Back Injuries

What does it mean to "injure your back?" Your back is made of bones, muscles and other tissues extending from your neck to your pelvis. Back injuries can result from playing sports, working around the house or in the garden, low- or high-speed car accidents, lifting heavy objects or a fall.

The lower back is the most common site of back injuries and back pain. Common back injuries include:

Sprains and strains: When you overstretch a muscle in your back or tear a ligament, the area around the muscles will usually become inflamed. The inflammation leads to a back spasm, and it is the back spasm that can cause both severe lower back pain and difficulty moving. This is because the spasm immobilizes the muscles in the injured area, acting as a splint to protect the ligaments and joints from further damage.

Herniated discs: When a patient has a symptomatic herniated disc, the disc itself is not painful but rather the material leaking out of the inside of the disc is pinching or irritating a nearby nerve. This type of pathology produces radicular pain (for example, nerve root pain), leading to pain that may radiate to other parts of the body, such as from the low back down the leg or from the neck down the arm.

Fractured vertebrae: Fractures range from simple compression fractures, in which the bone collapses upon itself, getting pushed together; to burst fractures, when pieces of bone explode out into the tissues around the spine, including the nerves and spinal cord. The worst of these injuries is called fracture-dislocation, in which the bone breaks but, because the ligaments are torn as well, the bones slide away from each other.

These injuries can cause pain and limit movement. Treatments include many different conservative modalities, including medicines, icing, bed rest and physical therapy, and interventions that include steroid injections or surgery. You might be able to prevent some back injuries by maintaining a healthy weight, keeping a strong core and using proper body mechanics while lifting objects with your legs.

In general, if the pain has any of the following characteristics, it is a good idea to see a physician for an evaluation:

  • Back pain that follows an accident, such as a car accident or falling off a ladder
  • Ongoing back pain that is getting worse
  • Pain that continues for more than four to six weeks
  • Pain that is severe and does not improve after a few days of typical remedies, such as rest, ice and common pain relievers (such as ibuprofen or Tylenol)
  • Severe pain at night that wakes you up, even from a deep sleep
  • Back and abdominal pain
  • Numbness or altered feelings in the upper inner thighs, groin area, buttock or genital area

The bottom line is that if you are in doubt, consult a physician. If back pain is getting worse over time, it does not feel better with rest and over-the-counter pain remedies, or it involves neurological symptoms, then it is advisable to be evaluated by a back-pain doctor.