficulty with walking or performing daily activities such as lifting things or bending.
  • Inability or difficulty to perform work or other types of recreational activities.
  • Insomnia, inability to have a steady sleeping routine, feeling restless at night.
  • Experiencing weakness, tingling, and numbness in different parts of the legs.
  • Experiencing reduced reflexes in the lower extremities.
  • Anxiety and depression

Chapter 3: What Are the Causes of Back Pain?

Usually, back pain occurs due to a problem with one of the parts of the back – namely the ligaments, the nerves, the muscles, or the bony structures that comprise the spine. There are cases in which back pain might occur due to a problem with the kidneys.

However, before we tackle several causes of back pain, it’s important to understand how the back works. The spine, which is also referred to as the backbone or the spinal column, represents one of the strongest parts of the body. Thanks to the spine, we enjoy a good deal of flexibility and strength. The spine is made of 24 bones – referred to as vertebrae, which sit on top of one another. Between the vertebrae, there are discs of strong ligaments and muscles, whose purpose is to provide support. As for the bones at the bottom of the back, they are fused, in the sense that there aren’t any discs between them.

The spinal cord is connected to the brain via the base of the skull, as well as to the rest of the body. The connection is made through the nerves that go through the spaces between the vertebrae. These nerves are also referred to as nerve roots. With age, the structure of the spine, joints, and ligaments alters. This also has to do with the fact that the back becomes stiffer with time.

As for the potential causes of back pain, these can be multifold. With that in mind, here is a list of the most common aspects that trigger back pain, acute or chronic.

  • Experiencing a traumatic event such as a car accident, a fall, a sports injury or something that might impact the lumbar spine in a negative way.
  • Poor body mechanics – when you don’t move correctly during daily activities such as lifting, bending, squatting, twisting or even walking. Poor body mechanics might add unnecessary pressure and stress to the structure of the spine.
  • Having the same posture for a prolonged time frame – we’ve already outlined that this is a contributing factor to back pain. Therefore, whether you stand or sit in the same position for an extended time frame, this makes you more predisposed to struggling with back pain. This is especially true if the structures in the spine aren’t accordingly aligned. This can result in tightness, pain, and stiffness. This might occur after sleeping, after working or after a long car ride or flight.
  • Engaging in stressful activities and not having a good technique – this can injure the lumbar spine and cause chronic or acute pain.

These are some of the potential causes to back pain. Nonetheless, there are also certain conditions that are associated with back pain. You should bear in mind that experiencing severe pain doesn’t necessarily mean that you are suffering from a serious condition. Let’s have a closer look at some common conditions that trigger back pain.

  • Spondylosis

Spondylosis is a condition that is very common, and it is mostly associated with neck pain. This condition refers to the degenerative changes that occur in the structure of the spine, including bone spurs. In addition to that, the intervertebral discs between the vertebrae might also mirror degenerative distress. Spondylosis may target the cervical spine (the neck area), the thoracic spine (upper and mid-back area) or the lumbar spine (lower back). The most common ones are lumbar and cervical spondylosis.

Since the spine gives the body structure, supporting most of the body weight, it plays a key part in your overall health and wellbeing. Also, the spine carries the main nerve branches, as we outlined beforehand. Between the vertebrae, there are joints that enable the spine to move freely – known as facet joints. In some cases, the condition is related to age. So, when it comes to age-related spondylosis, the symptoms might delay appearing right away, or they might appear out of nowhere. There are cases in which a sudden movement might lead to unwanted symptoms. 

On the other hand, there are also people that experience symptoms, such as weakness, numbness or pain in the neck area. In most cases, people complain due to a noticeable decrease in mobility, as they also experience stiffness. Cervical spondylosis might also lead to headaches, loss of balance, pain in the legs, numbness or incontinence. Since the parts of the body are connected, spondylosis doesn’t affect only the back area, but the entire body. Staying physically active and engaging in low-impact exercising such as walking or swimming can contribute to maintaining flexibility. At the same time, a low-impact exercising routine could contribute to strengthening the muscles that support the spine.

At the same time, back support is just as important. That is to say, you might choose to invest in a chair or a mattress that supplies optimal back support. This could make the world of a difference in your overall wellbeing and health. There are cases in which making the right lifestyle changes could be really helpful. But there are also cases in which medical assistance is mandatory in order to experience an improvement in the condition.

  • Spinal Stenosis

Let’s move on to another condition – namely spinal stenosis. This means that the spaces within the spine are narrowed. This can significantly increase the pressure applied to the nerves that go through the spine. Usually, spinal stenosis targets the lower back and the neck. There are cases in which people suffering from spinal stenosis might not know it until they experience a range of symptoms all of a sudden. On the other hand, others struggle with pain and discomfort, muscle weakness and numbness. Over the course of time, spinal stenosis might worsen.

