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The Ultimate Guide to Back Pain and Its Causes

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Millions of people all over the world suffer from back pain issues. Back pain may be caused by a number of reasons from injuries to serious medical conditions. There are specific symptoms associated with many back pain diagnosis, and most can be treated using medication, therapy, or surgery.

Here we will discuss the different types of back pain and their causes, as well as what you can do to help alleviate your pain.

Table of Contents

What are the Common Causes for Back Pain?

There are several factors that cause upper and lower back pain to occur. Pinpointing the exact cause of the problem is the best way to discover the optimal form of treatment for your pain.

Some of the most common causes for upper or lower back pain include,

  • Overuse
  • Muscle strain
  • Aging
  • Injury to the muscles, ligaments or discs that provide support to the spine.
  • Poor posture
  • Pressure on the spinal nerves which can be caused by disc issues
  • Arthritis, Osteoarthritis, or other underlying conditions
  • Compression fractures
  • Illness
  • Issues of the spine such as scoliosis
  • Myofascial pain that affects the connective tissues of the muscles in the back.

Your doctor can help determine the cause of your pain by performing a physical exam, imaging tests, and discussing your medical history. Fortunately, there are effective treatment options available for most back pain problems.

General Back Pain

Compression Fracture

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A compression fracture occurs any time one or more bones located in the spine weaken or crumple. There are more than 200,000 cases of compression fractures in the United States each year.

Compression fractures are often caused by the loss of bone mass (or osteoporosis) which often happens as we get older. These fractures can also be caused by a fall cough, or lifting a heavy object.

The symptoms of a compression fracture includes:

  • Back pain
  • Loss of height
  • A hunched-forward posture

Treatment for a compression fracture includes:

  • Physical therapy
  • Medication to relieve the pain
  • Surgery

You can receive these treatment options or be referred by your medical doctor, orthopedic surgeon, endocrinologist, or physical therapist.

Scoliosis

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Scoliosis is the sideways curvature of the spine. It occurs most often during puberty and most cases are considered mild with very few symptoms. There are some individuals who may develop deformities of the spine which become more severe as children grow into adults. Severe forms of scoliosis are painful and disabling.

The symptoms of scoliosis include pain in the back and leaning to one side. Those with the disorder also experience muscle deformities, an uneven waist or other physical deformities.

Treatment for scoliosis includes:

  • Using a back brace
  • Bone grafting or spinal fusion surgery
  • Physical therapy

Conditions That Can Cause Upper and Lower Back Pain

There are a number of conditions that can cause upper or lower back pain to occur, some of which you may not think about when trying to determine the cause of your pain.

Some individuals may already have a diagnosis for these conditions such as osteoarthritis or endometriosis, before their back pain begins. While others, may find out about these underlying conditions when their doctor has eliminated every other cause for their back pain. Here are a few of the most common health conditions that can lead to upper or lower back pain.

Arthritis

Arthritis, also known as joint inflammation causes pain in one or more joints as well as stiffness that worsens with age. There are many different types of arthritis and each one has different causes and treatment options. They can be caused by general wear and tear, infections, or other underlying diseases.

Symptoms of arthritis include:

  • Pain
  • Swelling
  • Reduced range of motion
  • Body stiffness

Treatment for arthritis includes taking over the counter pain medication such as NSAIDs and other anti-inflammatories, physical therapy and in some cases, surgery.

Arthritis can affect all areas of the body including the spine. This can lead to severe pain in the back. The symptoms of arthritis of the spine include

  • Pain that is mostly in the back that radiates tot eh buttocks or feels like it is in the hip area.
  • Burning sensation on the outer aspect of the thigh or a pain going down their leg
  • Sometimes arthritis of the spine is confused with nerve root pain because it goes down the leg.

Osteoarthritis

Osteoarthritis is also known as OA or degenerative joint disease. It is a type of arthritis that occurs when the tissue located at the ends of the bones wears down. This condition affects more than 3 million people in the United States each year. It is one of the diseases that cause chronic pain.

While osteoarthritis may not be considered a type of back pain because it affects other parts of the body as well, it is known for causing serious lower back and neck pain.

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The symptoms of osteoarthritis include:

  • Pain in the joints, hands, hip, knees, lower back or neck. This pain can be moderate to severe.
  • Stiffness in the joints as well as swelling, crackles or tenderness
  • Bumps on the fingers or bony outgrowths in fingers and toes
  • Limping or joint deformity

Treatment for Osteoarthritis includes:

  • Self-care such as physical exercise, losing weight, and applying menthol or ice packs to the affected area
  • Taking medications such as NSAIDs or other anti-inflammatory drugs. There are also dietary supplements that can help
  • Therapies such as hydrotherapy, stretching, acupuncture and physical therapy

You can also read our article, "10 Upper Back Pain Stretches & Exercises" where we go into specific ways to treat osteoarthritis and fibromyalgia through various stretches you can accomplish at home.

