Back pain is a top cause of disability worldwide and one of the most common reasons why people miss work or go to the doctor. In fact, at some time in their lives. This type of pain can range from a sharp, sudden pain to a dull, persistent ache. It can be localized at a certain spot in the back or spread across a large area of the body. Some different types of back pain worsen with standing, walking, lifting, and bending.
If back pain is interfering with your everyday activities and affecting your quality of life, physical therapy may provide much-needed relief.
The duration and frequency of back pain gives important clues to the diagnosis and manage different types of back pain.
Acute Back Pain
Acute back pain comes on suddenly and lasts less than 4 weeks. Acute back pain sometimes resolves on its own without medical intervention. It is hard to say how many people experience acute back pain, because many treat symptoms at home with heat and rest, rather than see a doctor for their condition.
Subacute Back Pain
Subacute back pain comes on suddenly or gradually and lasts from 4 to 12 weeks. Because subacute back pain often improves without invasive surgery, the American College of Physicians (ACP) recommends “nonpharmacologic treatment with exercise, multidisciplinary rehabilitation” and other noninvasive modalities.
Chronic Back Pain
Chronic back pain lasts longer than 12 weeks. A physical exam, health history, and imaging procedures help healthcare providers determine the root cause of chronic back pain. That’s important because not only does chronic pain affect movement and function, but people with chronic pain also have a greater risk of anxiety and mood disorders.
To understand how and why back pain occurs, it’s helpful to understand the basic anatomy of the back and the structures that work in concert to support the body.
The spine, or the backbone, is the body’s primary support structure. A healthy spine has three curves that create an “s” shape. Thirty-three bones, or vertebrae form the spinal canal that house and protect the spinal cord and nerves within.
The 33 vertebrae that form the spine are divided into five regions starting at the neck and traveling down to the buttocks:
The spinal cord and nerves transport messages between the brain and muscles. Between the vertebrae are disks which have a gel-like center that acts as a cushion to absorb force to the body. Injuries or degeneration of these disks is a common cause of back pain.
The spine also connects the different parts of the musculoskeletal system which is made up of bones, muscles, ligaments, tendons, and soft tissues. Ligaments support the spine and keep it in position. Muscles help create movement, and the tendons connect muscle to bone.
Now that we have an overview of the back and spine, let’s look at possible causes of acute, subacute, and chronic back pain.
Sprains, strains, and tears of the muscles or tendons cause different types of back pain. Sports injuries, car accidents, falls, and other trauma to the body may injure back structures and cause acute or chronic pain.
Back pain and related symptoms are also caused by inflammation, degeneration, or injury to intervertebral disks due to age, injury, or diseases like osteoarthritis and spondylosis.
A wide range of injuries and conditions of the nerves and/or spinal cord can cause severe back pain including sciatica, where pressing on the sciatic nerve causes pain that radiates down the back of the leg. Spinal stenosis is another condition that causes back pain. This is a narrowing of the spinal column that squeezes the spinal cord and nerves.
In some cases, back pain doesn’t start in the back at all. Pregnancy, endometriosis, kidney stones, and tumors are among the many conditions that can have back pain as a symptom.
It is common for a patient with back pain to have other symptoms. These symptoms are clues to help providers and physical therapists zero in on an injury or condition and help the patient feel better.
Symptoms that often occur with back pain include back stiffness, numbness, weakness, or tingling. It can be difficult to stand or sit, bend or twist. Pain, weakness, or numbness can also be felt in the arms, shoulders, or legs, particularly when a nerve root in the spinal column is damaged or pinched.
You should always discuss back pain and related symptoms with your healthcare provider to determine the underlying cause, rule out serious conditions, and discuss the benefits of physical therapy.
There are several risk factors that indicate a likelihood of developing back pain.
Age plays a role in back health. Because we lose bone strength as we age and the intervertebral disks lose volume and flexibility, back pain is more common in adults over 30. And that risk increases as we get older.
Weight is also a factor with back pain. Excess weight puts added pressure on the structures of the back, increasing the chance of pain. Lack of exercise can lead to weak core muscles which means less support for the spine. Smoking, stress, poor posture, and a physically demanding professional all increase the risk of back pain.
The good news is many of these factors are in our control. With frequent, low-impact aerobic exercise, an ideal weight, and techniques to reduce stress and anxiety, you can help keep your spine happy and healthy!
Several types of back pain can affect your ability to move and function comfortably. As noted above, the ACP recommends several noninvasive treatment options for patients with acute and subacute low back pain.
Physical therapy can be incredibly beneficial for patients with acute, subacute, and chronic back pain who don’t require immediate medical or surgical intervention.
Physical Therapy Is Noninvasive
Physical therapy is on the conservative end of back pain treatments because it doesn’t require incision into the body or require any removal of tissue. That means no risk of surgical error or infection, and no painful recovery period.
Did You Know: A study analyzing health insurance claims over a four-year period found that patients with low back pain who saw a physical therapist first had a lower probability of having advanced imaging services and emergency room visits, along with lower out-of-pocket medical costs.
Physical Therapy Offers Pain Management Without Medication
Physical therapy for back pain may also reduce or eliminate the need for medications, including opioids. One study found early physical therapy was associated with a notable reduction in opioid use among patients with musculoskeletal pain. That means a lower risk of side effects and dependence on prescription pain opioid killers.
Physical Therapy Addresses Your Individual Symptoms
It’s clear different types of back pain have a range of causes and symptoms. Back pain also presents differently from patient to patient. One person may have trouble bending over to put on their shoes, while another person feels pain when they extend backward.
Physical therapy is highly-individualized in the type and intensity of exercises you perform. As your therapist assesses your movement and comfort level, they determine the best movements to reduce your pain and build strength to prevent pain going forward.
You don’t have to suffer with back pain forever. For many patients, physical therapy is an essential component of a comprehensive treatment plan to reduce back pain and improve spinal health.
Always speak with your physician and get their approval before starting any exercise or physical therapy regimen for different types of back pain.