For the most part, spinal stenosis is triggered due to wear-and-tear changes in the spine that are typically connected to osteoarthritis. In severe cases, surgery is recommended in order to provide additional space for the nerves and spinal cord.

The main risk factor for this condition would be age. That is to say, most people suffering from this condition are over the age of 50. Aging leads to the loss of disk height, whereas the ligaments might also thicken.

Even so, we cannot exclude degenerative changes in younger people either, since there are also other causes that could play a part in the equation. For instance, having a genetic predisposition might also increase the odds of suffering from spinal stenosis. At the same time, trauma or congenital spinal deformity might lead to unwanted complications.

Moving on to the symptoms of spinal stenosis, they could affect both legs as well. In some cases, one leg might feel more sensitive than the other. When you sit down or rest, the pain might become more bearable. In most cases, though, the condition isn’t that severe and it can be handled with anti-inflammatory medication that diminishes the swelling and the pain. Physical therapy might also be helpful, in the sense that it could stabilize and protect the spine. In addition to that, therapy could contribute to building endurance and optimizing flexibility, which is crucial when dealing with a back condition. However, when these approaches don’t work and the condition interferes with the quality of your daily life, it’s highly advisable to discuss with a doctor and get advice on what should be done.

  • Sciatica

The following common cause of back pain is sciatica. What symptoms are normally associated with it and what causes it? Basically, sciatica accounts for the back pain that is triggered by a problem with the sciatic nerve. The sciatic nerve is a large nerve that goes through the lower back down to the back of the legs. When an injury occurs that affects or applies pressure on the sciatic nerve, this will lead to pain in the lower back, which affects the hip, legs, and buttocks. The good thing is that most people recover from this condition without the need for surgery.

Many people confuse sciatica with regular back pain. But the thing is that it is different since the pain originates from the sciatic nerves. The sciatic nerves represent the two largest nerves in the body, and they are as thick as your tiny finger. The pain can strike whenever a root in the sciatic nerve – or even the nerve fiber – is pinched or irritated. You might experience pain anywhere along the branch of the nerve – the low back, buttocks, calf, leg, or foot.

There is no specific age demographic that is more likely to get sciatica, meaning that it affects young and old people alike. However, pregnant women are more likely to develop this condition due to the pressure exercised on the spine by the growing uterus.

The thing with sciatic pain episodes is that they can range a lot. In some cases, one might experience a dull soreness, or a sense of unpleasant tingling, whereas in other cases one might experience stabbing pain and uncontrollable heat. As for the severity of the pain, it can also range, in the sense that in some situations, it is perfectly bearable whereas in other cases the pain feels so intense that you cannot stand or walk.

Usually, sciatica might go away by itself, depending on the severity of the pain. In some cases, it might go away in a matter of days or hours. Even so, there are isolated cases that could last up to weeks or even months. Rest could be very helpful in dealing with the pain, alleviating the symptoms. Applying ice on the affected area could also reduce the feeling of soreness. When the pain subsides, you should incorporate a daily exercising routine. Although most people fear that physical activity could make the pain more intense or even cause it, this is not true. Low-impact and exercise could strengthen the spinal area and prevent future attacks.

At the same time, having a correct posture, investing in a good mattress or chair – especially if you work at a desk – could enhance your overall comfort and wellbeing.

  • Ruptured Intervertebral Discs

Between the spinal vertebrae, there is a disc consisting of a tough, fibrous outer layer. The purpose of the disc is to facilitate shock absorption from gravity and impact. In a way, we could say that the disk acts as a cushion between the bones comprising the spine.

Due to a traumatic injury, poor lifting mechanics or due to unhealthy moving patterns, the outer fibers might be exposed to an increased amount of pressure. Due to that, the fluid in the inside, which has a gel-like consistency, is likely to protrude out of the disc. This is also referred to as a bulging disc or a herniated disc, depending on the severity of the condition. Essentially, this may lead to pressure on significant structures such as spinal joints, local nerve roots, and so on and so forth. The applied pressure results in local inflammation.

At the same time, it’s worth noting that age could also lead to degenerative changes. Even if some of these changes are normal, excessive disc degeneration could make the spaces between the vertebrae unbalanced, which would boost the pressure on the spinal joints and nerve roots.

People struggling with ruptured or herniated discs could find it difficult to sit for an extended time frame, bend forward or even lift objects. At the same time, they might experience numbness and tingling in the lower extremities, radiating pain, so on and so forth. On the other hand, one might experience relief from the pain by lying in a certain position or by walking. But standing might be especially painful due to the pressure applied to the spine.

