Most people will have a minor
back problem at one time or another. Our body movements usually do not cause
problems, but it's not surprising that symptoms develop from everyday wear and
tear, overuse, or injury. Back problems and injuries often occur during sports
or recreational activities, work-related tasks, or home projects.
Back pain can cause problems anywhere from the neck to the
tailbone (coccyx). The back includes:
Back injuries are the most common cause of back pain.
Injuries frequently occur when you use your back muscles in activities that you
do not do very often, such as lifting a heavy object or doing yard work. Minor
injuries also may occur from tripping, falling a short distance, or excessive
twisting of the spine. Severe back injuries may result from car accidents,
falls from significant heights, direct blows to the back or the top of the
head, a high-energy fall onto the buttocks, or a penetrating injury such as a
Although back pain is often caused by an injury to one
or more of the structures of the back, it may have another cause. Some people
are more likely to develop back pain than others.
Things that increase your risk for back pain and
injury include getting older, having a family history of back pain, sitting for
long periods, lifting or pulling heavy objects, and having a degenerative
disease such as
Slumping or slouching alone may not cause low back pain. But after the back has been strained or injured, bad posture can make pain worse. "Good posture" generally means your ears, shoulders, and hips are in a straight line. If this posture causes pain, you may have another condition such as a problem with a disc or bones in your back.
Low back pain may occur in
children and teenagers, but children and teens are
less likely to see a doctor for low back pain. Although most back problems
occur in adults ages 20 to 50, back problems in
children younger than 20 and adults older than 50 are more
likely to have a serious cause.
Pain from an injury may be
sudden and severe. Bruising and swelling may develop soon after the injury.
Pain from an acute injury usually does not last longer than 6 weeks. Acute
You may not remember a specific injury,
especially if your symptoms began gradually or during everyday activities.
These injuries occur most often from improper movement or posture while
lifting, standing, walking, or sitting, or even while
sleeping. Symptoms can include pain, muscle spasms,
and stiffness. The pain often goes away within 4 weeks without any
may not be related to an injury.
Most back pain will get better and go away
by itself in 1 to 4 weeks. Home treatment will often help relieve back pain
that is caused by minor injuries. It is usually a good idea to continue your
regular activities while your back is healing. Avoid heavy lifting and
activities that seem to make your back problems worse.
treatments for a back problem or injury may include first aid measures,
physical therapy, manipulative therapy (such as chiropractic), medicine, and, in
some cases, surgery. Treatment depends on:
Check your symptoms to decide if and when
you should see a doctor.
Health Tools help you make wise health decisions or take action to improve your health.
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
Pain in adults and older children
Urinary tract infections may occur in
the bladder or kidneys. Symptoms may include:
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.
Symptoms of shock in a child may include:
Pain in children 3 years and older
Major trauma is any event that can
cause very serious injury, such as:
Bladder or bowel trouble can
With severe bleeding, any of these may
With moderate bleeding, any of these may
With mild bleeding, any of these may be
Based on your answers, you need
or other emergency services now.
Do not move the person unless there is an immediate threat to the person's life, such as
a fire. If you have to move the person, keep the head and neck supported and in
a straight line at all times. If the person has had a diving accident and is
still in the water, float the person face up in the water.
Based on your answers, you need
After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Symptoms of a heart attack may
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness,
tingling, or a strange feeling in your chest or other areas.
Based on your answers, the problem may not improve without medical
Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can.
Home treatment may help relieve
pain, swelling, and stiffness related to a back problem.
Exercises to reduce pain
Do not smoke. Smoking slows healing because it decreases
blood supply and delays tissue repair. For more information, see the topic
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
Back pain often gets better when you gradually increase
your physical activity. Try to get back to your normal routines and activities
as soon as possible. Resting and not doing anything may actually increase back
pain or make it last longer.
Call your doctor if any of the following occur during home
There is no clear evidence that you can
back pain. But there are some things you can do that may help prevent it. And they can prepare you for faster recovery if you
do have back pain.
Some exercises actually increase
the chances of causing of low back pain. Avoid:
Most back problems that occur
in the workplace are caused by physical stress, such as being in an awkward
position for a long time, making the same motions over and over, and simply
using your back too much. These injuries can cause stress and strain on
muscles, nerves, tendons, joints, blood vessels, or spinal discs.
Arrange your work to help prevent work-related injuries. It is important
to position yourself so that you can sit comfortably and minimize stress on any
one area of your body. Change your positions and tasks as often as possible,
and match tools to your size and preferences. If you are doing a job or task
that requires you to sit for long periods, get up and stretch and move around
at least once an hour.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
May 23, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& David Messenger, MD
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