Back pain is among the most common medical problem in modern society and one of the most common conditions treated by our experts. Up to 84 percent of adults experience back pain at some time in their lives. Back pain could occur at all ages with a peak around 40-50. Back pain is worldwide the most common cause of disability in persons younger than 40.

Back Pain can have many different causes. Therefore, as a first step, it is important to find the underlying cause and plan the right treatment according to it.

Most causes of back pain are treatable with good results and surgery can be avoided. Moreover, there are very effective measures to prevent back pain from reoccurring.

Types of Back Pain

Acute vs chronic back pain: Acute back pain is most often caused by an injury or wrong movement, has a sudden onset, and lasts only hours our days. Chronic back pain is characterized as a pain lasts more than 12 weeks.

Location of pain: Most common is lower or lumbar pain, but the pain can be located in the middle of the back, the upper back or neck, too. In disc related back pain and sciatica we often see a radiating pain down the legs.

Severity of pain: from mild to unbearable pain

Symptoms / Signs

Symptoms could occur after lifting heavy items or other physical exercise. However, it can also occur without any previous activity. Peripheral nerves are having 3 functions: Pain, sensory and motor function. This explains the symptoms.

  • Back Pain
  • Pain in the back, buttock or leg (sciatica)
  • sensory loss, numbness or tingling of the skin
  • Muscle weakness of the legs
  • The pain could lead to muscle strain or spasm of the back muscles. Thus, the movement is impaired and the posture affected.
  • A very serious symptom is called cauda equina compression. Neurologists define it as numbness of the legs, bladder / bowel dysfunction and impotence. This requires urgent surgery.
  • Neck pain
  • Pain in the neck, shoulder, arm, chest, Headache
  • Vertigo, dizziness, giddiness, Tinnitus, Visual disturbances
  • numbness in arm and hands
  • weakness in arm and hands
  • The pain could lead to muscle strain or spasm of the back muscles. Thus the movement is impaired and the posture affected.


Since back pain can be caused by many different underlying conditions, a thorough examination is needed to find the true cause.

Some of the most common causes and underlying conditions are:

  • Disc diseases
  • Osteoarthritis, spondylolisthesis, fractures, osteoporosis, Spinal stenosis, Dysfunction of the joints of the lower back
  • Accidents and Muscle strain
  • Cancer like bony metastases and others
  • Infection like osteomyelitis, tuberculosis, diskitis, epidural abscess and others
  • Vascular like abdominal aortic aneurysm, epidural hematoma and others
  • Rheumatologically diseases like arthritis and others

Other causes of back pain

  • Pain originating in the organs close to the spine, like the stomach, kidneys, or bladder, and can radiate to your back.
  • Swelling of the aorta – the main blood vessel going away from the heart – can cause back pain.
  • Fibromyalgia – widespread pain and tenderness of the body – can cause back pain.
  • Inflammatory diseases, stomach ulcers, and UTIs can hurt your back.
  • Women: In the case of women, conditions like pregnancy and fibroids (tumours of the womb) or a disease like endometriosis can cause back pain.
  • Men: In the case of men, testicular rupture or testicular torsion can be a cause.

There can be so many causes of back pain, therefore, consulting a healthcare professional is necessary to find the exact cause.

Here some of the most common causes in more detail


Ageing can cause our muscles, bones and the discs of the spine to weaken gradually. Everyone goes through this process of weakening of the spine, but that doesn’t necessarily become a cause of pain.

The spinal discs are located between the vertebrae (bones making the spine) and act as shock absorbers. As they shrink with time, the space between the vertebrae reduces meanwhile bone spurs start developing along the edges of the vertebrae and joints.

In medical terminology, this condition is referred to as spondylosis.

As the discs are shrinking, the inner part of the disk, which is still more flexible, breaks thru the outer part and squeezes the nerve roots nearby. Neurologists call this a prolapsed intervertebral disk. Most common locations are the lower back, L4-L5 and L5-S1 or the neck, C5-6 and C6-7.


