back pain Basics

Understanding and Overcoming Back Pain: Causes, At-Home Remedies, and Professional Solutions

Back pain has become a global issue. The WHO (World Health Organization) states that more than 600 million people were affected by low back pain in 2020. They project 850 million will be affected by 2050. This means a very significant portion of the population will be affected by back pain at some point in their lives.

Back pain is the leading cause of disability globally. It affects people’s ability to work and perform basic daily self-care activities. This translates to lost productivity and a large economic burden on the person experiencing the pain as well as family.

What causes back pain?

Poor Posture

Our sedentary lifestyles, hunched over desks and computers, and poor posture are big contributors to the epidemic.

Sprains and strains

When you lift heavy things, or swing a golf club too many times, you could end up with a strain or sprain that causes back pain.

The symptoms can be similar (pain, swelling, bruising and limitation of movement) but the injuries are different. A strain is an injury to a muscle or tendon. Tendons are cords that connect muscles to bones. Strains occur when a muscle or tendon is overstretched or torn.

A sprain is an injury to a ligament. A ligament is a very strong band of tissue connecting two bones across a joint. Sprains happen when a ligament is stretched, torn, twisted as a result of a sudden violent movement.

Both strains and sprains are graded from Grade I to III based on the severity of the injury. The higher the grade, the worse the injury and the longer it will likely take you to heal.

Aging 

As the population ages, there is a natural increase in the incidence of degenerative diseases, (diseases which cause the deterioration of the structure or function of organs and tissues) affecting discs, nerves and bones; degenerative disc disease includes conditions like herniated discs, adult scoliosis, spinal stenosis and spondylolisthesis.

Back pain is a global issue affecting millions of lives. Most of us, and probably you, will experience debilitating back pain at some point in your life. 

What are the different types of back pain?

What causes upper back pain?

Muscle strain

If your upper back hurts, it could be because you’ve strained your muscles hunching over your desk, looking at your computer screen or because you leaned forward one too many times during manual labor or sports. Booth poor posture and repetitive motion are common causes of muscle strains that lead to upper back pain.

Sore muscles and pinched nerves are not the only causes of upper back pain. Other tissues can cause problems as well.

Fascia knots

The fascia, a web of thin, strong tissue that encases muscles, tendons and organs can develop tightness and knots referred to as trigger points. Recent research has shown that fascia is densely packed with nerves and is a key creator and transmitter of pain. 

Often the knot in fascia transmits pain to a distant location in the body. Upper back pain can be caused by knots or trigger points in the shoulder blades, neck and chest.

Herniated disks

Another common cause of upper back pain is thoracic disc herniation is the bulging or rupturing of intervertebral discs in the thoracic spine. This can compress or irritate adjacent nerves causing very intense pain radiating to the back, ribs and arms. Have you ever tried to get off your knees and the pain in your back was so intense you couldn’t get up?

What causes lower back pain?

Strains and sprains

Mid back pain has a similar range of causes as upper back pain including poor posture, hunched over desk and computer positions, repetitive motions and often, heavy lifting utilizing poor technique for lifting.

Conditions related to aging

As you age you may become more susceptible to osteoarthritis or degenerative disc disease(a condition in which a damaged disc causes pain) or from joints (osteoarthritis).

Injuries

Trauma injuries from accidents, falls and sports can cause sprains, strains and fractures in the thoracic spine (the middle section and longest section of your spine) can cause sudden pain.

Referred Pain

Your pain may not even originate in your back at all. In fact, your internal organs can cause pain that you’ll feel in the middle of your back. Referred pain from internal organs can be felt acutely in the back and strongly mimic musculo-skeletal pain. 

• Gallbladder -inflammation of the gallbladder often due to gallstones can cause intense referred mid-back pain and shoulder pain. The pain can be very sharp and accompanied by vomiting and nausea.

• Pancreatitis-inflammation of the pancreas can cause severe pain which radiates deep to the lower back and can worsen when lying flat or eating. It is often accompanied by fever, nausea and vomiting. 

• Lungs-certain lung conditions such as pneumonia can cause referred pain to the mid back area which often worsens with coughing

Red flag symptoms for medical care

It is vital that, if you experience mid back pain with any of the following symptoms, that you seek medical help immediately for proper diagnosis and treatment:

• Fever

• Nausea

• Difficulty breathing

• Pain that worsens with certain activities

Lower back pain

Almost everyone will feel lower back pain at some point in their lives. Your lower back is fragile, and many conditions can make it hurt.

Lumbar strain or sprain

Ever have a day lifting boxes from a low shelf and putting them in a higher location while moving into or out of your home? Did the next day leave you feeling like every move you made could result in serious damage to your lower back? Lumbar strains and sprains are the most common form of lower back pain. It involves the overstretching or tearing of muscles and ligaments in the lower back. It is often caused by sudden twisting, turning, lifting with the lower back instead of the legs and overuse. Symptoms include pain, stiffness and muscle spasms.

Sciatica 

Sciatic nerves travel from the buttocks down both legs to the feet. When a herniated disc or a bone spur presses on this nerve, you can feel pain in your lower back. Ever hear someone say “Ouch, it’s my sciatica again!”?