Fibromyalgia

Also known as fibrositis, fibromyalgia is a widespread form of muscle pain and tenderness. There are more than 3 million cases of fibromyalgia reported each year. It is often accompanied by common symptoms such as fatigue, memory loss, altered mood and lack of sleep. Pain and tenderness throughout the body, including the back,  are also common symptoms.

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Treatment options for Fibromyalgia include

  • Taking pain medication
  • Therapy
  • Stress reduction
  • Stretching and Exercise

The Most Common Back Pain Conditions and Their Causes

There are several different types of back pain and they can occur in either the upper back or the lower back. There are also some types of pain that can show up in both areas of the back. Here are some of the most common types of upper and lower back pain causes and what you or your doctor can do to help alleviate this pain.

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Upper Back Pain

The upper back, otherwise known as the thoracic spine, is made up of 12 vertebrae which are all stacked on top of one another. They are labeled as T1 through T12. These vertebrae create the foundation of the strong spinal column which supports the rib cage, the neck, soft tissues, blood vessels, flexible joints, and our nerves.

Thoracic Spine

The thoracic spine works to protect the spinal cord and anchors the rib cage. Unlike the cervical spine and the lumbar spine which are designed to provide us with mobility, the thoracic spine is built to offer stability.

Common Thoracic Spine Pain Issues

Issues with the thoracic spine are one of the leading causes of back pain. Pain in the upper back area is often due to one of the following conditions. These are considered to be thoracic back spine red flags.

Muscular irritation

One cause of upper back pain is muscle irritation and tension. This is also referred to as myofascial pain. The cause of this pain is often due to poor posture. It can also be caused by any other type of irritation to the back and shoulder muscles like muscle strains or spasms.

Joint Dysfunction

The thoracic spinal joints become painful for various reasons. The cartilage may tear, or degeneration can start in the facet joints. This is the area where the adjacent thoracic vertebrae articulate with one another. A rib may also become displaced from the vertebrae or misaligned. In most cases, facet joint degeneration (another term for osteoarthritis), and degenerative disc disease can occur at the same time.

Treatment for Thoracic Spine Pain

Since more people suffer from neck and lower back pain than thoracic spine pain, there are fewer treatments available for this part of the spine. There is also less known about T-spine pain than other parts of the cervical and lumbar regions.

If you are looking for treatment options for thoracic spine pain, you can schedule an appointment with your regular doctor, a chiropractor, physical therapist or a massage therapist who can provide relief for this type of pain. You can also try thoracic spine exercises, stretches and supportive braces for treatment.

Several of our readers have been reporting that our supportive brace, BackBuddy, has left a huge impact on posture correction and has even relief symptoms of spinal stress.  Developed by chiropractic specialists, the BackBuddy support system gently restores the natural curvature of your spine mainly caused from daily slouching.

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Shoulder Blade Pain

Common Shoulder Blade Pain Causes

The most common reason shoulder blade pain occurs is due to injury in the area, affecting either the tendon or the muscle.  This type of incident can be cause by several factors but the most notable are:

  • Improper Posture
  • Lifting heavy objects
  • Injury cause by exercise
  • Trauma
  • Poor posture influenced by electronic devices 

Typically, shoulder blade pain shouldn't be too concerning.  There are several things that can be done at home, or with the help of over the counter solutions.

Treatment for Pain In Between the Shoulder Blades

With any treatment, it's always best to take care of the situation at the first sign of discomfort.  Muscular imbalances compound daily and before you know it, could rise to affect mobility and in worst case the tendons.  Before you know it, more than just a strain can put you off for more than a week.

Properly treating pain between the shoulder blades is relatively easy, but its the patience and the persistence that will be the hard part.  The best part is that most of this could be treated at home with the help of proper stretches.

However, if the pain becomes severe.  We do advise that you seek professional help from a medical practitioner.

Middle Back Pain

Herniated Disc

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A herniated disc, also known as spinal disc herniation, or a bulging disc,  is a condition that occurs when the soft center of the spinal disc presses through a crack in the tough exterior casing. Sometimes, a herniated disc will not cause any pain or issues. Others may irritate the nerves located nearby and cause the individual to experience pain, weakness or numbness in their arm or leg.

Herniated disc pain can cause these middle back pain symptoms to occur.

  • Pain in the arms, back, foot, or leg
  • Pain the middle of the back
  • Pain in the middle right side of back
  • Pain in between the shoulder blades
  • Muscle weakness, muscle spasms or overactive reflexes
  • Leg numbness, pins and needles feeling, uncomfortable tingling or numbing sensations
  • Foot and/or hand numbness or neck stiffness

While not every herniated disc requires treatment, there are some treatment options out there for those who need it. Herniated discs can be located in different areas, for instance a thoracic herniated disc can cause severe pain in the mid-back area while a lumbar herniated disc causes pain to occur in the lower back.