Back pain is often linked to numbness, tingling feeling, or pain in the legs which is a condition called sciatica.

It originates when the spinal nerve (sciatic nerve) – running down the back of the legs – gets damaged or squeezed. People with sciatica often feel more intense pain in the legs than in the back or less often feel no pain in the back.

A slipped disc or an outgrowth of bone can put pressure on the sciatic nerve and cause pain or numbness along the nerve’s pathway. This can cause pain anywhere from the lower back to the foot or toe.

Spinal Stenosis

Another condition linked to back pain is spinal stenosis which is characterized by pain in the legs, arms, back, neck, hands, or feet. The pain can start at once and fade away or might get worse over time – depending on the location of the pain. This can be a genetic condition or might be experienced with the growing age.

Our spine has a canal that contains the nerves of the spinal cord, the narrowing of this canal can result in spinal stenosis. Some people are born with a narrow canal and some may experience the narrowing of space later in life. Less space can put pressure on the nerves running through this canal, and this results in pain or numbness in different parts.

Along with other areas, both or one leg can be affected, and the pain is more severe in the legs than in the back. Some people feel relieved when they sit down or walk while slightly hunching their back.

Risk factors

  • Obesity
  • poor physical health
  • poor nutrition
  • Smoking
  • Heavy manual labor
  • Psychological reasons like depression, work related problems and others.
  • Pregnancy
  • Weather? No! Lower back pain is commonly associated to weather changes. But this seems to be untrue.


The diagnostic procedures used depend on the patient’s complete medical history and physical examinations which determine if there is any serious underlying condition that could be causing the pain. Only after a thorough back examination and neurological tests can a healthcare provider establish the cause of back pain and the appropriate treatment. A doctor may perform several tests to identify the exact cause of back pain. These tests include;

  • Consultation
  • Physical examination
  • Neurological examination
  • Electromyography (EMG): checks the electrical activity in the nerves of your spine. It is a minimally invasive technique that helps in identifying the nerve damage causing back pain.
  • Nerve Conduction Velocity (NCV) Nerve conduction velocity (NCV) is a diagnostic test that measures the speed at which electrical impulses travel through nerves in the body
  • X-rays: This is done to see if there is some sort of dislocation, fracture, or degeneration of bones.
  • MRI: An MRI scan is usually performed to get a detailed overview of your spine. This helps in identifying even small changes and problems.
  • CT scan: It is helpful in getting a complete and detailed image of your bones. It involves multiple X-rays and helps in diagnosing back pain by providing a 3-D picture of your bones.

When to See a Doctor

Back pain is common and usually gets better within a few days, but there are some conditions when you should see a doctor:

  • Your pain is getting worse day by day
  • If it lasts for more than a week or two
  • If you are unable to perform your routine tasks
  • You have extreme pain that is interrupting your activities
  • You are facing other health problems like fever or difficulty in penile erection

Treatment and prevention

90% of acute back pain cases will fully recover. Patients with subacute or chronic back and neck pain (3 month>) still have a favourable prognosis, however not as positive as acute back pain. Moreover, the treatment of chronic back pain or neck pain differs from treatment of acute pain.

There should never be a treatment without a proper examination. Before going into detail, we will answer the most common questions patients will ask:

  • Do I need to get surgery? Any surgery is a potential harm to the patient. Therefore, there must be a clear indication. Luckily only less than 2% of patients suffering from neck or back pain need surgical intervention.
  • Do I need to stay in bed? If the pain is acute, you will most probably lay down anyway. If your muscles cramp and the movement is impaired you don’t have much other possibilities. After the treatment started there is no beneficial effect of prolonged bed rest. Moreover, other problems like thrombosis could occur.

How to Manage Your Back Pain

There are many things you can do to ease your back pain. Staying active and maintaining a healthy lifestyle is a good way to start. Rest is important but preventing your back from any movement can worsen the pain and slow down the recovery process. Mild exercise often speeds up the recovery process.

