Back Pain: Symptoms, Causes, and Prevention

Back Pain: Symptoms, Causes, and Prevention

Back pain is one of the most common health problems affecting people of all ages. It can range from mild discomfort to severe, disabling pain that affects daily activities. Whether it affects the lower back, upper back, neck or the entire back, or stays one-sided, understanding the associated causes and symptoms helps in early management and prevention.

Discomfort or stiffness felt anywhere along the spine; from the neck to the lower back, constitutes back pain. It may be acute (lasting a few hours, days or weeks) or chronic (lasting more than 12 weeks). The pain can be sharp, dull, constant, or radiating to other body parts.

This comprehensive guide covers its presentation and symptoms, the causes, investigations needed for appropriate diagnosis, treatment, and effective prevention strategies.

Common forms of presentation

• Lower back pain (lumbosacralregion pain)

• Upper back pain(thoracolumbar region pain)

• Neck pain (cervical region pain)

• One sided back pain(left or right sided pain)

• Radiating pain (pain radiating from the back to the arms, legs, or back of the head)

Symptoms

Vary depending on the cause. Some appear suddenly, others may develop gradually.

Common symptoms are

• Sharp or stabbing pain

• Dull aching sensation

• Pain radiating to buttocks, legs, or shoulders

• Soreness, stiffness or tightness on getting up in the morning

• Pain worsening with movement (bending, twisting, turning)

• Pain while resting/sleeping

• Reduced flexibility or range of motion

• Numbness or tingling in the arms or legs

The lower back (lumbar region) supports body weight, making it prone to injury. Typical symptoms seen with lower back pain include:

• Pain when bending or lifting

• Pain after standing for long periods

• Pain radiating to legs (sciatica)

• Painbs associated with cramps/muscle spasms

Upper back pain is less common but can occur due to poor posture while sitting or working, producing following symptoms

• Soreness or stiffness in the neck and upper back

• Pain radiating to the back of head(cervicogenic headaches)

• Pain radiating to the arms (cervical radicular pains)

• Tightness between shoulder blades

• Pain when twisting or sitting for long hours 

Common Causes

Back pain is mostly due to mechanical overuse/abuse (postural, occupational, or due to injury: acute, repetitive stress or chronic), and sometimes due to underlying medical conditions (inflammation, infection, metabolic disorders, tumors and other miscellaneous conditions).

1. Mechanical back pain(Muscle Sprain/Ligament Strain)

Improper lifting, overuse, sudden movements, or exercise injuries cause muscle fibers or ligaments to overstretch.

2. Poor Posture

Slouching, hunching at a desk, or sleeping in an incorrect position puts pressure on the spine.

3. Injuries or Accidents

Falls, sports injuries, and car accidents often result in acute back pain (fractures and dislocations).

4. Herniated Discs & Sciatica

When there is an excess load on the spinal discs, they rupture causing the inner soft tissue to herniateand irritate nearby nerves, leading to radiating leg pains.

5. Degenerative Disc Disease& Arthritis

Wear and tear over time causes chronic back pain. Similarly, osteoarthritis can affect the spine, causing stiffness and pain.

6. Spinal Stenosis

Narrowing of the spinal canal due to prior slipped discs/injury or aging (arthritis) leads to nerve compression, causing difficulty walking long distances and stooping posture.

7. Inflammatory Arthritis

Systemic illnesses like rheumatoid arthritis, seronegative spondyloarthropathy, ankylosing spondylitis and gout can cause inflammation in the spinal joints and discs leading to back pain and stiffness.

8. Referred pain from the visceral organs

Kidney infections/stones may cause one sided back pain.

9. Infections and tumors

Associated weight loss, loss of appetite and fever is usually present

Risk Factors

Certain lifestyle and health factors increase the risk of developing back pain:

• Age (common after 40+)

• Obesity

• Sedentary lifestyle

• Smoking

• Stress and anxiety

• Poor ergonomics

• Pregnancy

• Repeated heavy lifting

Diagnosis

To diagnose the cause of back pain, doctors use:

1. Detailed history of the problem

These include checking for presentation, aggravating and relieving factors, associated symptoms, etc.

2. Detailed physical examination

Checking posture, flexibility, and nerve function.

3. Imaging tests

• X-rays
• MRI
• CT scan

4. Blood Tests

To check for infections or inflammatory diseases.

5. Nerve Studies

Electromyography (EMG) & nerve conduction velocity (NCV) identifies nerve compression. 

Treatment Options

Treatment varies depending on the cause and severity.

1. Medication

• Pain relievers

• Anti-inflammatory medication

• Muscle relaxants

2. Physical Therapy

A physiotherapist helps relieve acute pain through modalities, and then teaches posture correction and strengthening exercises.

3. Hot and Cold Therapy

Ice reduces swelling; heat relaxes muscles.

4. Manual Therapy

Chiropractic adjustments or massage.

5. Back Pain Exercises

Helpful exercises include:

• Hamstringstretches

• Core strengthening

• Pelvic tilts

• Cat-cow stretch

• Bridge exercises

6. Injections

Corticosteroid injections are sometimes given into the facets or epidural space for severe pain.

7. Surgery

Considered for serious disc problems or nerve compression. 

Prevention

Preventive care reduces both the frequency and intensity of back pain.

1. Maintain proper posture

Keep your back straight while sitting or standing.

2. Exercise regularly

Include core-strengthening and flexibility exercises.

3. Lift properly

Bend your knees, not your back.

4. Maintain healthy weight

Reduces pressure on the spine.

5. Ergonomic workstations

Use a supportive chair, monitor at eye level, and take breaks.

6. Sleep correctly

Use a firm mattress and avoid stomach sleeping.