Treatment for herniated disc pain includes:

  • Self-care such as using a heating pad or exercising
  • Taking medication such as NSAIDs
  • Therapy sessions such as physical therapy and chiropractic care
  • Medical procedures like therapeutic ultrasounds or epidural steroid injections
  • Spinal surgery may also be required if no other treatment options work

Pinched Nerve

A pinched nerve, also known as a compressed nerve, can cause back pain to occur. When a nerve is pinched the flow of fluid from the nerve cell body is often halted. This causes the nerve’s membrane to lose its ability to transmit electrical charges. The nerve fibers die eventually and that causes the fibers to stop working. This can lead to muscles not contracting or numbness.

Pinched nerves can be caused by a number of factors including herniated discs or bone spurs that are a result of spinal arthritis. A pinched nerve in lower back can be extremely painful.  Muscle spasms, weakness and numbness are common issues associated with pinched nerves.

To treat a pinched nerve:

  • You an use hot and cold compresses on the affected area
  • Take a hot shower to relieve the pain
  • Use a handheld massager
  • Get a massage from a professional
  • Lie down with a rolled up towel underneath your neck

Radiculitis, Radiculopathy, and Radicular Pain

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Radiculitis is a term often used to describe radiculopathy. Radiculitis refers to the spinal nerve root when it becomes inflamed either part or all the way into the patient’s extremity. It causes upper back pain.

Radicular pain and radiculopathy are not the same thing. Radicular pain is a symptom that lets you know something is wrong. Radiculopathy on the other hand, is the process of the disease itself.

Radiculopathy leads to radicular pain. But it doesn’t represent the total symptom spectrum of radiculopathy. These symptoms include:

  • Numbness
  • Weakness
  • The feeling of pins and needles
  • Burning or shock sensations that go down the extremities

Treatment for Radiculitis include:

  • Taking NSAIDs or other anti-inflammatory drugs
  • Losing weight to relieve pressure on the problem areas
  • Physical therapy
  • Steroid injections

Some individuals may require more advanced forms of treatment such as surgery to relieve the pressure of the nerve root by widening the area where the root exits the spine. This is an alternative if all other treatment options fail.

Facet joint syndrome

Facet joint syndrome is pain that is located at the joint between the two vertebrae of the spine. Another common term for this issue is osteoarthritis. It is one of the most well-known causes of middle back pain.

Facet joint syndrome is caused by several factors such as aging, an overload of pressure at the joints, or injury.

The symptoms of facet joint syndrome include:

  • Difficulty twisting or bending the spine
  • Pain
  • Numbness
  • Muscle weakness

Treatment for Facet Joint Syndrome can involve therapy, rehabilitation, spinal injections and surgical treatment.


    Lower Back Pain

    The lumbar spine is the section of the lower back that curves inward toward the abdomen. This section begins about five to six inches below the shoulder blades and connects the thoracic spine at the top, as well as the sacral spine below.

    Lumbar Spine

    Like the thoracic spine, the lumbar spine is made up of several important vertebrae.

    • The lower vertebrae located in the spinal column bears most of the weight of our bodies. The five vertebrae (L1-L5) are the largest infused vertebrae in the entire spinal column. Their size allows them the support the entire weight of our torso.
    • The lower two spinal segments of the lumbar spine, the L4-L5 and the L5-S1, include the vertebrae and the discs. Because these areas are impacted by the most weight, they are prone to injury and degradation more than the other vertebrae.
    • The lumbar spine connects with the sacrum located at the lumbosacral joint (L5-S1) This joint allows for ease of rotation so that our hips and pelvis can swing naturally while we walk or run.

    The following can lead to pain in the lumbar spine.

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    Lumbar Disc Herniation

    Lumbar herniated discs or torn lumbar discs often occur in the lumbar spine. It can occur due to an injury or after heavy lifting.

    Muscular Problems

    As with the thoracic spine, muscular problems such as strains can also lead to lumbar spine pain. Muscle strains can be caused by heavy lifting, bending or other types of repetitive use.

    Degenerated Discs

    The intervertebral discs are sponge-like pads that work as shock absorbers for our spine’s vertebrae. Degenerated discs can cause pain to occur in that open space. This condition is known by many terms, including degenerative disc disease, which is discussed in more detail below.

    Treatment for Lumbar Spine Pain

    Treatment for lumbar spine pain include:

    • Over the counter pain medication such as NSAIDs and other anti-inflammatories
    • Muscle relaxers
    • Topical pain relief cream
    • Injections
    • Exercises and stretches for lower back pain
    • Posture braces like the PosturePerfect

    Degenerative disc disease

    Degenerative disc disease occurs when the discs that provide a useful cushion for the cervical spine begin to break down, usually as a result of ongoing wear and tear.

