Chronic Back Pain

While most back pain is caused by muscle strain, injury or spinal deformity, it can also be caused by a systemic or rheumatic illness. Pain is considered chronic when it is present for more than six months.

Back pain can develop anywhere from the neck to the lower spine. The pain can be localized or spread across a wide area and radiate from a central point.

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Symptoms

In addition, the exact cause of pain may be difficult to identify since it can originate in soft tissue, bone, discs or nerves. People who smoke, work at jobs that require repetitive or heavy lifting or involve vibration from vehicles or industrial machinery are more likely to develop low back pain. Certain sports, such as cross-country skiing, or driving a vehicle for a long time can also cause back pain.

Diseases such as spinal osteoarthritis, spondylitis and compression fractures can also cause pain. Some of these diseases are more prevalent in the elderly; consequently older people are at higher risk for back pain.

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Diagnosis

The doctor needs to decide if the pain comes from bones, muscles, nerves or an organ. The doctor will take a careful history and perform a physical examination. Injecting an anesthetic or a steroid or both into the soft tissue or joint spaces can help to both diagnose and treat back pain. Imaging procedures to help identify where the pain is coming from include X-rays, bone scans, computerized tomography (CAT scan) and magnetic resonance imaging (MRI).

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Treatments

Pain relievers, such as aspirin, acetaminophen and non-steroidal anti-inflammatory drugs are often the only treatment needed for back pain. Patients should avoid any activity that makes the pain worse. If the pain doesn't go away, additional consultations may be needed so that treatment can be directed at the specific cause of pain.

Sometimes, such as after back surgery a mechanical back supports may be recommended for a limited time. Injections with local anesthetics and steroids can help alleviate the pain. When other types of treatment don't work, surgery can be helpful. Physical and occupational therapy are important forms of treatment.

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