Back pain is one of the most common physical complaints – with eight out of 10 human beings saying their back hurts at some point in their lives. But what is back pain, really, and what might your body be saying when your back hurts?
The back is a complex system consisting of the bones of your spine and pelvis – along with the muscles, tendons and ligaments that hold them together. A web of major nerves runs through the spine. And in the same space we think of as our “back” lie our internal organs. So when your back first hurts, how do you know what’s going on?
Several conditions of the spine itself will cause your back to hurt. Treatment options for each are different, so a good evaluation is necessary.
A herniated disk occurs when the liquid that cushions the space between your vertebrae pushes out of its normal location, pressing on nerves. This condition is more likely in younger patients with back pain, commonly from ages 20 to 40. This type of pain may be experienced in the hip, buttocks or back of the leg, since the nerve being pressed on in the spine travels down the leg.
As we age, the vertebra in the spine may begin to suffer wear and tear, resulting in degenerated discs or spinal stenosis. The collapse of the disc itself, or narrowing of the canal around the nerves, can press on nerves and cause the back to hurt. These conditions typically affect those 40 and older.
Inflammatory diseases of the spine – similar to rheumatoid arthritis — will cause stiffness, difficulty moving and pain in the back. And of course injuries to the spine may result in back pain – at the time of the injury or later in life.
- Injury or overuse of muscles, ligaments, and joints.
- Pressure on nerve roots in the spinal canal. This can be caused by:
- A herniated disc, sometimes brought on by repeated vibration or motion (as during sport activity or when using a machine or lifting in the wrong way) or by a sudden heavy strain or increased pressure to the lower back.
- Osteoarthritis, usually caused by getting older. When osteoarthritis affects the small joints in the spine, it can lead to back pain. Osteoarthritis in other joints, such as the hips, can cause you to limp or to change the way you walk. This can also lead to back pain.
- Spondylolisthesis, a defect that allows one vertebra to slide over another.
- Spinal stenosis, or narrowing of the spinal canal, which is usually caused by getting older.
- Fractures of the vertebrae caused by a lot of force, such as from an auto or bicycle accident, a direct blow to the spine, or compressing the spine by falling onto the buttocks or head.
- Spinal deformities, including curvature problems such as severe scoliosis or kyphosis.
- Compression fractures. These are more common among post-menopausal women with osteoporosis and in men or women after long-term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.