Back Problems And Injuries

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Topic Overview

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:

• The bones and joints of the spine (vertebrae ).
• The discs that separate the vertebrae and absorb shock as you move.
• The muscles and ligaments that hold the spine together.

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 stab wound.

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. Factors 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, or having a degenerative disease such as osteoporosis.

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 who are between the ages of 20 and 50, back problems in children who are younger than 20 and adults who are older than 50 are more likely to have a serious cause.

Sudden (acute) injuries

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 injuries include:

• An injury to the ligaments or muscles in the back, such as a sprain or a strain.
• A fracture or dislocation of the spine. This can cause a spinal cord injury that may lead to permanent paralysis. It is important to immobilize and transport the injured person correctly to reduce the risk of permanent paralysis. See first aid for a spinal injury.
• A torn or ruptured disc. If the tear is large enough, the jellylike material inside the disc may leak out (herniate) and press against a nerve. See a picture of a herniated disc or pressure on a nerve root .
• Compression of nerves in the lower back (cauda equina syndrome).

Overuse injuries

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 treatment.

Conditions that may cause back problems

Back problems may not be related to an injury.

• Conditions that weaken the spine, such as osteoarthritis, osteoporosis, spinal stenosis, or Paget's disease, can cause back pain. These conditions are most common in older adults. In rare cases, tumors or infections can develop in or around the spine.
• Some medical conditions can cause pain to spread to the back from other parts of the body (referred pain). Many health problems that can cause back pain have nothing to do with the bones, joints, muscles, or ligaments of the back.
• Spinal deformities such as scoliosis, kyphosis (Scheuermann's disease), and spondylolisthesis can cause back pain.
• Chronic pain syndrome caused by a previous injury or degenerative disease with aging can cause back pain.

Treatment

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.

Other 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:

• The location, type, and severity of the injury.
• Your age, health condition, and activities (such as work, sports, or hobbies).

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Last updated:	August 28, 2007
Author:	Jan Nissl, RN, BS
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer