Most people experience back pain at least once during their lifetime. It is a common health issue that is often reported as the number one reason people see a doctor. Although back pain can occur in any part of your back, the lower back pain (lumbago) is the most common kind.

Back pain is rarely a consequence of a serious health issue. It usually resolves on its own after a few days or weeks. However, this kind of pain can sometimes be very persistent and tends to recur. In such cases, back pain can seriously inhibit normal daily activities.

This article will look at the ways of relieving back pain. We will provide self-help tips, as well as the information about the available back pain treatments.

Overview

Around half of all adults experience back pain at least once a year. In the total population, more than ninety percent of people are affected at least once in their lifetime. 

The pain can originate from nerves, bones, or muscles and can be chronic (lasting more than 8 weeks) or acute (lasting less than 8 weeks). Other parts of the body, such as legs, feet, arms, and hands are often affected indirectly. The pain caused by problems with kidneys, pancreas, and gallbladder can sometimes manifest as back pain as well.

Depending on the area, back pain can be divided into lower back pain (lumbago), tailbone or sacral pain, middle back pain (thoracic), and neck pain (cervical).

In most cases, back pain resolves successfully after a period of rest and medication therapy. It is not common for back pain to be permanently disabling unless linked to an underlying conditions like injury, stenosis or compression of the spine, or arthritis.

Back pain is often non-specific, meaning there is not a clear physiological cause. Because of that, the usual treatment focuses on relieving the pain rather than on treating its cause. The list of possible back pain causes is long but we can mention a few:

• Muscles (especially those around the spine)
• Nerve routes
• Spinal cord
• Vertebral column
• Major blood vessels (Aorta)
• Internal organs
• Osteoporosis
• Small fractures
• Arthritis
• Infections
• Intervertebral discs and their anterior ligaments
• Synovial joints of the spine
• Metastatic Cancers
• Spinal osteomyelitis
• Epidural abscesses

Lack of exercise, obesity, smoking, and pregnancy are considered to be the risk factors for back pain.

The Types of Back Pain

Back pain can be classified by its characteristics and by the area which it affects. The classification by pain characteristics is based on the description of the pain. In this way, we can differentiate three types of back pain:

Radicular Pain

This type of back pain is most commonly associated with the inflammation of the sciatic nerve. The pain is usually deep, spreading down the path of the nerve, and can affect the leg or the arm that is connected to that nerve, causing feelings of numbness. The cause of this type of pain is the compression of a spinal nerve. The other condition associated with radicular pain is the herniated disc or slipped disc.

Axial Pain

Axial pain is usually caused by muscle strain. This type of back pain can be sharp and caused by movement (stabbing pain) or it can be constant and dull.

Referred Pain

This is a pain which originates in the back, but radiates in other parts of the body. It is usually dull and can vary in intensity. A good example is the pain felt in the hips and thighs as a consequence of the degenerative disc disease.

By its location, we can classify back pain into four main categories:

Sacroiliac joint pain (Tailbone Pain)

This type of pain is felt in the buttocks area. It originates in the sacroiliac joints where the spine connects with the hips. The pain can be felt on one or both sides and it can radiate to the thighs, groin, and hips. Sacroiliac joints are surrounded by muscles and ligaments which sometimes become strained and painful. Sitting and standing for long periods of time as well as climbing the stairs are actions associated with the worsening of the symptoms.

Lower back pain (Lumbago)

Can be both, acute and chronic. The pain is usually constant with stabbing sensation felt during certain, especially sudden, movements. Lower back pain is often a consequence of heavy lifting. The cause for lumbago is most commonly the inflammation of the sciatic nerve and muscle strain.

Thoracic pain (Middle Back Pain)

Thoracic pain affects the area of the spine located behind the thorax (chest). It usually occurs in the space between the shoulder blades. Sitting uncomfortably and backpack carrying are among the activities commonly associated with causing thoracic pain. This type of back pain is also more likely to have a serious cause when compared to the lower back pain and neck pain.

Neck pain (Cervical Pain)

Neck pain is usually caused by poor posture or a sudden strain. In most cases, it is not a serious condition. People suffering from neck pain should pay more attention to the position in which they sleep and sit as well as their posture. When neck pain is caused by an injury an urgent medical assistance is recommended.    

Tips to Relieve Back Pain

Back pain can be caused by many of the normal daily activities such as sitting at work, sleeping, lifting objects, exercising, etc. Changing the way of doing some of these activities can bring you a back pain relief in a long run.

Sleeping

Reconsider your sleeping position. The way you sleep can be a cause for your back pain. Sleeping on the side with a pillow between the knees will help to keep the spine in a neutral position. An uncomfortable, or too soft mattress can also aggravate back pain.

Posture

A bad posture, especially when sitting will make the back pain worse. When you are sitting keep your back straight, shoulders relaxed, and make a full use of your chair’s support.

