Most people have felt back pain at sometime in their life. It can be due to many reasons. They can be due to accidents, sports injuries or muscle strains. The main symptom is persistent pain or stiffness at any area on the spine. Herniated discs, spinal stenosis, Spondylolisthesis, vertebral fractures and degenerative disc disease are the possible causes of back pain.

Back Pain Causes

The possible causes of back pain are:

• Nerve root syndromes which create signs of nerve impingement because of a herniation or a bulging of the disc for example sciatica pain.
• Herniated discs: It is a painful problem where the hard outer coating of the discs is damaged, causing the jelly-like center of disc to leak. It irritates the nerves and causes sciatica and nerve pain in the leg.
• Spinal stenosis: It is the contraction of the spinal canal where the spinal cord and spinal nerves are present. It happens when intervertebral discs lose water content and volume with age, which diminishes the disc space.
• Spondylolisthesis: It is a situation where a vertebra of the lumbar spine slides out of place.
• Vertebral fractures: These fractures are caused by accidents affecting the vertebrae of the spine or from osteoporosis.
• Degenerative Disc Disease: This causes degeneration of disc with time. A person with this problem exhibit morning stiffness or pain while standing for a long duration.
• Cauda equina syndrome: It is a medical emergency. The disc matter spread out into the spinal canal and compresses the nerves.
• Sacroiliitis or infections of the bones of the spine can also cause back pain.
• Cancer can also cause pain in back.

Symptoms of Back Pain

The back pain might be caused by numerous different symptoms but the symptoms are same. They are:

• Continual pain or rigidity at any region on the spine
• Piercing pain in the region of neck, upper back, or lower back. The pain increases after lifting heavy objects or any other exhausting activity.
• Back pain that spreads out from the low back to the buttock and on the back of the thigh moving into the calf and toes.
• Unceasing ache in the middle or lower back particularly after sitting or standing for long time periods.
• Lack of ability to stand without extreme muscle spasms in the lower back.

Diagnosis of Back Pain

• The doctor performs a physical examination. He/she will check for your range of motion and nerve function. The doctor will also try to locate the area of uneasiness.
• The doctor will advise some blood and urine tests to make sure that the pain is not because of any other problem.
• X-rays are used to check for any broken bones or other skeletal imperfections. They can also locate troubles in connective tissue. The computed tomography (CT) and magnetic resonance imaging(MRI) is used to analyze soft-tissue problems
• Plain x-rays are generally advised only in case of significant trauma or in people older than 55 with osteoporosis or those with stretched steroid use.
• Myelogram is an x-ray study in which a radio-opaque dye is inserted into the spinal canal. The test is done along with a CT scan only in cases where a surgery is considered.
• Magnetic resonance imaging (MRI) scans are highly developed test that use very strong magnets to produce images. MRI is considered after 4-5 weeks of symptoms to exclude any other serious problems.
• Electromyogram or EMG is a test involving putting tiny needles into the muscles. Then the electrical activity is observed. It is a nerve test used to forecast the level of nerve root damage.

Treatment

The treatment goals of back pain are pain relief and restored movement. The fundamental treatment for easing back pain from any type of strain or injury is taking appropriate rest. An ice pack, aspirin or non-steroidal anti-inflammatory drug (NSAID) is used to decrease pain and swelling. Long-term bed rest is now considered harmful for most cases of back pain.

• Physical therapy treatments are quite useful in cases of back pain. They employ massage, ultrasound, heat application, and separately customized exercise programs to aid you to recover the complete back usage.
• You should strength the abdominal and back muscles to aid in curing the spine. With soft stretching exercises, correct lifting methods and a proper posture, you can strengthen you can prevent back ache.
• If back pain hinders your daily activities, your doctor recommends pain medications like aspirin, or ibuprofen. The doctor might recommend opioid/acetaminophen medications like Vicodin or Percocet. At times muscle relaxants are also recommended.
• In cases of extreme pain, injections of steroids or anesthetics are used to control the pain.
• A new treatment known as radiofrequency ablation is frequently used. It is a process of sending electrical stimulation to particular nerves and making them less responsive to pain or by using electricity to damage the nerve to avoid any further pain.

Surgery

Surgery for back pain is a last option.

The surgery is required in people with low back pain and sciatica as they have a herniated disc, spinal stenosis or spondylolisthesis with nerve participation or in people with degenerative disc disease where discs wear with age.
The Operative treatments for herniated discs include:

• Laminectomy/discectomy: In this surgery, the herniated disc is removed via an incision of around two inches.
• Microdiscectomy: Here the herniated disc or damaged portion of a disc is removed via an incision in the back. The incision is small and it may decrease pain as well as the disruption of tissues.
• Laser surgery: In this procedure, the surgeon puts a needle in the disc which gives few spout of laser energy so as to vaporize the tissue. This decreases its size and alleviates.
  The Operative treatments for spinal stenosis:
  Laminectomy: The tapering of the spine puts pressure on the nerve roots which causes pain and impacts sensation. The surgeon opens the spinal column via a surgery called a laminectomy. It is a major surgery and must be followed by hospital stay and physical therapy.

The Operative treatments for spondylolisthesis:

Spinal fusion: The surgical treatment includes both laminectomy as well as spinal fusion. In spinal fusion, two or more vertebrae are connected together through bone grafts, screws, and rods to avoid slippage.

Exercises

Exercises that help in decreasing or prevent low back pain include

• Aerobic exercise is used to tone your muscles for good health.
• Strengthening exercises are used to strengthen your back and leg muscles.
• Stretching exercises are needed to the muscles and other tissues flexible.