Low Back Pain: All Things You Want to Know About Low Back Pain Signs, Symptoms, Causes, Diagnosis, and Home Remedies

If one could guess symptoms that all people have experienced at one point in their lives, back pain would be one of them. We use our backs in everyday activities from walking to sitting to sleeping to lifting objects. Our backs and their structure are the reason we are able to stand on two legs, to begin with. Therefore, conditions that affect our backs cause severe distress and hinder all our daily activities. Back problems are not always severe, but the pain resulting from them is enough to make a healthy individual bedridden within days. Many patients may also -through misguided medical knowledge- think that they have cancer whenever they feel low back pain. In this article, we will discuss the causes of low back pain, how it is diagnosed, home remedies, and when you should see your doctor regarding your back pain.

Read Also:

Why is back pain common?

Back pain is very common because its causes are diverse. Most of those cases are mild and need no medical attention. They are, in fact, easily avoided with some healthy practices. However, one should know when to take things seriously and visit their physician regarding their back pain. In recent times and owing to our less-than-ideal lifestyle, our posture, and the long periods for which we sit, back pain has become a problem of all age groups. Patients as young as 20 now complain of chronic back pain. This new pandemic is slowly growing and should alert us to change our lifestyle and resort more to exercise. A healthy back is, after all, necessary for us to stay mobile for as long as possible.

Causes of back pain:

Our backs are formed of bones (our spine), ligaments, muscles, and intervertebral discs. The spinal cord runs in our back and sends nerves that supply muscles and receive pain impulses. Common causes of back pain include:

Muscle or ligament injury: This can be seen in the workplace or sports-related injuries. Our muscles and ligaments can get sprained or torn. In most cases, the condition is mild and is manageable at home. Severe cases, however, need medical care.
Bulging or injured discs: Our intervertebral discs are soft discs of cartilage that separate every 2 vertebrae (bony bodies). They act as shock absorbers and allow for smooth back movements. They can get injured acutely and bulge if you lift an excessively heavy object using your back muscles solely or in the elderly when they get less elastic. When those discs bulge, they compress the spinal cord or the nerves that come out of it causing immense pain. Some mild cases can be managed conservatively, while others may need surgical intervention.
Arthritis: Although we commonly associate arthritis with joints of the hands, feet, or the knee joint, the back can also be associated with arthritis. This can also be a part of a special type of rheumatoid-like condition called ankylosing spondylitis. Patients with ankylosing spondylitis have severe back pain that limits their daily activities. They also suffer from morning stiffness and pain that improves on movement contrary to the other causes of arthritis that worsen on movement.
Bone fractures: Bones of the back can be fractured in severe trauma like road traffic accidents or falling from heights. Back pain can be attributed to fractures of the spine or the pelvis.
Endometriosis: Endometriosis is a gynecological condition that occurs when the inner lining of the uterus goes somewhere else in the body, commonly in the pelvis. The pain characteristically occurs with menstruation and improves on oral contraceptive pills.
Pelvic inflammatory disease: Pelvic inflammatory disease is one of the complications of recurrent genital infections in females and is characterized by low persistent fever, coital problems especially pain or discomfort, and pelvic deeply seated pain. In some cases, the pain may be referred to as the back causing low back pain.
Kidney problems: Several kidney problems can cause low back pain including upper urinary tract infection (pyelonephritis) and renal stones. In upper urinary tract infections, the pain is dull, while in stones, the pain is sharp and radiates down to the scrotum or vagina.
Cancer: Back pain is not a common symptom of cancer by any means, but low back pain in a man above sixty with urinary symptoms can be a warning sign of prostatic cancer. The prostate is connected to the lower back by a complex network of veins through which prostatic cancer can spread. Prostatic cancer is not only cancer that spreads to the backbones, and other cancers may be the cause including multiple myeloma. Multiple myeloma is a blood cancer that affects the blood cells within the marrow of such bones. The important thing to know here is that cancers make up less than 1% of all causes of low back pain and only a few danger signs should alert you to it as will be mentioned later in the article.

Home remedies to back pain:

Since most back pain causes are inflammatory and related to muscles and tendons, some simple home remedies can be enough for most cases. They include:

Read Also:

Rest: If you sprained a ligament or a muscle, they need time to heal. Overexerting yourself will hinder your body’s ability to heal the damage, causing worsened pain.
Ice application: Applying ice to the inflamed area will decrease inflammation and cause pain relief.
Topical anti-inflammatory creams or ointments: Several formulations for anti-inflammatory creams and ointments are available. They commonly include diclofenac or salicylates as well as menthol to help numb the area and decrease its inflammation.
Painkillers: If your back pain is severe and affects your sleep, you can take Paracetamol tablets for pain relief. Avoid using other tablets like Diclofenac or Ketoprofen because they have adverse effects on the stomach and kidney, especially on prolonged use. Use them only as instructed by your doctor.

