This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 11/01/2016
There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.
For persistent low back pain, the short-term outcome is also positive, with improvement in the first six weeks but very little improvement after that. At one year, those with chronic low back pain usually continue to have moderate pain and disability. People at higher risk of long-term disability include those with poor coping skills or with fear of activity (2.5 times more likely to have poor outcomes at one year), those with a poor ability to cope with pain, functional impairments, poor general health, or a significant psychiatric or psychological component to the pain (Waddell’s signs).
Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray… which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken. BACK TO TEXT
Continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain, but don’t avoid activity out of fear of pain. If home treatments aren’t working after several weeks, your doctor might suggest stronger medications or other therapies.
Kidney stones are solid masses of crystalline material that form in the kidneys. Symptoms of kidney stones can include pain, nausea, vomiting, and even fever and chills. Kidney stones are diagnosed via CT scans and specialized X-rays. Treatment of kidney stones involves drinking lots of fluids and taking over-the-counter pain medications to medical intervention including prescription medications, lithotripsy, and sometimes even surgery.
Appendix — The appendix is one of the few clearly one-sided structures in the region. It is on the right. However, appendicitis rarely causes back pain (or at least not without a great deal of abdominal pain as well).
A weakness in Dr. John Sarno’s (otherwise interesting) writing about back pain17 is that he tends to give patients the idea that recovery from low back pain is all a mind game. That’s going too far. “The biology of pain is never really straightforward, even when it appears to be.” (Moseley)
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^ Jump up to: a b Choi BK, Verbeek JH, Tam WW, Jiang JY (2010). Choi, Brian KL, ed. Exercises for prevention of recurrences of low-back pain. Cochrane Database of Systematic Reviews (1): CD006555. doi:10.1002/14651858.CD006555.pub2. PMID 20091596.
Infection. Also called osteomyelitis, a spinal infection is rare but can cause severe pain and is life threatening if untreated. It can be caused by surgical procedures, injections, or spread through the blood stream. Patients with a compromised immune system are more susceptible to developing an infection in the spine.
Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK, Clinical Efficacy Assessment Subcommittee of the American College of Physicians, American College of Physicians, American Pain Society Low Back Pain Guidelines Panel (Oct 2, 2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 147 (7): 478–91. doi:10.7326/0003-4819-147-7-200710020-00006. PMID 17909209.
If you have any underlying emotional issues and unresolved trauma, it can profoundly influence your health, particularly in terms of physical pain. A 2004 study on back pain supports this theory. Its researchers followed 100 patients over the course of four years. All of the patients, who were back pain-free at the start of the study, underwent psychological tests. Afterwards, the researchers compared which of the participants remained pain-free and which ones developed back pain.
Depending on the cause of your pain, your treatment could include lifestyle changes, medication, or possibly surgery. Talk with your doctor if your back isn’t feeling right. He can help you discover what’s causing the hurt and can help you feel better.
Complaints of low back pain are one of the most common reasons people visit doctors. For pain that has lasted only a few weeks, the pain is likely to subside on its own. Thus, if a person’s medical history and physical examination do not suggest a specific disease as the cause, medical societies advise against imaging tests such as X-rays, CT scans, and MRIs. Individuals may want such tests but, unless red flags are present, they are unnecessary health care. Routine imaging increases costs, is associated with higher rates of surgery with no overall benefit, and the radiation used may be harmful to one’s health. Fewer than 1% of imaging tests identify the cause of the problem. Imaging may also detect harmless abnormalities, encouraging people to request further unnecessary testing or to worry. Even so, MRI scans of the lumbar region increased by more than 300% among United States Medicare beneficiaries from 1994 to 2006.
Strong ligaments also attach to nearby (adjacent) vertebrae to give extra support and strength to the spine. The various muscles that are attached to the spine enable the spine to bend and move in various ways.
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Gall bladder — The gall bladder is on the right. Gall bladder pain can be felt in the back. However, it is usually quite high — even the shoulder blade — and almost always overshadowed by abdominal pain.
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2011 — Major update: Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.
Some spinal difficulties, however, require more sizable intervention. Herniated discs, fractured vertebrae and other severe complications can often be mitigated or removed completely by minimally invasive surgery.