Back pain is surpassed only by headache as the most common cause of pain. It presents acutely, intermittently or as chronic pain and is mostly caused by minor injuries, slipped discs, facet joint problems or arthritis.
Ageing, a sedentary lifestyle, poor posture, obesity, genetic factors, adverse work environments, pregnancy, smoking and psychological factors can put people at risk of back pain. Good back hygiene and regular exercise can prevent or postpone back problems.
Sinister symptoms – such as back pain combined with bladder or bowel dysfunction, are indications to contact a doctor immediately. Ongoing unexplained backache for longer than one week should also be reported to your doctor. Eighty to ninety percent of backache due to muscular strain, resolves spontaneously within six weeks.
Less than 5% of back pain patients will need an operation. Consider asking for a second opinion if back surgery has been recommended.
Back pain can occur anywhere along the spine, but the most common site is the lower back or lumbar region. The lower part of the back bears the weight of the upper body, as well as any weight you’re carrying. It also twists and bends more than the upper back.
Back pain may be acute, recurrent or chronic. Most cases of back pain are acute – i.e. the pain starts suddenly and intensely – and usually last a short time (less than a month). Acute back pain is not usually caused by a serious medical condition and most cases resolve within a few days.
Recurrence is very common and takes the form of repeated episodes of acute pain with pain-free intervals. Chronic back pain is present all the time and persists beyond three months. Recurrent or chronic pain is usually more intractable than acute pain and often requires specialist advice.
Causes of back pain
Treating back pain
Diagnosing back pain
Reviewed by Dr Pradeep Makan, orthopaedic surgeon, Melomed Gatesville and Life Vincent Pallotti Hospital in Cape Town and part-time lecturer in the department of orthopaedic surgery at the University of Cape Town, March 2016