Back pain is a common issue that can affect people of all ages. It's not just a problem for the elderly, as adults are spending more and more time sitting and working on computers. Severe back pain can have a significant impact on both quality of life and work performance.

Overview of Different Back Pain Conditions

Conditions

  • Herniated Disc
  • Spinal Stenosis
  • Spondylolisthesis
  • Cervical spondylosis
  • Osteoporotic compression fracture

Structure of the Back

The back has three primary parts, which are:

  1. Spine

    The spine is an essential body part that serves as the foundation to support our body's weight. It comprises multiple bones, called vertebrae, that are stacked from the cervical area (neck) to the lumbar area (waist). Physicians commonly refer to vertebrae by sequential numbering based on their location in the spine.

    • The cervical spine section consists of 7 vertebral bones (known as C1-C7).
    • The thoracic spine section consists of 12 vertebral bones (known as T1-T12).
    • The lumbar spine section consists of 5 vertebral bones (known as L1-L5). This area is the most common location for back pain as it supports the upper body's weight.
    • The sacral spine section consists of 5 vertebral bones (known as S1-S5) that are fused together to form the coccyx bone (also known as the tailbone).

  2. Back muscles

    The muscles of the back are attached to the spine by connecting tendons and ligaments.

  3. Spinal nerves

    In the cavity of the spine, there are 31 pairs of spinal nerves to carry sensations from different parts of the body to the brain and instructions from the brain to the organs and parts of the body.

Risk Factors of Back Pain

  • Age: Back pain can affect people of any age, but is more likely as we get older.
  • Lack of exercise: People who do not perform regular exercise will not have strong back muscles to support the spine.
  • Overweight: Excess weight puts pressure on the spine, accelerating spine degeneration. Also, fat around the abdomen impairs the body’s natural balance and increases the risk of injury or accidents.
  • Diseases: Some diseases, such as arthritis and cancer, can cause back pain.
  • Job: Jobs that require lifting, pushing, or pulling can temporarily or permanently twist the spine. People who work at a desk for long periods of time with bad posture may get back pain.

Causes of Back Pain

There are many causes of back pain, including poor posture or the condition of the spine itself. The common causes of back pain are:

  • Bad posture: Bad posture and body movement are the most common causes of back pain, mainly in people who work with computers (especially laptops) for long periods of time. Poor sitting posture with a bent back, stooped shoulders, and an overly low head towards the computer screen, as well as bending the back to lift heavy objects, will transfer the weight to a bent spine.
  • Back injuries: Back injuries caused by an accident or sports (such as rugby, football). The continuous impact from sports may accelerate spine degeneration.
  • Congenital disorders: Congenital disorders such as congenital stenosis, congenital scoliosis, and congenital vertebral abnormalities (transitional vertebra) can contribute to back pain.
  • Spine and muscle disorders: Conditions of the spine and muscles are one of the major causes of back pain. They are:
  • Diseases: Kidney disease, ovary and uterus diseases, abdominal aortic aneurysms, or cancer spreading to the spine may cause pain radiating into the back.

Symptoms of Back Pain

You might have pain only in the back or pain that radiates into the hips or legs. Different people may feel different types of pain from the same condition. The pain may be sharp pain, dull pain, or only numbness.

  • Neck pain and Upper back pain
  • Mid back pain (with leg symptoms)
  • Back pain with or without leg pain

When to See a Doctor?

Some back pain may only require time to heal. But if you have any of the following problems, go to see the doctor as soon as possible:

  • Chronic back pain more than three consecutive months
  • Sciatica or radicular pain (the pain that radiates into the hip, legs, and foot).
  • A severe pain that does not improve with rest
  • Pain after an injury or a fall
  • Pain plus any of these problems
    • Trouble urinating
    • Leg weakness
    • Numbness in the leg, foot, or rectal area
    • Nausea, vomiting, or fever
    • Unexplained weight loss

Treatment Options for Back Pain

The goal of treatment is to reduce pain and to enable the patients to pursue normal daily life. The treatment depends on the cause and duration of back pain. The doctor will determine the appropriate treatment for each patient. The treatment will first start with the cause of the back pain, and finding the best way to lessen pain for the patient.

In general, treatment consists of 2 main options.

Conservative treatment

  • Supportive treatment: The doctor always begins the treatment with medication, physical therapy, and resting, except cases with specific indication of an alternative treatment.
  • Spinal intervention: Aims to relieve or find the cause of pain. Also, helps determine the specific location in the spine from which the pain originates. This procedure is suitable for the patients who have had unsuccessful results from other conservative treatments, or those whose pain is caused by a disturbed nerve.

Spine surgery

The doctor will consider a surgery if the patients cannot control urinating, has leg weakness, cannot walk or has had unsuccessful results from other treatments. There are many procedures depending on the patient’s condition and the indication of the surgery.

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