Back pain: Why does it hurt so much?

If you have back pain, you are in good company. It is estimated that 75 to 85 percent of Americans will experience some form of back pain during their lifetime. Back pain is second only to headaches as the most common neurological ailments and the most common cause of job-related disability, doctor visits and missed work.

Your pain can arise if there is a problem with any of the structures in the back (bones, muscles, ligaments, tendons and discs). Sometimes you can not determine the reason for your back pain, but here are some major causes for the pain.

Strains: Muscles and ligaments can get strained if you don't lift properly, do heavy lifting or after a sudden awkward movement.

Injuries: Sprains and fractures can cause short-lived or chronic pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractures may be caused from accidents and falls. These are less common, but sometimes more severe injuries.

Structural Problems: Structural problems are like bulging or ruptured/herniated discs, sciatica, arthritis, skeletal irregularities, osteoporosis, and disc degeneration. Bulging or ruptured/herniated discs. Discs serve as cushions for the vertebrae. If this cushion bulges out of place or ruptures it can press on a nerve causing pain.

Sciatica: If your disc bulges or herniates and presses on the main nerve that travels down your leg, it can cause sciatica (sharp, shooting pain through the buttock and back of the leg.)

Arthritis: Pain can occur when arthritis in the spine causes a narrowing of the space around the spinal cord.

Skeletal irregularities: If your spine curves abnormally, this can cause back pain. An example of skeletal irregularities is scoliosis (a curving of the spine to the side).

Osteoporosis: If you develop osteoporosis, your spine's vertebrae can become porous and brittle. This can cause compression fractures in your spine.

Disc degeneration: This happens when the discs break down with age. Standing for a long time, stiffness upon awakening or a feeling of pain after walking may be due to the stress on the spine due to disc degeneration. It is the most common cause for back pain.

Four work-related factors associated with increased risk of back pain and injury are:

Force. When you frequently lift or move heavy objects this exerts too much force on your back and may cause injury.

Repetition. When you perform the same task over and over, this can lead to muscle fatigue or injury. You are stretching the limit on your range of motion.

Posture. Watch your posture when sitting, standing, or performing a task. If you are not following good posture guidelines, you can experience occasional aches and pains when sitting in the same position for more than 20 minutes.

Stress. Muscle tension and tightness can be caused by pressures at work or at home. This tension and tightness can lead to back pain.

Warning signs for back pain that may need immediate doctor attention:

• numbness or tingling;

• pain that goes down your leg below your knee;

• severe pain that doesn't improve with rest (one to two days only because prolonged rest can make back pain worse and decrease function);

• severe pain that doesn't improve within three days;

• pain after a fall or injury;

• pain plus any of these problems: trouble urinating; numbness in your leg, foot, groin or rectal area;

• nausea, vomiting, stomachache; weakness; sweating; or fever; or unexplained weight loss.

For more info on back pain, the Extension Service health specialists have put together a resource, which you can find at healthhints/2009/jul/back-pain. pdf.

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2009-07-16 digital edition

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