Back pain is one of the most common health complaints. Almost everyone will have back pain at some time in their life. Most of the time, the exact cause of the pain cannot be found.
This article discusses long-term (chronic) low back pain. For information on other types of low back pain that occur suddenly, see: Low back pain - acute.
Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low
Causes, incidence, and risk factors
One single event may not cause your pain. You may have been doing many things improperly -- such as standing or lifting -- for a long time. Then suddenly, one simple movement (such as reaching for something or bending from your waist) leads to pain.
Many people with chronic back pain have arthritis and extra wear and tear on the spine. This may be due to:
Heavy use from work or sports
Past injuries and fractures
You may have had a herniated disk, where part of the spinal disk pushed onto nearby nerves. Normally, the disks provide space and cushion in your spine. If these disks dry out and become thinner and more brittle, you can lose movement in the spine over time.
If the spaces between the spinal nerves and spinal cord become narrowed, this can lead to spinal stenosis. These problems are called degenerative joint or spine disease.
Other possible causes of chronic low back pain:
Curvatures of the spine (such as scoliosis or kyphosis), which may be passed down in families
If you have any concerning symptoms, call your doctor right away.
Your back pain may not go away completely, or it may get more painful at times. Learning to take care of your back at home and how to prevent repeat episodes of back pain can help you continue with your normal activities.
Your doctor and other health professionals can help you manage your pain and keep you as active as possible.
Your doctor may refer you for physical therapy. The physical therapist may try to reduce your pain, using stretches and traction. The therapist will show you how to do exercises that make your back muscles stronger, so you can prevent future back pain.
You may also see a massage therapist, someone who performs acupuncture, or someone who does spinal manipulation (a chiropractor, osteopathic doctor, or physical therapist). Sometimes a few visits with these specialists will help back pain.
You may need a back brace to support your back at work.
Cold packs and heat therapy may help your back pain.
Cognitive behavioral therapy may be helpful. This technique helps you better understand your pain and teaches you how to manage your back pain.
A number of different medications can help with your back pain:
Drugs (NSAIDs) such as aspirin, naproxen sodium (Aleve), and ibuprofen (Advil)
Low doses of prescription medicines used to treat seizures or depression (antidepressants)
Pain medicines called narcotics or opioids when the pain is very severe
See also: Medicines for chronic back pain
When a severe episode of pain does not improve with medicine, physical therapy, and other treatments, you may need an epidural injection.
Spinal surgery should be considered only if you have nerve damage, or the condition causing the back pain does not heal after a long period of time.
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Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.