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Even though back pain can affect people of any age, it is significantly more common among adults aged between 35 and 55 years. Experts say that back pain is associated with the way our bones, muscles and ligaments in our backs work and connect together.

Pain in the lower back may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdomen and pelvic internal organs, and the skin around the lumbar area. Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

You will also see introductions at the end of some sections to any recent developments that have been covered by MNT’s news stories. Also, look out for links to information about related conditions.

Causes

The human back is composed of a complex structure of muscles, ligaments, tendons, disks and bones – the segments of our spine are cushioned with cartilage-like pads called disks. Problems with any of these components can lead to back pain. In some cases of back pain, its cause is never found.

Strain – the most common causes of back pain are:

  • Strained muscles
  • Strained ligaments
  • A muscle spasm

Things that can lead to strains or spasms include:

  • Lifting something improperly
  • Lifting something that is too heavy
  • The result of an abrupt and awkward movement

Structural problems – the following structural problems may also result in back pain:

  • Ruptured disks– each vertebra in our spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
  • Bulging disks– in much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
  • Sciatica – a sharp and shooting pain that travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.
  • Arthritis– patients with osteoarthritis commonly experience problems with the joints in the hips, lower back, knees and hands. In some cases spinal stenosis can develop, which is the term used to describe when the space around the spinal cord narrows.
  • Abnormal curvature of the spine– if the spine curves in an unusual way the patient is more likely to experience back pain. An example is scoliosis, a condition in which the spine curves to the side.
  • Osteoporosis– bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.

Below are some other causes of back pain:

  • Cauda equina syndrome– the cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. People with cauda equine syndrome feel a dull pain in the lower back and upper buttocks, as well as analgesia (lack of feeling) in the buttocks, genitalia and thigh. There are sometimes bowel and bladder function disturbances.
  • Cancer of the spine – a tumor located on the spine may press against a nerve, resulting in back pain.
  • Infection of the spine – if the patient has an elevated body temperature (fever) as well as a tender warm area on the back, it could be caused by an infection of the spine.
  • Other infections – pelvic inflammatory disease (females), bladder, or kidney infections may also lead to back pain.
  • Sleep disorders– individuals with sleep disorders are more likely to experience back pain, compared to others.
  • Shingles– an infection that can affect the nerves may lead to back pain, depending on the nerves affected.
  • Bad mattress– if a mattress does not support specific parts of the body and keep the spine straight, there is a greater risk of developing back pain.

Everyday activities or poor posture.

Back pain can also be the result of some everyday activity or poor posture. Examples include:

  • Bending awkwardly
  • Pushing something
  • Pulling something
  • Carrying something
  • Lifting something
  • Standing for long periods
  • Bending down for long periods
  • Twisting
  • Coughing
  • Sneezing
  • Muscle tension
  • Over-stretching
  • Straining the neck forward, such as when driving or using a computer
  • Long driving sessions without a break, even when not hunched

Risk factors

A risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2.

The following factors are linked to a higher risk of developing low back pain:

  • A mentally stressful job
  • Pregnancy – pregnant women are much more likely to get back pain
  • A sedentary lifestyle
  • Age – older adults are more susceptible than young adults or children
  • Anxiety
  • Depression
  • Gender – back pain is more common among females than males
  • Obesity and overweight
  • Smoking
  • Strenuous physical exercise (especially if not done properly)
  • Strenuous physical work.

Symptoms

A symptom is something that the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

The main symptom of back pain is, as the name suggests, an ache or pain anywhere on the back, and sometimes all the way down to the buttocks and legs. Some back issues can cause pain in other parts of the body, depending on the nerves affected.

In most cases, signs and symptoms clear up on their own within a short period.

If any of the following signs or symptoms accompanies a back pain, people should see their doctor:

  • Weight loss
  • Elevated body temperature (fever)
  • Inflammation (swelling) on the back
  • Persistent back pain – lying down or resting does not help
  • Pain down the legs
  • Pain reaches below the knees
  • A recent injury, blow or trauma to your back
  • Urinary incontinence – you pee unintentionally (even small amounts)
  • Difficulty urinating – passing urine is hard
  • Fecal incontinence – you lose your bowel control (you poo unintentionally)
  • Numbness around the genitals
  • Numbness around the anus
  • Numbness around the buttocks

According to the British National Health Service (NHS), the following groups of people should seek medical advice if they experience back pain:

  • People aged less than 20 and more than 55 years
  • Patients who have been taking steroids for a few months
  • Drug abusers
  • Patients with cancer
  • Patients who have had cancer
  • Patients with depressed immune systems

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