  • Injured Facet Joints

Every vertebra has four facet joints – two are on the top and two are on the bottom. The thing is that these facet joints interact with one another, and they are important in regulating the motion of the spine. As soon as the joints are either irritated or restricted due to trauma, prolonged positioning, or inadequate movement patterns, one might deal with limited movement, and the pain might affect the lower extremities, depending on the affected part.

Similar to other joints in the body, facet joints might also go through degenerative changes such as osteoporosis. Once again, this will exercise increased pressure and rubbing of the joints. It is mainly due to the loss of articular cartilage lining of each facet. In addition to that, when the facet joints are injured, then you might encounter difficulty in engaging in certain movements or even maintaining a posture when sitting or standing. Most people get relief from the pain when sitting, stretching or lying down.

  • Neutral Tension

The reason why back pain is so prevalent, and it is also linked with pain in the legs, hips or buttocks is that the spine includes all the body’s nerves. More specifically, the nerves located in the lower extremities are derived from the nerve roots exiting the lumbar spine. Adequate blood flow, movement, and space are key elements in ensuring that the nerves function accordingly. When one of these elements is compromised or affected, then the nerve is more prone to become irritable and trigger pain.

This leads to neutral tension – which has to do with a certain degree of mobility restriction of a nerve along the pathway. Diminished intervertebral space might result in neutral tension, or the tightening of the muscles, so on and so forth.

When experiencing neutral tension, you might deal with symptoms such as sharp, shooting pains in both or one of the lower extremities. In addition to that, feeling a sensation of tightness in the legs is also a common symptom. The good thing is that neutral tension is treatable by engaging in a specific exercising routine. Certain body movements could contribute to restoring neutral mobility and diminish the sensitivity of the nerves.

  • Muscle Spasms

Furthermore, muscle spasms also referred to as muscle hypertonicity, are quite common. They occur when the nervous system determines that there is a potential injury or a tissue injury. What does the nervous system do? Basically, it emits signals to the surrounding muscles to tighten and safeguard the affected area from becoming more injured and inflamed.

We’re talking about a protective response whose duration can last from days to weeks. Whenever the nervous system determines that there is a threat when engaging in a specific movement, the response might be emitted again and again resulting in local inflammation. Other symptoms associated with muscle spasms are diminished movement, increased pressure on the surrounding structures, tenderness in the area of the muscles, so on and so forth. The good thing is that in most cases, you can easily recover from muscle spasms by gradually coming back to normal movement patterns.

Chapter 4: Back Pain – An Alarm System

Although back pain can interfere with the quality of your daily life and it can be very unpleasant, you should understand that pain is part of your body’s alarm system, so to speak. It is, of course, difficult to establish the cause of the pain, and the process itself can be demoralizing and discouraging especially if you don’t necessarily understand the way in which back pain works. But the thing is that we have grown accustomed to fear and dread pain, even if the pain is normal. That is to say, pain can be a good thing, as it prevents you from engaging in activities that could harm you or aggravate a condition you might be coping with.

In a way, we could say that pain is a type of built-in reflex that protects humans from doing things that could affect them negatively. As soon as the body senses that there is a threat, the alarm system is automatically turned on, and when you experience pain, the body will do what it can to diminish the threat. When the threat is out of the picture, the alarm system shuts off.

Nevertheless, when dealing with chronic pain, this alarm system we’re talking about might not turn off as soon as you’d want it to. This means that the threat is still there and you should do something about it. Due to the permanent stimulation of the alarm system, you might feel that engaging in day-to-day activities is painful or overwhelming. You might even cope with pain without necessarily doing something too strenuous or tiring.

As pointed out above, in most cases, back pain is easily treatable, in the sense that it doesn’t require surgery or any serious treatment. Making the right lifestyle changes such as exercising, having a correct posture or even investing in a mattress for back pain could really help. Many times, we don’t do the easiest things because we assume that we have to struggle more in order to deal with pain or discomfort. But the solution can be easier than we think. The same goes for back pain – but we’ll get into more detail in the section specifically dedicated to treating back pain.

Chapter 5: Diagnosing Back Pain  

Although back pain is so common, this doesn’t mean you should dismiss it if you don’t notice any signs of improvement whatsoever. If you notice that your symptoms are just as severe, then you should certainly see a certified professional and discuss your problem.

When should you see a doctor?

  • If you’re experiencing chronic pain that doesn’t seem to go away even after implementing a few lifestyle changes
  • If the pain interferes with the quality of your daily life and you can’t engage in daily activities due to the discomfort you experience
  • If you notice that it is getting worse by the day

All these are warning signs indicating that it’s high time to see a doctor. A doctor will inquire more details about the type of pain you’re dealing with, the symptoms you are experiencing, in order to provide a diagnosis.

