What is back pain?

Back Pain

Back pain: Overview

In most cases, there isn't a clear cause for back pain. It may be related to problems with muscles and ligaments of the back. It may also be related to problems with the nerves, discs, or bones of the back. Moving, lifting, standing, sitting, or sleeping in an awkward way can strain the back. Arthritis is another cause of back pain.

Although it may hurt a lot, back pain usually improves on its own within several weeks. Most people recover in 12 weeks or less. Using self-care, such as ice or heat and light activity (like walking) may help you feel better sooner.

Back Pain and Flank Pain

It is sometimes hard to tell the difference between back pain that is caused by a bone or muscle problem and back pain (flank pain) that is caused by a kidney or bladder infection or a kidney stone.

Back pain that is caused by a bone or muscle problem:

  • Occurs in the lower back; below the waist; or in the upper back, over the spine or between the shoulder blades.
  • Gets worse with movement.

Flank pain that is caused by a kidney infection or a kidney stone:

  • Is pain felt just below the rib cage and above the waist. Flank pain can be on one or both sides of the back.
  • May spread to the bladder area or genitals.
  • Gets worse as the bladder fills.
  • Does not get worse when a person moves.

Flank pain with fever and urinary symptoms may mean a kidney infection (pyelonephritis) is present.

Back Pain: Acupuncture and Massage

How can you move in ways that protect your back?

The way you use your body is called body mechanics. Pay attention to how your body mechanics affect your back. When you lift, bend your knees and flex from your hips. Don't let your spine slump. If lifting makes your symptoms worse, try to not bend, lift, or reach.

Avoid or change movements that cause pain. For example:

  • Use the upper rack of the dishwasher and "mid-height" cupboard shelves to avoid reaching and bending.
  • Walk or swim for exercise instead of jogging.
  • Rake leaves using the opposite arm from your usual side.
  • Perch on a high stool for kitchen or workbench tasks.
  • Put one foot on a low stool (and switch back and forth) if you have to stand for a while.
  • Shower instead of bathing to avoid having to get in and out of a tub.

Who can diagnose and treat back pain?

Health care professionals who often diagnose the cause of back pain include:

  • Primary care providers. Examples are:
    • Family doctors.
    • Internists.
    • Osteopathic physicians.
    • Chiropractors.
    • Physical therapists.
    • Nurse practitioners.
    • Physician assistants.
  • Emergency doctors.

If your back pain is severe or long-lasting, health professionals who can treat you include:

  • Orthopedists.
  • Rheumatologists.
  • Neurologists.
  • Neurosurgeons.
  • Physiatrists.

You can also get care from:

  • Acupuncturists.
  • Certified massage therapists.

What can you do first to relieve back pain?

When you first feel back pain, try these steps:

  • Walk. Take short walks several times a day. You can start with 5 to 10 minutes 3 or 4 times a day and work up to longer walks. Walk on level surfaces and avoid hills and stairs until your back is better.
  • Relax. Find a comfortable position for rest. Some people are comfortable on the floor or a medium-firm bed with a pillow under their head and another under their knees. Some people prefer to lie on their side with a pillow between their knees. Don't stay in one position for too long and avoid bed rest after the first day of back pain.
  • Try heat or ice. Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of using the heating pad once a day. Or you can buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. You can use an ice pack or a bag of frozen vegetables wrapped in a thin towel. There is not strong evidence that either heat or ice will help, but you can try them to see if they help. You may also want to try switching between heat and cold.
  • Take pain medicine exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Having sex when you have back pain

Healthy, satisfying sex is very important for relationships. And the fear of having sex because of back pain can be a big problem. If your sex life has suffered because of back pain, take heart. Many people have faced this problem. And there are steps you can take to deal with it.

  • Talk to your doctor.

    This can be hard, because some people are embarrassed to talk about sex. But you need to find out which sexual positions may be good or bad for your back. Some back problems cause pain when you bend forward. Others cause problems when you arch your back. Just remember that doctors hear these questions all the time. They can give you tips that may help you.

  • Talk to your partner.

    Your partner can't possibly know what hurts and what doesn't. You have to tell your partner. And if the thought of having pain during sex scares you, talk about that too. Discuss which movements are comfortable for you and which aren't.

  • Go slow.

    Sex is like exercise. Warming up and stretching first are important. A hot shower will help relax your muscles. A massage can be soothing. Many people use yoga to gently stretch their muscles. When you're ready to have sex, keep your movements slow and gentle.

  • Be prepared to try new things.

    You may need to try positions you've never thought about before. You may need to use a firmer surface than your mattress, such as a nice soft rug on the floor or even a sturdy chair. Oral sex might be easier than intercourse for some.

  • If it hurts, stop.

    That may seem obvious. But when things get passionate, it can be hard to stay in control. Try to keep it slow so that you can stop right away if your back starts to hurt.

How can support help when you have back pain?

When your back hurts all or most of the time, it can affect more than just your body. There's an emotional side to chronic pain. Family members and friends can help you cope by giving you comfort and encouragement. Support groups can be a great source of comfort and advice.

Back Pain: What Is It?