    The symptoms of degenerative disc disease include:

    • Upper Back Pain
    • Lower back pain
    • Neck pain
    • Nerve Pain
    • Numbness and tingling of the arms, hand, and/or fingers
    • Pain that worsens with movement

    Degenerative disc disease can be diagnosed by a medical professional performing a physical exam or an imaging test such as an MRI, X-Ray or CT scan.

    Treatment for degenerative disc disease includes changes in your lifestyle, rest, pain management with medication or injections, and ice or heat therapy.

    Spinal Stenosis

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    Spinal stenosis is the narrowing of the spinal canal. There are more than 200,000 cases per year. This disorder puts pressure on the spinal cord and the nerves that are located within the spine. It occurs in the neck and lower back. This condition is caused by wear and tear over the years

    The symptoms of spinal stenosis include:

    Treatment for spinal stenosis includes medication, physical therapy and in some cases, surgery.

    Sciatica

    Sciatica is a term used to describe the symptom of radiating pain that goes into the buttock, leg or hip. Once of the most common causes of sciatica is radiculopathy. Other causes include lumbar disc herniation and spinal stenosis.

    There are several things that you can do to treat sciatica on your own at home. You can apply a hot or cold pack to the affected area for 15 to 20 minutes, or take an anti-inflammatory drug. Natural supplements such as turmeric and curcumin have been known to lower the inflammation associated with sciatica.


    Acute Pain, Subacute Low Back Pain, and Chronic Back Pain

    Along with the many types of back pain linked to various diseases and disorders, it is also possible to suffer from general back pain not caused by any underlying condition. This pain can be either acute, subacute, or chronic.

    • Acute back pain is a  type of pain that is present for at least six weeks. The symptoms include an aching, burning, stabbing, sharp or dull pain. It can range in intensity from mild to severe and may even fluctuate or radiate to the hips, thighs or buttocks.
    • Subacute low back pain is the same as acute pain, only it has been present longer. Usually subacute pain exists between six weeks and three months.
    • Chronic back pain is a type of lower back pain that the patient has experienced for longer than three months. It is often associated with some type of injury or trauma to the back.

    Mechanical pain (Axial pain)

    Mechanical pain, also known as Axial pain is one of the most common forms of lower back pain. This type of pain is characterized as,

    • Lower back pain that becomes worse with certain activities such as exercise or playing sports
    • Lower back pain that becomes worse after staying in the same position for long periods
    • Lower back pain that is relieved by rest

    Treatment for Axial lower back pain include:

    • One or two days of rest
    • Physical therapy sessions
    • Applying ice or heat to the affected area
    • Taking medication such as NSAIDs for pain relief

    Claudication Pain

    Claudication is cramping or pain in the lower legs due to poor blood circulation. The pain can often cause the person to limp. Other symptoms of this condition include sharp, dull, aching, throbbing or burning pain. Calf pain is the most common location for leg cramps. That is because of the atherosclerotic plaques that begin in the arteries farthest away from the heart.

    Treatment for claudication pain includes:

    • Medication that helps to improve blood flow or widen the arteries
    • A surgical procedure known as a revascularization
    • Surgical grafting or bypassing an artery
    • Compression therapy

    Ligament sprain or Lower Back Sprain

    A ligament sprain is a stretch or tear in a ligament. These are very common in athletes and can occur in various parts of the body, such as the ankle, wrist or knee. You can also suffer from sprains in the lower back area.

    The muscles and soft tissue in the back can become strained or sprained due to abnormally stretching or twisting. They can also be a result of a sudden injury or overuse of the muscle.

    Symptoms of lower back sprains include:

    • Pain or stiffness in the back
    • Pain in the buttocks and legs, usually in the back of the thigh
    • Pain that gets worse when bending, stretching, coughing or sneezing

    Treatment for lower back strain include:

    • Applying ice to the affected area
    • Applying heat to the affected area
    • Taking painkillers such as NSAIDs

    Endometriosis

    Endometriosis is a disorder that occurs in women where the tissue that usually lines the uterus grows on the outside. With is condition, the tissue can be located on the ovaries, the fallopian tubes, or even the intestines. The most common symptoms include pain and menstrual irregularities. Endometriosis is also known to cause ongoing pain in the pelvis and lower back. It is one of the most common women lower back pain causes.

    Treatment for endometriosis includes hormone therapy and excision surgery.

      Living with any type of back pain can put a great amount of stress on your life. Back pain can range from moderate to severe, and it may be caused by a number of factors. It can be difficult for experts to pinpoint the exact cause of your back pain without performing any type of diagnostic tests. But once they diagnose your condition, they can usually come up with treatment options that can help.

      Sometimes life changes, therapy, or pain medication can do the trick. But it is also possible for many back pain sufferers to require surgery in order to receive the optimal amount of relief for their pain.