Research also suggests that your emotional responses also play a significant role in speeding up the back pain recovery process. So, one must learn to tackle the emotional challenges to get better faster. If your back pain takes too long to get better, you should see a healthcare provider.

Staying Active and Exercising for Back Pain

Staying active is the first thing you can do to ease up your back pain. Regular exercise or movement makes your back flexible and keeps your spine-supporting muscles strong. This also helps in reducing pressure on your joints and bones.

Your back may initially experience soreness, but it will not cause any harm. Begin with a mild exercise and gradually increase the duration and intensity. Lack of exercise or movement for a long time makes your muscles weaker and stiffer, leading to a more painful back.

Regular exercise gradually eases the back pain. It also releases pain-relieving chemicals – known as endorphins – which not only help in alleviating the pain but also improve the mood.

You can also take painkillers with the recommendation of your healthcare provider before performing any exercises. Gradually, you will have a stronger and more flexible back, which will reduce pain.

Exercises for Back Pain

There are plenty of exercises you can choose to help relieve your back pain. Some of them are:

  • Swimming: It is one of the best exercises that is gentle on your back. This low-impact exercise doesn’t put too much pressure on your joints, improves circulation and alleviates back pain.
  • Walking: It is another way to stay active and relieve your back pain. You can choose the duration and pace according to your comfort and gradually increase them.
  • Yoga: It mainly improves your muscles’ stretching and balance, which can be helpful for back pain.
  • Pilates: It is also one of the recommended exercises for back pain that improves the flexibility of the body muscles and boosts core strength.
  • Gym Workouts: Various workouts that are usually performed at the gym, like strength training and cardiovascular exercises can help improve overall fitness and spine health.

Just remember to be patient and keep in mind that the key is finding the right exercise, gradually incorporating it and performing it consistently.


  • Common Pain killers are reducing pain, swelling and inflammation. They are commonly used for the treatment of acute back pain. However, new studies found that these drugs are inadequate in many chronic pain scenarios, while anti-depressants and anti-convulsants can have remarkable effects on many forms of chronic bone and joint pain. Moreover, the addictive potential of opioids must be taken in consideration.
  • Muscle relaxants help to release muscle spasm. Thus, the vicious circle of pain – muscle spasm – impaired movement and posture – pain – could be stopped.
  • Antidepressants are commonly used and very effective for chronic lower back pain.
  • Anti-convulsants (medications to prevent seizures) are successfully used in the treatment of chronic back pain.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is a FDA approved, commonly used method in up-to-date pain management. It’s used for many forms of acute and chronic pain.


Acupuncture may be useful as adjunctive treatment for low back pain.

Physical therapy, Massage, Occupational therapy

Physical therapy, Massage, Occupational therapy can be used to alleviate pain and restore function (but this treatment is not encouraged in the early phase of injury)

Surgical therapy

Surgical therapy including Lumbar microdiskectomy,Spinal stabilization, Laminectomy, Endoscopic therapy, percutaneous arthroscopic diskectomy

CBT (Cognitive Behavioural Therapy)

CBT (Cognitive Behavioural Therapy) was underestimated for a long time but as new studies prove, they are highly effective. In some cases even more effective than medication, with less side effects. A recent study published by the American Psychological Association showed when it comes to chronic pain, psychological interventions often provide more relief than prescription drugs or surgery without the risk of side effects, but are used much less frequently than traditional medical treatments

Lifestyle adjustments

Lifestyle adjustments to eliminate the risk factors, such as obesity, poor physical health, poor nutrition, smoking, heavy manual labor.

Support groups are monthly meetings of 5-10 people, having one thing in common, impaired quality of life due to a chronic disease.

For psychology and psychiatrist related problems, you can always consult a psychologist, psychiatrist or for counseling our psychotherapists are always available to help you.

For psychology and psychiatrist related problems, you can always consult a psychologistpsychiatrist or for counseling our psychotherapists are always available to help you.