December 09, 2020
Back pain affects around 31 million people in the United States. More than 540 million people worldwide will experience spine or back pain in their lifetime. The University of Kansas Health System provides comprehensive care for people with back and spine issues.
What is back pain?
Back pain is muscle aches, shooting, burning or stabbing in the lower, middle or upper back. It can also involve sciatic pain, or shooting nerve pain. The back contains joints, ligaments, muscles and 33 bones called vertebrae. The vertebrae stack together to form the spinal canal and protect the spinal cord. Nerves that run between the neck and the lower back make up the spinal cord, which carries messages to and from the brain. The muscles in the back surround the spine and promote good posture.
Back pain can be either acute or chronic, depending on the injury and its intensity. Acute back pain is short-term and usually lasts a few days or weeks. Chronic back pain continues for 12 weeks or longer. One in 5 of those who experience acute low back pain will develop chronic low back pain with persistent symptoms.
How common is spinal and back pain?
Back and spinal pain is the most common type of disability in the world. Back and spinal pain can affect all ages and demographics. It is most likely to occur in people ages 30-50 years old. The pain is usually related to strain, injury or overuse. Adults age 60 and older often experience pain related to spinal joint deterioration. The most common causes of low back pain in older adults include spinal stenosis and osteoarthritis.
Causes of back pain
Back pain can be caused by irritated joints, sprained ligaments, strained muscles or a ruptured disc. Back pain can also be caused by arthritis, infection, fracture or cancer. Injuries can occur from events, such as sports, accidents or minor events, like bending over to pick up a toddler. The following spinal conditions can also cause back pain.
Bulging discs are less severe than herniated discs but may still be painful. Discs experience wear over time and "bulge" between the vertebral bones. Unlike a herniation, bulging only affects the exterior of the disc.
Degenerative disc disease is one of the most common causes of low back and neck pain. Symptoms include weakness, numbness and shooting pain in the arms or legs.
Fibromyalgia is widespread musculoskeletal pain related to fatigue, sleep, memory and mood issues from painful sensations.
Herniated discs are also known as slipped or ruptured discs. Discs are the rubbery cushions between the vertebral bones of the spine that stack on one another. When a disc becomes herniated, the soft center pushes out through a small tear in the exterior, causing pain, numbness, weakness and irritation in the nerves.
Osteoarthritis is the most common cause of low back pain in people over age 50. It occurs due to inflammation of 1 or more of the 5 pairs of joints on each side of the spinal bones.
Piriformis syndrome occurs when the sciatic nerve is compressed. Symptoms include pain and numbness in the buttocks and down the leg.
Sacroiliac joint dysfunction is debilitating pain caused by abnormal motion in the SI joint that results in inflammation.
Spinal stenosis occurs when 1 or more bony openings within the spine narrow and close in on the nerves. Depending on where the stenosis occurs and how much it narrows over time, the compressed spinal nerves can cause pain, tingling, numbness or weakness.
Spinal tumors are abnormal masses of tissue in the vertebral column or spinal cord. They can be benign or cancerous.
Spondylolisthesis occurs when a vertebra slips and becomes misaligned. It is more likely to occur in women and people over age 65.
What is the difference between a herniated disc and muscle pain?
There are a few ways to tell if back pain is muscle pain or a herniated disc. However, the best option is to make an appointment with your healthcare provider to rule out anything serious.
A herniated disc can cause pain while coughing, bending forward or returning to an upright position. Slipped or ruptured discs may also cause weakness in the legs, a duller reflex on the affected side or shooting pain to one side or the other. In very extreme cases, bowel or bladder control may be affected.
Back pain can be caused by:
- Inadequate sleeping surface
- Lifting, twisting or bending with poor form
- Occupational hazard
- Poor posture
Back and spinal pain symptoms
Symptoms include discomfort anywhere from the base of the neck to the tailbone, including:
- Aching, especially after sitting
- Radiating pain
- Shooting, sharp or stabbing pain
- Spasms, often triggered by trying to straighten the spine
It can be difficult to tell the difference between bone pain and muscle pain. Bone pain is constant and dull while muscle pain is sharp and temporary. Muscle pain symptoms include aching, cramping, spasms or a pulled muscle.
Back pain treatment and diagnosis
Back pain specialists focus on specific areas of spinal or back pain. Spine specialists are experts in treating back pain and spinal conditions. Back doctors include:
Neurosurgeons are physicians who specialize in surgical treatment for neurological conditions. A spine neurosurgeon diagnoses and treats disorders of the central nervous system, which can affect the:
- Intracranial and intraspinal vasculature
- Spinal cord
An orthopedic surgeon is a physician who specializes in the surgical treatment of musculoskeletal diseases and diagnosis and treatment of spinal disorders, trauma and fractures. Orthopedic surgeons also treat spinal arthritis and injuries.
Pain management doctors care for a wide range of complex conditions that cause all types of pain. Pain management targets both the physical and mental aspects of discomfort.
People with back pain or spine conditions may meet with a spine specialist who is a physical medicine and rehabilitation physician. This expert, also known as a physiatrist, performs an evaluation, completes a full medical history and physical exam and orders diagnostic testing.
Pain and rehabilitation physicians focus on nonsurgical management of illnesses of the spine, nerves and joints.
Psychiatrists and clinical psychologists treat pain that is partially or wholly psychogenic, meaning that it arises from emotional, psychiatric or mental disorders. They also manage the depression associated with chronic back pain.
People who have experienced a spine injury that requires spine surgery will consult a surgeon who has additional training in performing spine surgery. These surgeons are expert spine doctors.
When to see a spine specialist
People should seek help when experiencing certain types of back pain. If you experience any of these symptoms, you should see a spine specialist:
- Advanced age
- Foot drop
- IV drug use
- Loss of bladder or bowel function
- Night pain
Back or spinal pain symptoms are often relieved with medical management. Your physician may prescribe heat and over-the-counter pain medication like nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen sodium. Stop any activity that aggravates your back pain, and if the pain is too much, consider physical therapy to increase your flexibility, strengthen your back and abdominal muscles and straighten your posture.
Medications like muscle relaxants, topical pain relievers and antidepressants may also be used to target the pain’s specific cause. The antidepressants duloxetine and amitriptyline relieve chronic back pain while minimizing the side effects of depression.
If medical management does not work and the pain is due to structural problems, there is the option of spinal and back surgery. If the spinal condition requires surgery, there are minimally invasive surgical options available. The benefits of minimally invasive surgery include faster procedures, decreased blood loss, fewer complications and a quicker recovery.
Most disc herniations and spinal and back conditions do not need to be treated surgically. Symptoms can be managed through medication, rest and physical therapy performed in partnership with your healthcare team.
Why choose The University of Kansas Health System for back pain and spine injury care
The Marc A. Asher, MD, Comprehensive Spine Center offers multidisciplinary care and treatment for back pain and spinal injuries. The University of Kansas Health System is ranked No. 30 nationally in neurosurgery and neurology by the U.S. News & World Report, with an excellent nursing staff and Magnet recognition.
We provide advanced technology for diagnosis, treatment and rehabilitation services. Our care team includes neurosurgeons, orthopedic surgeons, pain management physicians, rehabilitation doctors and neurologists. They work together to develop a minimally invasive care plan. The University of Kansas Health System is also the first in the state of Kansas to offer robot-assisted surgery.