Back pain is not an uncommon complaint. In fact, four out of five adults will experience symptoms of lower back pain at least once in their lifetime. A complex structure, the back is made up of 33 vertebrae, more than 30 muscles, ligaments, multiple joints, and inter-vertebrae dics. With all of those muscles, joints, and discs, it's not surprising there are many ways in which these elements can become injured or affected.



Muscular strain is the most common cause of back pain. When an unexpected force, twist, or pull is applied to one or several muscles in the back, tears occur in the muscle. These muscle tears cause the pain felt in the back. Ligamentous sprains, or sprains to the ligaments is another common cause of back pain. This occurs when the back ligaments are stretched beyond their limit. These sprains can often coincide with muscular strains.

When the spinal nerves in the back are compressed at the point where they exit the spinal column, the result is a herniated disc. Repetitive vibratory motion, such as experienced by truck drivers or machine users, often leads to this condition. A sudden heavy loading of the back, as occurs with improper lifting, can also cause a herniated disc. Because the condition affects the nerve endings, a radicular type of back pain is felt at the site of injury, as well as along the course of the affected nerve. Sciatica, a condition resulting from the irritation of the sciatica nerve is also a type of radicular pain. As the largest nerve in the body, it runs from the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb.

Another cause of back pain, spinal stenosis occurs more commonly in adults over 50 years old. The term refers to a narrowing of the spinal canal. Spinal stenosis has numerous causes including thickened ligaments along the spinal canal, bony spurs, and enlarged joint cartilage from arthritic changes. In many cases, the pain of this condition is made worse with extended periods of weight bearing or walking. Surgery is sometimes required to correct the disorder.

As with spinal stenosis, osteoporosis affects the joints in the spine and is also more common in people over 50 years of age. Considered a degenerative joint diseases, over time the cartilage begins to degenerate in the discs between the vertebrae and the joints in the spine. Without a cartilaginous cushion, the bones begin to rub against each other, which results in inflammation, swelling and stiffness. As the condition progresses, bone spurs develop and ligaments become thick, both of which result in spinal stenosis.

A common cause of back especially in women, osteoporosis is a disease characterized by progressive loss of bone density. As the bone tissue begins to thin, it becomes more susceptible to fractures or broken bones. Bones of the spine are especially affected with osteoporosis. Injury from falls and lifting heavy objects can result in painful vertebral compression fractures.

Fibromyalgia is also a common cause of chronic back pain. The rheumatic condition is characterized by widespread soft tissue pain, fatigue, sleep disturbance, and the presence of evenly distributed areas of tenderness. A presence of widespread pain and tenderness for at least three months in 11 or more of the 18 designated tender point sites is required in diagnosing this disorder.

Prevention is the first line of defense when it comes to protecting your back from injury. Injury prevention includes everything from proper seat positioning at work to stretching before performing strenuous exercises. Lower back stretches, which can be recommended by a physician or physical therapist, are a quick and effective way to keep the back muscles and joints limber. Performing simple stretches can help prevent back pain or provide pain relief from present back aches.

Strengthening exercises help to build strong muscles which provide joint stability. These exercises are also important after sustaining injuries that require resting affected muscles. Especially in cases of post-operative recovery, discomfort after surgery often leads to decreased use of the affected area which leads to stiffness and weakness. As a result, strengthening and stretching exercises in early rehabilitation helps to prevent this from occurring.

For those experiencing chronic lower back pain, it's important to first see your physician, who may refer you to a specialist or physical therapist. Physical therapy is very effective in treating lower back conditions and providing pain relief. A physical therapist may focus on decreasing pain with both passive and active therapy. Examples of passive therapy include heat/ice packs, ultrasound treatments, and TENS units. Active treatments include stretching, strengthening exercises, pain relief exercises, and low-impact aerobic conditioning.