Back pain
Understanding back pain
Back pain is a common issue that impacts a significant portion of the population. It can range from a dull persistent ache to sudden, sharp discomfort, and can occur suddenly due to injury, activity, or certain medical conditions. Back pain can impact people of all ages for various reasons. A person’s job or degenerative disk disease may increase the likelihood of experiencing back pain, especially as people age.
While most cases of back pain resolve on their own, some may require medical attention if they persist beyond a few days or worsen over time. Penn Medicine is home to experts in neurosurgery, orthopedics, physical rehabilitation, and pain medicine who use advanced approaches to treat and relieve your back pain.
Types of back pain by area
Back pain is typically categorized by where the pain occurs, as lower, upper, and middle back pain. Each type of back pain may also be categorized as acute, subacute, or chronic depending on how long the pain lasts and how frequently pain episodes occur. Acute back pain happens suddenly and lasts for a few days to a few weeks. Subacute back pain may last anywhere from six weeks to three months. Chronic low back pain is the most severe and typically lasts longer than three months.
Back pain that begins in the lumbar region or the back area below the ribcage is called lower back pain. It’s the most common type of back pain and causes mild to severe pain that can hinder daily activities like walking or working. Lower back pain usually occurs due to aging, working occupations that involve heavy lifting, carrying excess body weight, or having a family history of osteoarthritis. Treatment typically involves rest, medication, and physical therapy, though more severe cases of low back pain may require surgery. Early intervention by a skilled provider can ensure a fast recovery and reduce the need for surgery.
Upper back pain refers to discomfort felt from the base of the neck to the lower rib cage. This type of pain affects the thoracic spine, which is made up of 12 vertebrae. This region of the spine is responsible for maintaining stability and protecting vital organs such as the heart and lungs. It’s supported by ribs and ligaments, and the disks between the vertebrae help absorb shock during movement.
Unlike the neck and lower back, the upper back has limited mobility and is therefore less prone to pain. When people experience upper back pain, it’s often due to injuries or medical issues that affect the bones, disks, muscles, or ligaments. Mild to moderate upper back pain is typically managed with home remedies. If the pain worsens, there may be an underlying cause that requires treatment.
Middle back pain is a discomfort in the thoracic spine between the base of the neck and the rib cage. Numerous factors can cause this pain, including muscle strains, poor posture, impact trauma, or arthritis. Because of the delicate make-up of the thoracic spine, this area is susceptible to irritations to its nerves, muscles, ligaments, and disks. This region is crucial in protecting the spinal cord, which is a nerve bundle that facilitates communication between the brain and the body. Any damage or irritation to the spinal components of the thoracic spine can lead to middle back pain, which may require a range of medical treatments, home remedies, and exercises, depending on the underlying cause.
Symptoms associated with back pain
Back pain can vary in intensity from a dull ache to sharp shooting sensations that cause discomfort and make it difficult to move. The pain may radiate to the buttocks or down the legs, and certain positions can make it worse. While home remedies and self-care may help alleviate this pain, persistent or severe back pain requires medical attention, especially if the pain is accompanied by symptoms like numbness, tingling, weakness, or unexplained weight loss.
Back pain symptoms can include:
- Difficulty standing straight
- Muscle spasms
- Stiffness
If you experience any of the following combinations of symptoms, contact a back pain specialist right away. They may indicate underlying issues that require immediate medical attention:
- Back pain after a severe blow, fall, injury, or trauma to the back
- Back pain with new bowel or bladder issues
- Back pain that worsens when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Unexplained fever with back pain
- Weakness or numbness in the buttocks, leg, pelvis, or thigh
What causes back pain?
Back pain causes can vary from strain and tension to underlying medical conditions.
Other potential causes of back pain include factors like obesity, poor muscle tone, and smoking, which can worsen back pain and make you more susceptible to injury. Understanding the role of each of these contributing factors can help you to take proactive steps to manage or prevent back pain.
Back pain is often caused by simple daily activities. Things like heavy lifting, playing sports, making sudden movements, or even having poor posture can lead to muscle strain or ligament sprains that cause back pain.
- Lifting something improperly
- Making abrupt, awkward movements
- Twisting the back
- Using prolonged poor posture, such as hunching over a computer
- Overstretching
- Bending awkwardly or for extended periods of time
- Pushing, pulling, lifting, or carrying heavy objects
- Standing or sitting for prolonged periods without breaks
- Straining the neck forward, such as during driving or computer use
- Sleeping on a mattress that doesn’t support the body or maintain spinal alignment
Back pain can occur due to problems with the spine's structure or soft tissue injuries that press on nearby nerves.
- Ruptured disks
- Bulging disks
- Sciatica
- Unusual curvature of the spine, such as in scoliosis
- Osteoporosis that leads to compression fractures
Chronic conditions can contribute to persistent back pain by affecting the spine and causing inflammation.
- Arthritis, osteoarthritis, ankylosing spondylitis, or other conditions affecting the spine
- Cauda equina syndrome
- Cancer of the spine
- Infection of the spine
- Other infections, including inflammatory disease and kidney or bladder infections
- Sleep disorders
- Shingles
Diagnosing back pain
Diagnosing back pain involves a thorough evaluation by your provider, including an assessment of your symptoms, medical history, and lifestyle followed by a physical exam. During the exam, your doctor will check for range of motion, nerve function, and muscle spasms. Depending on the suspected cause of the pain, your doctor may perform blood tests, urine tests, and a variety of imaging tests to assess the condition of your bones, muscles, nerves, and other soft tissues in the spine. These tests help identify the source of the pain, evaluate its severity, and rule out more serious underlying conditions.
Back pain relief treatments
Treating back pain often involves a combination of approaches that a doctor will tailor to an individual’s specific type of back pain. Treatment typically begins with conservative methods like rest, over-the-counter medications, and light physical activity to promote healing. Complementary therapies such as chiropractic care, acupuncture, or massage may also offer back pain relief. For more severe cases, rehabilitative therapies, medications, or surgery may be recommended.
Penn Medicine’s spine treatment program is led by a team of experts who provide evidence-based care to address each patient’s back pain needs. We use conservative, non-surgical treatments or minimally invasive techniques whenever possible to restore your back function and help you get back to living your life pain-free.