However, note that diagnosing back pain is challenging, in the sense that specialists might find it difficult to determine precisely what causes your back pain. You should be open about your symptoms and give as many details as possible.

National guidelines indicate that doctors should embrace a wait and see approach when it comes to diagnosing back pain. To that end, before recommending a type of treatment or before deciding to switch the treatment, time can provide useful insight. That’s because many cases of back pain might enhance by themselves.

In case you’ve had a serious injury to your back, or you’ve had a really bad fall, your doctor might recommend doing additional tests. In addition to that, extra tests might be required if your healthcare provider believes that there is an underlying root of your pain. If the pain is chronic and has lasted for a while, then certain tests might be advisable as well.

  • A magnetic resonance imaging (MRI) scan is, many times, advisable when coping with back pain.
  • In other cases, a computerized tomography (CT) scan might be required.
  • Blood tests are also used since they can determine whether you have an infection or an underlying condition causing the back pain.
  • In some cases, nerve studies might be helpful since electromyography (EMG) assesses the electrical impulses emitted by the nerves, as well as the way in which the muscles respond to them. This test might confirm nerve compression triggered by herniated disks or spinal stenosis.

The reason why X-rays aren’t used in most cases is that they aren’t that reliable in diagnosing back pain. That’s because many times, back pain is triggered due to problems with the soft tissue – such as muscles or ligaments, which cannot be analyzed in x-rays. While it’s true that a specialist can assess changes to the spine on x-rays in the case of spondylosis, such changes may also occur in the x-rays of the people that don’t struggle with back pain.

Usually, a doctor will carefully examine your back and your ability to walk, stand, sit, or lift your legs. Concurrently, you might be asked to rate your pain depending on its severity, on a scale from 0 to 10.

Chapter 6: Treating Back Pain

Generally speaking, back pain tends to diminish with the passing of time. But there are cases when home treatment is necessary. It’s worth noting that everyone is different. On a different note, back pain is a complex condition that affects each person differently.

When dealing with acute pain, over-the-counter pain relievers and using heated compressions might be especially helpful. Bed rest isn’t advisable. As a matter of fact, bed rest is contraindicated, and the myth according to which if you have back pain you shouldn’t engage in physical exercise couldn’t be more inaccurate. In fact, it is advisable to carry on with your daily activities as much as you can. In addition to that, you should engage in low-impact activities such as walking, swimming, so on and so forth.

Of course, if you see that certain activities are making your pain worse, you should stay away from them. But that doesn’t mean you shouldn’t stay active simply because you are fearful of the pain. If a new mattress for back pain or work chair, exercising or heat compresses don’t diminish your symptoms, your healthcare provider might recommend you stronger medications or physical therapy.


  • OTC (over the counter) pain relievers – Non-steroidal anti-inflammatory drugs could alleviate the severity of the pain. However, you should take pain relievers only if your doctor advised you to do so. Overusing them is associated with side effects, which is why you shouldn’t take them unless it’s recommended by the doctor.
  • Topical pain relievers – These can be salves, creams or ointments that are applied to the affected area.
  • Muscle relaxants – Usually, muscle relaxants are prescribed when the pain is more severe. There are some side effects worth noting, though, including sleepiness and dizziness.
  • Narcotics – For a short time frame, your doctor might recommend ingesting drugs that contain opioids such as hydrocodone or oxycodone. But usually, a doctor supervises the intake of such medicine. When it comes to chronic pain, opioids aren’t that efficient – this is why they are widely prescribed for acute pain.
  • Antidepressants – Specialists have pointed out that certain doses of specific antidepressants – such as tricyclic antidepressants – have been proven to offer pain relief in some types of chronic back pain, regardless of the source of the problem.
  • Injections – Usually, these injections come in the form of anti-inflammatory medication that aims at providing relief, more specifically in the space surrounding your spinal cord (epidural space).A cortisone injection can contribute to diminishing inflammation around the nerve roots, but the pain relief effect might be short-lived.

On a different note, physical therapy combined with exercising can be just as efficient, contributing to enhancing your flexibility and strengthening your muscles. These will also have a positive impact on your posture, which is imminently linked with back pain.

The Bottom Line

To conclude, we hope that this guide answered most of the questions you had regarding back pain. Being so prevalent, it is important to get the right information to see the potential cause of your pain. This way, you can determine the approach that would work best in your case. Essentially, you shouldn’t overlook back pain even if it has become a part of your daily life. As pointed out several times throughout the guide, back pain can be addressed with the implementation of a few key lifestyle changes, so don’t get discouraged as there is a light at the end of the tunnel.