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OVERVIEW

Back pain is personal.

Each ache and pain is different, that's why Goodpath takes a personalized approach to creating back pain programs. Each program is designed to get you on the path back to better health.

Our algorithm builds well-rounded programs based on your symptoms, lifestyle details, and medical history. Click below to take a 3-4 minute assessment.

It's also common.

Back pain is a common condition, and there is a very good chance that a person will experience it from time to time. In the United States, up to 8 out of 10 adults will have back pain in their lifetime. Some facts about back pain include:

A 2012 U.S. National Health Survey found 1 out of 4 adults reported low back pain in just the last 3 months.

Back or spine problems are the second most common causes of disability among adults in the U.S. In fact, studies of U.S. workers found 149 million lost work days in one year due to back pain.

Back pain is frequently the reason for doctors’ appointments and emergency department visits.

This page has been reviewed by the GoodPath medical team. Medical Writer: Beth Holloway, RN, M. Ed; Medical Reviewer: Stephanie Gianoukos, MD, MPH; Updated: November 2020.

TYPES & CAUSES

Time is a helpful tool.

A key piece of information in determining the best back pain treatment:

How long symptoms have lasted and/or if they have gone away and later returned.

Acute

(Short-Term)

Acute back pain is defined by most doctors as lasting less than four weeks. 

It can be treated with a combination of therapies, such as over-the-counter (OTC) pain medicine and a heat wrap or cold pack applied to the back. The medicine and heat or cold combination will often provide the needed relief until the back begins to heal. If it does not improve, then different OTC products, natural supplements, and/or exercises may be helpful.

Chronic

(Long-Term)

Doctors usually define chronic back pain as lasting for over 12 weeks. 

When an individual has chronic back pain, they may have tried previous treatments. However, there may be new treatments or different methods they have not yet tried which may provide relief.

Recurrent

(Off and On)

Back pain that goes away and then returns is called recurrent back pain. 

People with recurrent back pain may also benefit from the same OTC medicines and heat wraps or cold packs recommended for treating acute back pain. Daily exercise may also help to prevent back pain from recurring. People with recurrent back pain may also need additional instructions or a new program, similar to the approach with chronic back pain.

Regardless of whether an individual has acute, chronic, and/or recurrent back pain, the experience is often quite painful and may interfere with work, activities, and sleep.

Location matters, too.

From the neck to the lower back, location helps doctors diagnose back pain and treat it correctly.

Low Back Pain

Low back pain may be called lumbago or lumbar pain (as in the lumbar spine). This is the part of the spine most often affected by pain. It is one of the most common musculoskeletal conditions. In fact, up to 8 in 10 people experience pain in the lower back during their lifetime.

Upper Back Pain

Upper back pain may be called thoracic pain (as in the thoracic spine ). This is the area of the back between the neck and the lower back. Along with the ribs and breastbone (also called the sternum), this part of the back protects the heart, lungs, and other structures within the chest.

Whole Back Pain

A person might feel pain in their entire back rather than a single part. This is sometimes called generalized back pain or a backache. This is often the case with certain types of inflammatory arthritis.

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Back pain has many causes.

The back is made up of bones, discs, muscles, tendons, ligaments, and other structures. Any of these can contribute to back pain. Regardless of what parts are involved in the pain, the symptoms may be similar – doctors call this nonspecific back pain. 

Sometimes, back pain can indicate a very serious condition. For most people, though, it does not mean something serious and can be treated. 

Below, we have outlined three common causes of back pain.

Common Cause 1: Strains and Sprains

Both strains and sprains mean that tissue is stretched or torn. Often, we think of these injuries happening to wrists, ankles, and knees. But they can also impact the muscles, tendons, and ligaments of the back – the low back especially. 

According to the National Library of Medicine, a strain is an injury to a muscle or tendon and a sprain is an injury to a ligament. The difference? Muscles support bones. Tendons attach muscles to bones. Ligaments attach bones to joints. 

When a person experiences a sprain or strain, they may feel a stretch or tear followed by pain. There may also be swelling or bruising in the area. Movement can make the pain worse, making it difficult to take part in daily activities.

Common Cause 2: Accidents, Injuries, Incorrect Movements

Minor accidents, injuries, and incorrect (or lack of) movement can cause back pain. Some common causes include:

  • Slipping or other quick movements

  • Improper bending, lifting, or twisting

  • Overusing the back (for instance, while golfing or playing racquet sports) 

  • Underusing the back (for instance, sitting for long periods of time) 

Serious accidents and injuries may also cause back pain. Those situations are medical emergencies and require immediate medical treatment.

Common Cause 3: Osteoarthritis

The most common type of arthritis is osteoarthritis, which can affect many joints in the body. Also known as wear-and-tear arthritis or degenerative joint disease, it most often impacts the hips, knees, spine, and hands.

About 31 million people in the U.S. have osteoarthritis affecting one or more of their joints, according to the Arthritis Foundation

Osteoarthritis becomes more common with age. Due to daily wear and tear, the spongy cartilage that protects many joints begins to break down. This results in pain and stiffness. 

One study found osteoarthritis of the lower back, based on imaging tests, in about:

  • 1 in 3 adults under 45 years of age

  • 3 in 5 adults between 45 and 64 years of age

  • 9 in 10 adults above 65 years of age

TREATMENT

There are many paths to feeling better.

The best back pain treatment programs consider many different factors. Medical experts advise that a well-rounded, personalized treatment approach produces the best results.