What causes back pain?

In most cases, there isn't a clear cause. Back pain can be caused by overuse, strain, or injury. For example, people often hurt their backs playing sports or working in the yard, being jolted in a car accident, or lifting something too heavy.

Aging plays a part too. Your bones and muscles tend to lose strength as you age, which makes injury more likely. The spongy discs between the bones of the spine (vertebrae) may suffer from wear and tear and no longer provide enough cushion between the bones. A disc that bulges or breaks open (herniated disc) can press on nerves, causing back pain.

In some people, back pain is the result of arthritis, broken vertebrae caused by bone loss (osteoporosis), illness, or a spine problem.

Although most people have back pain at one time or another, there are steps you can take to make it less likely.

Sleeping With Back Pain

Picture of sleeping positions for people who have low back pain

Sleeping can be hard when your back aches. You toss and turn, and it hurts.

Try to sleep with your back in a neutral position-not arched a lot, but not flat either. This takes pressure off your spine. These two positions can help:

  • When sleeping on your side, place a pillow between your knees. Try to keep your top leg from falling over your bottom leg. You also can put a small, rolled-up towel under your waist.
  • When sleeping on your back, place a pillow under your knees. You also can put a small, rolled-up towel under the curve of your back.

Many people find that these positions work for them, but they may not work for you. Find the position that helps you the most.

If you have a very soft mattress, you may be more comfortable if you sleep on the floor.

To rise from bed:

  • Roll onto your side and bend both knees.
  • Drop your feet over the side of the bed as you push with both arms to sit up.
  • Scoot to the edge of the bed and position your feet under your buttocks.
  • Stand up, keeping your back in the neutral position.

Back pain: When to call

Call your doctor now or seek immediate medical care if:

  • You have new or worsening numbness in your legs.
  • You have new or worsening weakness in your legs. (This could make it hard to stand up.)
  • You lose control of your bladder or bowels.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a fever, lose weight, or don't feel well.
  • You do not get better as expected.

How can physical therapy help with back pain?

Physical therapy may help you when back pain makes it hard to move around and do everyday tasks. This treatment helps you move better and may relieve pain. It also helps improve or restore your fitness level and how well you function.

The goal is to make daily tasks and activities easier. For example, physical therapy may help with walking, going up stairs, or getting in and out of bed.

Your physical therapist will examine you and make a treatment plan. You may need help with flexibility, strength, endurance, coordination, and/or balance.

This treatment almost always includes exercise. It can include stretching, core exercises, weight lifting, and walking. You may learn an exercise program so you can do it at home.

The therapist also may use manual therapy, education, and techniques such as heat, cold, water, ultrasound, and electrical stimulation.

Physical therapy may be used alone or with other treatments.

Patty's story: Using positive thinking to help back pain

Patty, 33
Patty's positive thinking helps her back pain.
"I really work at finding the good things in my day. It helps me get through the day, and I think it makes my pain not bother me as much."

Sometimes Patty doesn't know whether to laugh or cry when one of her three kids runs at her for a flying hug. She loves the affection, but picking up her kids all the time is one reason the 33-year-old third-grade teacher has back pain. She tries to smile and gently remind her kids to hug mommy with their feet on the ground.

Patty feels pretty good most days, even with back pain that comes and goes. "I've learned over the last few years to try to focus on what I can do. I'm lucky that my pain is just nagging, not debilitating. But still, it can make me really cranky with my kids at home and with my kids at school."

Patty did some reading on the mind-body connection. She learned that the things she tells herself about what's going on in her life and how she feels about it can make her pain worse—or better. "So I really work at finding the good things in my day. It helps me get through the day, and I think it makes my pain not bother me as much," she says.

Stopping negative thoughts to reduce pain

Patty walks a lot, swims, and does exercises for her back. And she now sits next to her kids when they want a hug. But she also works at thinking in a positive way.

"I used to feel so discouraged whenever my back would hurt again," Patty says. "I would tell myself that it was never going to get better."

She learned to notice when she had those negative thoughts. "I would catch myself thinking, 'Why do I bother exercising? The pain is just going to come back.' But instead of keeping on that train of thought, I would say to myself, 'Exercise has helped my back before. I know it will make my back stronger if I stick with it.'"

"I started keeping a 'pain diary.'" I write down when my pain is bad. I also write down what helps and what doesn't, along with a quick note about how I'm feeling.

"I also started using something my counselor told me about. Whenever I start thinking negative thoughts, I close my eyes and then picture my mind as a sky and my thoughts as clouds. When a negative thought comes up, instead of fighting with it or trying to stop it, I just note that it has come into mind. I don't judge it as good or bad, or that it will last forever, because it is just a thought. And like passing clouds in the sky, my negative thoughts will also move along. It's funny, but by accepting the thoughts as they are and not judging them, I find that they lose their power and allow me to let go of them more easily. This method works better some days than others—it depends on how stressed I am about other things. But most of the time, it really does help.

"This, plus keeping my pain diary, has really helped me to feel more in control."

This story is based on information gathered from many people facing this health issue.

©2011-2024 Healthwise, Incorporated

The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.

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