Preventing back pain:

Back pain usually results from our bad posture or our lack of understanding of how to use our back muscles properly. Avoiding these common malpractices will help you avoid back pain and lead a healthier life. Simple measures include:

Try to sit upright or better still, slightly inclined backward. Our backs are not designed to carry our weight while hunched. This causes increased stress on our lower back and chronic lower back pain.
When lifting objects from the ground, do not bend your back. Bending your back puts the whole weight of the object on your lower back. Bend your knee to get down while keeping your back straight (squatting position). This allows your thigh muscles to carry the weight instead of your back.
Sleep on your back or sides, not on your abdomen. Sleeping on your abdomen is a bad habit and puts increased stress on your back for long hours. It also makes breathing harder and can cause chest pain from the effort that your chest muscles were doing.
Regularly stretch throughout the day. Do not sit for more than one hour without moving your back. Stretching will prevent muscle sprain and keep your spine healthy.
Stay hydrated. This might seem like strange advice, but our intervertebral discs are made of cartilage, and cartilage is affected by your state of hydration. Dehydration decreases its elasticity and makes it more liable to injury.

When to worry about your back pain:

As mentioned above, the vast majority of cases of back pain can be managed conservatively. More than 70% of people who have back pain have sprained a ligament or overexerted their muscles. However, you should know when to consult your doctor regarding your lower back pain. Red flags to look for are:

Back pain that does not go away: Most cases of muscular or ligament sprains last for 1-2 weeks and then go away. If your back pain lasts for more, then it is likely that the cause needs medical attention.
Back pain associated with numbness or leg pain: Our thighs and legs are supplied by nerves coming out of our spine. If those nerves are pinched by a bulging disc, they can cause severe pain and/or numbness of our legs and thighs. This condition is called sciatica and needs medical care as soon as possible. Some cases can improve on medical treatment while others need surgical intervention.
If you have morning stiffness: Most cases of back pain do not involve the joints themselves, and if morning stiffness is present, especially if it lasts for more than 30 minutes, then it is likely that arthritis is present. Ankylosing spondylitis is a common cause, and it must be managed medically.
If you have urinary symptoms: In males, the prostate is a gland that surrounds the urethra -where urine flows out of the urinary bladder-. If the prostate enlarges and regardless of the cause, many people experience symptoms like burning pain while voiding or a sense of incomplete voiding. Prostatic enlargement is usually benign, but if back pain is accompanying the symptoms, then you should visit your doctor for further assessment.
If your back pain accompanies your menstruation: Back pain that accompanies menstruation can be due to endometriosis or pelvic inflammatory disease. Both conditions need gynecological consultation and care.

Diagnosing lower back pain:

Most cases of low back pain are due to strained muscles and need no further investigations. Your doctor will listen to your complaint and if nothing alerts them to another cause, they will diagnose it as a simple muscle strain. If, however, they suspect another cause to be the problem, they may order a number of investigations including some lab tests and imaging studies. Laboratory tests that may be ordered include:

A complete blood count: A complete blood count may not reveal the cause, but it helps give a general look at the patient’s condition as in cases of infection in pelvic inflammatory disease or anemia.
Inflammatory markers: Inflammatory markers are certain substances secreted when the tissues are inflamed. The most commonly measured are the CRP and ESR. They are elevated in cases of arthritis and infection.
Tumor markers: Tumor markers are chemical substances that a tumor produces by itself or produces when it destroys normal tissue. Not all cancers have tumor markers, but for low back pain, prostatic cancer can be screened by using a tumor marker called prostatic specific antigen or PSA. Elevated PSA is not a sure sign that prostatic cancer is present, and further, more specific investigations would be needed.

Imaging studies are more specific in back pain and can be ordered routinely. They include:

Plain X-rays: A plain X-ray doesn’t show much, but it can exclude fractures and, sometimes, kidney stones.
CT scans: CT stands for computerized tomography and is an advanced form of X-rays that produces high-resolution images of bones and organs. They are most useful in kidney stones, fractures, and cancer.
MRI: MRI stands for Magnetic Resonance Tomography. It is a form of imaging that uses magnets to see body tissue. It doesn’t involve radiation and is safe in most patients. MRI is especially useful to see the spinal cord and any disc bulge or herniation.
Ultrasonography: Ultrasound imaging is rarely used in back pain except in gynecological conditions like endometriosis or pelvic inflammatory disease. Prostatic cancer can be seen by a special type of ultrasound called endorectal ultrasound, and a sample can be taken.

In the end:

Read Also:

Back pain is not a major cause for concern, and in most cases, it needs no treatment except rest, but if you experience any dangerous signs from those mentioned above, then a doctor’s visit won’t harm you. It is tempting to try to diagnose yourself, but diagnosis is an art that is taught for years in medical schools and needs extensive medical knowledge. Non-medical personnel is more likely to misdiagnose and any treatment taken based on such a misdiagnosis can cause unnecessary harm. Internet articles like this one are not written to help you self-diagnose, but to enlighten you regarding a condition and to help you understand the possible diseases or disorders that can cause your symptoms. Whatever your symptoms are, do not worry or feel anxious until after you are properly diagnosed.