Exercise

Certain types of exercise such as walking, swimming, and yoga are proven to be beneficial for back pain relief. There are also some specific exercise programs about which you can consult a physiotherapist.

Hot and Cold Packs

Cooling the painful area of the back with ice can bring short-term relief. It is important to note that ice should not be placed directly on the skin because it can cause cold burns. Wrap the ice in a cloth or put it on top of your clothes.

A hot water bottle or a hot bath can help with muscle relaxation and mild back pain. Alternating between hot and cold packs is also helpful in some cases.

Relaxation  

Taking a rest and relaxing the muscles of the back is important when you are experiencing back pain. However, most often, you do not rest for a very long time. One or two days are usually enough. After that, you should slowly increase the activity. Staying optimistic is also important.

Treatment Options

In most cases, your general practitioner will be able to help you with back pain relief. The usual treatment for non-specific back pain are the painkillers. These medications do not treat the cause of the pain, but they lower its intensity and help you to go through with your daily activities until the pain resolves completely.

If a more specific cause is suspected your GP will refer you to a specialist. This can be an orthopedic specialist, neurologist, physiotherapist, etc. Depending on the cause of the pain, the specialist can suggest a type of treatment ranging anywhere from massage to surgery.

Painkillers

For mild to moderate back pain, a common primary treatment are the oral painkillers in the form of pills or tablets. These are usually non-steroidal anti-inflammatory drugs (NSAID). Well-known examples are Diclofenac, Ibuprofen, Aspirin, etc. These medications are available over the counter and without a prescription.

Non-steroidal anti-inflammatory injections are also commonly used for treating severe back pain (e.g. sciatic pain). Many of the NSAIDs are also available as creams and gels intended for local topical use. However, their effect is limited.

For people who are unable to take NSAIDs there are other options available. Most of these are stronger drugs which can have certain side effects, such as addiction. A good example is Codeine. These drugs should not be taken over a long period of time.

Paracetamol, also known as tylenol, is another option. Its properties are usually not strong enough to relieve back pain on its own, but. combined with other, stronger, painkillers works very well.

If the cause of the back pain is a muscle spasm, muscle relaxants are a top treatment option. Muscle relaxants usually have a sedative effect and tend to provide the best results in combination with physical therapy and painkillers.

Manual Therapy

Manual therapy treatments are usually performed by physiotherapists, osteopaths, and chiropractors. A variety of manual treatments can be applied to relieve back pain. Most of them involve applying precise and careful pressure to bones, muscles, and the spine. These massage-like treatments are performed by hand. Manual therapy can be very helpful in reducing back pain, especially if it is applied over a longer period of time and together with other types of treatments, such as exercise.

Exercise Therapy

Exercise therapy is usually a group program led by a qualified instructor. The purpose of exercise therapy is to teach people, who are affected by back pain, how to perform various exercises which are beneficial for back pain relief. These exercises usually focus on stretching, improving the posture, and strengthening of the muscles. Exercise therapy is good for treating chronic and recurring back pain.

Surgical Therapy

Surgery is a final stage treatment option for specific back pain in which the cause is well established. Slipped disk (prolapsed disk) and sciatica are common reasons for a surgical procedure.

Surgery is usually considered when the back pain is:

• Severe
• Lasts for a long time
• The cause of the pain is well-known

Surgical procedures carry a risk of complications such as increased back pain and even paralysis. However, these are extremely rare.

Another procedure, called the radiofrequency denervation is sometimes used to treat back pain. This procedure affects the nerves responsible for sending pain signals from different tissues (muscles, tendons, etc.) to the brain.

During radiofrequency denervation, special needles are inserted inside the nerves which are then heated up. This stops the nerves from sending pain signals. The procedure is performed under a local anesthesia and hospitalization is usually not necessary.

Complication related to radiofrequency denervation includes:

• Accidental nerve damage
• Infection
• Bleeding
• Bruising

Other Treatments

There is a variety of back pain treatments whose benefits have little or no evidence to support them. However, these treatments can sometimes be recommended by your doctor if he thinks they could help you with relieving the pain.

These treatments include:

• Acupuncture – A treatment which involves a stimulation of various points in the body by the insertion of fine needles.
• Transcutaneous electrical nerve stimulation (TENS) – Patches containing electrodes are attached to the back and electrical pulses are delivered through them to the muscles.
• Percutaneous electrical nerve stimulation (PENS) – Needles inserted at different points in the back deliver electrical pulses to nearby nerves.
• Interferential therapy (IFT) – Electrical current is passed to the tissues of the back to accelerate their healing.
• Therapeutic ultrasound
• Belts, corsets, and foot orthotics
• Steroid spinal injections

The Final Word

Back pain is extremely common and it can be caused by a variety of reasons. It usually resolves on its own or with the help of painkillers, ice and heat packs, and/or physical manipulation. In rare cases when the cause for back pain is a serious illness or an injury more specific diagnostic methods and treatments are necessary.