Degenerative disc disease

Degenerative disc disease is a disease that involves the breakdown of spinal discs over time leading to episodes of lower back pain of varying intensity and location. This can cause pain in the lower back or neck, pain that radiates through the extremities, pain that worsens by sitting, bending or twisting. The pain may be accompanied by numbness or tingling. It is very common in adults over 40. The pain is sometimes excruciating.

Note: Discs are cushions that sit between the vertebrae of your spine (bones) and act as shock absorbers allowing flexibility for bending and twisting and very importantly, allow space for nerves to exit the spinal cord.

Scoliosis

Scoliosis is an abnormal twisting and curvature of the spine. Doctors typically diagnose scoliosis when there is a larger than 10 degree curvature. It can occur in childhood, causes unknown, but is increasing in frequency among older adults. Scoliosis can present with pain, arthritis, breathing difficulties and pinched nerves. Surgery is an option for people with severe scoliosis but more often it is treated with specialized physical therapy called the Schroth Method. Schroth Method seeks to return the spine to a more natural position through specialized exercises.

What causes my neck pain?

Millions of people have neck pain. There are two main types of pain: those caused by mechanical issues and those that are non-mechanical in nature.

Are there different types of neck pain? 

Mechanical causes of neck pain, much like back pain, include working long hours hunched over a desk or computer, as well as repetitive motion and overuse.

• Cervical strain and sprain: Sudden movements such as whiplash that can strain or sprain muscles and ligaments in the necks causing pain and stiffness.

• Cervical disc herniation: The gel-like center of cervical disk can push out of the cartilage that encases them between bones in the spinal column in the neck area and put pressure on nerves creating pain in a variety of locations.

• Cervical Spondylosis: Age-related wear and tear on the spine including bone spurs which can put pressure on nerves causing pain.

• Cervicogenic headaches: Headaches that originate in the neck are usually a symptom of an underlying injury or illness. The pain begins with neck movement and results in a more limited range of motion of the neck.

Non-mechanical causes of neck pain.

Non-mechanical causes of neck pain range from stress to infection.

• Stress: Stress can manifest as muscle tension leading to pain and soreness.

• Inflammatory conditions: Autoimmune diseases like rheumatoid arthritis can affect the joints in the neck causing pain and soreness.

• Fibromyalgia: Fibromyalgia is a chronic condition that causes widespread pain and tenderness including in the neck. Researchers believe there may be connections to sleep problems and stress, though the cause of the illness is currently unknown. It frequently follows physical or emotional stress.

• Meningitis: Meningitis is an infection of the meninges, the membranes surrounding the brain and spinal cord, and can cause severe neck pain, headaches and fever.

While many causes of neck pain can be resolved with hot/cold therapy, over the counter medications, chiropractic adjustments, physical therapy and myofascial release, there are red flags to be aware of that indicate immediate medical attention may be needed. If you have pain along with any of the following symptoms, you should seek immediate medical attention:

• Severe pain that doesn’t improve

• Loss of bladder or bowel control

• Fever, chills and confusion

• Numbness or weakness that progresses

• Difficulty swallowing or breathing

• Neck pain following a recent injury

Is shoulder pain serious?

Shoulder pain is very common, affecting people of all ages. Understanding the root causes are critical as the shoulder is a complex joint, the most movable joint in the human body. It is a ball and socket joint which means it allows for backwards, forwards, sideways and rotating movements. It has four tendons, eight muscles and two ligaments and is a marvel of engineering but very fragile. Shoulder pain is very common for athletes and for all people as we age.

Referred shoulder pain

Problems in other parts of your body can cause pain in your shoulders. The pain can be transmitted through the nerves. Tight muscles, pinched nerves, even pain from other organs can create shoulder pain. Common symptoms include dull aching pain, accompanied by heaviness or tightness.

Rotator cuff tendinopathy 

Rotator cuff tendinopathy is one of the leading causes of shoulder pain. The rotator cuff is a group of muscles and tendons that stabilize and control the movement of the shoulder. It is a leading injury among athletes and people who work with their hands and arms raised overhead. Rotator cuff tears or  tendinopathy (inflammation) cause piercing pain, difficulty in movement and problems sleeping on the side. A complete rotator cuff tear can greatly restrict movement of the arm at all. Most rotator cuff tears are caused by wear and tear of the tendon tissue over time. A distinguishing feature is pain at night when trying to sleep on that side.

Arthritis

Osteoarthritis, which is caused by wear and tear over time, damages the protective cartilage lining the shoulder joint. The deterioration of the cushioning and controlling cartilage causes bone on bone grating with pain and limitation of movement. Rheumatoid arthritis, an autoimmune disease, can also affect the shoulder with swelling, inflammation and pain.

Bursitis 

Bursitis of the shoulder occurs when a bursa, a small fluid filled sac that reduces friction between moving parts in the shoulder. If it becomes inflamed the condition is bursitis. Symptoms include swelling, pain, redness and warmth around the area.

Additionally, other syndromes such as Frozen shoulder and impingement syndrome (when the rotator cuff tendons become pinched) can produce shoulder pain and restricted movement.

Learn more:

How to Manage Back Pain

What to Know About Migraines, Balance Problems, and Dizziness

How to Find a Chiropractor