What is back problems and injuries?

Most people will have a minor back problem at one time or another. Our body movements usually don't cause problems. But sometimes symptoms can develop from everyday wear and tear, overuse, or injury. Back problems and injuries often occur during sports or recreation 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 often occur when you use your back muscles in activities that you don't do very often. This can be things like lifting a heavy object or doing yard work. Minor injuries also may occur if you trip, fall a short distance, or twist your spine too much. A severe back injury may be caused by a car crash, a fall from a high place, a direct blow 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.

Back pain is often caused by an injury to one or more of the structures of the back. But it may have another cause. Some people are more likely to have 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 too long, lifting or pulling heavy objects, and having a degenerative disease such as osteoporosis.

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 that 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 teens. It's often caused by overuse or repeated activities like carrying a backpack. But children and teens are less likely to see a doctor for low back pain. Most back problems occur in adults ages 20 to 50. But back problems in children younger than 20 and adults 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 occur soon after the injury. Pain from an acute injury usually doesn't last longer than 6 weeks. Acute injuries include:

• An injury to the ligaments or muscles in the back. Examples of this are a sprain or a strain.
• A fracture or dislocation of the spine. It can cause a spinal cord injury that may lead to lifelong paralysis. It's important to immobilize the injured person and then move him or her the right way to reduce the risk of lifelong paralysis.
• 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.
• An injury that causes the compression of nerves in the lower back (cauda equina syndrome).

Overuse injuries

You may not remember a specific injury, especially if your symptoms began slowly or during everyday activities. These injuries occur most often from a wrong movement or posture when you lift, stand, walk, sit, or even sleep. 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 pain or problems may not be related to an injury. Some other causes include:

• Conditions that weaken the spine. These include ankylosing spondylitis, osteoarthritis, osteoporosis, spinal stenosis, and Paget's disease. They are most common in older adults. In rare cases, tumors or infections can form in or around the spine.
• Some medical conditions that 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. These include scoliosis, kyphosis (Scheuermann's disease), and spondylolisthesis.
• Chronic pain syndrome caused by a past injury or degenerative disease with aging.

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's caused by minor injuries. It's usually a good idea to keep doing 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, physical therapy, manipulative therapy (such as chiropractic), and medicine. In some cases, surgery is needed. Treatment depends on:

• The location and type of injury, and how bad it is.
• Your age, health condition, and activities (such as work, sports, or hobbies).