A well-rounded treatment approach considers a patient’s medical history, symptoms, lifestyle, and more. For instance, this might include: the over-the-counter medicine naproxen sodium (Aleve), the natural medicine turmeric, topical treatments or a heat wrap on the back, and lifestyle additions or exercises, like yoga and stretching breaks throughout the workday. 

A personalized strategy for a particular person might mean taking acetaminophen (Tylenol) and not ibuprofen (Advil, Motrin) because it causes them gastrointestinal (GI) issues.

Here are treatments that can fit a person's symptoms:

Oral Treatments

Over-The-Counter (OTC) Medicine


Prescription Medicine


Natural Remedies & Supplements

Topical Treatments & Devices

Topical Medications


Natural Topical Products


Heat, Braces, and Other Devices

Therapy & Lifestyle

Behavioral Therapy


Complementary Therapy


Lifestyle Changes


Movement & Exercise

Learn the basics of back anatomy.

Bones (called vertebrae), discs, supporting muscles, tendons, ligaments, and other structures make up the back. Any combination of these may be involved in back pain.

When specific areas of the back are involved in back pain, they are named for the spine in those same areas. 

  • Neck pain may be called cervical pain, like the cervical spine.

  • Upper back pain may be called thoracic pain, like the thoracic spine.

  • Lower back pain may be called lumbar pain, like the lumbar spine. It is also known as lumbago.

The Spine.

The bones along the back (called the spinal column) start at the base of the skull and go all the way to the tailbone. This column is made up of 33 separate bones, which are also called vertebrae. The whole spine may also be called the vertebral column – it’s made up of bones with discs in between. 

Discs of the Spine

Discs (or intervertebral discs) are located between the vertebrae. These discs are made of spongy cartilage and serve as a cushion between the bones. 

Nerves of the Spine

Nerves from the spinal column go through small holes in the vertebrae to other parts of the body. When an individual experiences back pain, it may be because a nerve has been rubbed, irritated, or pinched. This type of pain travels to other areas of the body along the nerve. For example, an irritated nerve in the neck may cause pain in the neck and the arm.

The Back.

Muscles, tendons, and ligaments support the spine. They also play a part in moving the head, shoulders, arms, hips, and legs. Injuries to these will commonly result in back pain. 

Muscles of the Back

Different-sized muscles layered over the back allow the spine to bend forward and straighten, bend to the left and right, and twist from side to side. 

Tendons and Ligaments of the Back

Tendons attach the muscles to the bones, while ligaments hold the bones together at joints (defined as any place where two bones meet).

PREVENTION

Some back pain is preventable.


How can back pain be prevented?

When an individual has back pain or has had it in the past, they may be wondering how to prevent it in the future. GoodPath is here to help them treat current symptoms and/or prevent future pain.

POSITIONING

Individuals can help prevent back pain by paying attention to their back throughout the day. If it begins to hurt, they should change positions. 

For example: If they experience discomfort while sitting on the sofa, they should, stand up and walk around, or move to another seat.

STRENGTHENING

The muscles in the abdomen or belly (sometimes called core muscles) help to support the lower back. Strengthening these muscles can help prevent pain.

PROTECTING

Individuals can protect the back by keeping the spine straight. When lifting or moving heavy objects, it’s helpful to use the largest muscles and hold items close to the body.

STRETCHING

Doctors recommend doing gentle back stretching exercises every day. These can even be performed while sitting in a chair.

POSTURE

Good posture is helpful for back pain prevention. As much as possible, individuals should stand tall and sit up straight.

MAINTAINING ACTIVITY

Doctors recommend staying as active as possible for back prevention and to increase overall health.  The U.S. Department of Health and Human Services (HHS) recommends "Once approved by their doctors, adults should have at least 2½ hours of medium-paced aerobic activity (for example, walking quickly), 1½ hours of intense aerobic activity (for example, jogging), or a combination of both every week. Aerobic activity strengthens the heart and lungs."


When should I see my doctor?

In most cases, back pain does not mean a person has a serious condition. However, there are situations when one should see a doctor right away. Individuals should see a doctor when they have back pain and any of the following:

RISK FACTORS

  • History of cancer

  • Recent infection

  • Decreased ability to fight infection (suppressed immune system)

  • Intravenous (IV) drug use

  • Osteoporosis (weakened bones)

  • Long-term use of steroid medicine

  • Recent serious accident or injury

SYMPTOMS

  • Fever

  • Pain extending to the arms or legs

  • Numbness, tingling, or burning in the arms or legs

  • Severe pain

  • Recent, severe headache


How is back pain diagnosed?

Individuals may or may not need to see a doctor when they’re experiencing back pain. If they decide to see a doctor, the doctor will ask questions and perform a physical exam. They may also order tests or suggest seeing a specialist.

QUESTIONS

The doctor might ask questions like: How long has the pain been present? Where is the pain located? Do certain things make the pain better or worse?

They will likely ask about the patient’s medical history, which helps diagnose the reason(s) for back pain. The physician might also ask about work, daily habits, and exercise level. For example, doctors will try to determine if someone’s medical history might include a previous diagnosis of osteoarthritis of the spine. Or, for instance, if their patient works on a computer every day and then developed pain.

EXAMS

As with other medical problems, the doctor might complete an exam. The exam may include putting the person through certain movements and checking their reflexes.

TESTS

Many times, tests are not needed when someone is experiencing back pain. Yet some symptoms of back pain are cause for concern. In these cases, doctors may order imaging tests like X-rays and scans. In some situations, they may also order lab tests.

REFERRALS

The doctor may advise a patient to see a specialist or therapist for further evaluation or testing. Medical specialists are professionals like orthopedists or neurologists. Therapists include physical therapists (PTs) and occupational therapists (OTs). 

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