Back pain is one of the most common health problems worldwide, with studies suggesting that up to 80% of adults will experience it at some point in their lives. It is the second most frequent reason for doctor visits after respiratory infections. Beyond the physical discomfort, back pain also carries significant economic and social consequences. It is a leading cause of sick leave and absenteeism, often resulting in reduced work performance, decreased productivity, and considerable losses for both individuals and organisations.
While most cases are mild and improve either on their own or with conservative treatments, some individuals suffer from recurrent or chronic pain that affects their daily quality of life. In certain instances, back pain can signal more serious health problems that require urgent medical intervention to prevent complications.
Understanding Back Pain
Back pain refers to any discomfort in the region stretching from the base of the neck down to the lower spine. The nature of pain varies widely: it may be sharp and sudden, dull and persistent, or a heavy sensation accompanied by stiffness.
By duration, back pain is classified as:
Acute Pain: Lasts less than six weeks and is often triggered by physical exertion or prolonged sitting.
Subacute Pain: Persists for six to twelve weeks.
Chronic Pain: Continues beyond twelve weeks, affecting sleep, movement, and work capacity.
By location, it is divided into:
Neck and Upper Back Pain: Often caused by muscle strain or poor posture during prolonged computer or device use.
Mid-Back Pain: Related to spinal or muscular issues.
Lower Back Pain: The most common type, usually linked to overexertion, disc problems, or nerve compression.
Common Causes of Back Pain
Back pain arises from a wide range of conditions, some simple and others more serious. The main categories include:
Mechanical (Musculoskeletal) Causes
Muscle strain and overexertion due to prolonged sitting or improper lifting.
Herniated discs pressing on nearby nerves, sometimes radiating pain to the legs.
Arthritis and spinal degeneration, especially with ageing.
Spinal deformities or curvature.
Compression fractures in individuals with osteoporosis.
Neurological Causes
Nerve compression in the lumbar or sacral spine.
Narrowing of the spinal canal, causing pain and weakness in the lower limbs.
Non-Mechanical Causes
Kidney problems such as stones or infections.
Primary or secondary spinal tumours.
Infections affecting the spine.
Symptoms and Risk Factors
The intensity of back pain can range from mild discomfort to severe pain that restricts mobility. Certain factors increase the likelihood or severity of back pain, including:
Prolonged sitting and poor posture, particularly when using devices.
Lack of physical activity and obesity which place greater strain on the spine.
Smoking reduces the blood supply to spinal tissues and delays healing.
Psychological stress and anxiety may trigger muscle tension without an underlying physical cause.
Pregnancy-associated weight gain and hormonal changes that affect muscles and ligaments.
Some warning signs require immediate medical attention:
Weakness or numbness in the legs.
Difficulty controlling the bladder or bowels.
Severe pain that does not improve with rest or disturbs sleep.
Persistent pain lasting more than two weeks without improvement.
Fever, unexplained weight loss
History of cancer or osteoporosis.
Diagnosis
Diagnosis usually involves:
Medical history and physical examination to assess movement, muscle strength, and nerve reflexes.
Imaging tests such as X-rays, MRI, or CT scans to evaluate discs and vertebrae.
Blood tests if infection or inflammation is suspected.
Nerve tests to measure the impact of compression or inflammation.
Treatment Options
Conservative Management (most common)
Temporary rest, while avoiding prolonged bed rest.
Pain relievers and anti-inflammatory medications.
Physical therapy with strengthening and stretching exercises.
Hot or cold compresses.
Local steroid injections in selected cases.
Cognitive behavioural therapy for chronic pain associated with stress.
Surgical Intervention (as a last resort)
Persistent herniated discs not responding to other treatments.
Severe neurological deficits.
Advanced spinal stenosis.
Tumours, infections, or unstable fractures.
Prevention
Maintaining spinal health and reducing the risk of back pain is possible through:
Practising correct sitting posture and supporting the lower back.
Using proper techniques when lifting heavy objects.
Avoiding prolonged sitting or standing without movement.
Exercising regularly, particularly stretching and strengthening exercises for the core and back.
Maintaining a healthy weight.
Sleeping on a supportive mattress and avoiding overly high pillows.
Quitting smoking to improve circulation and bone health.
Conclusion
Back pain is more than just a temporary nuisance; it is a global health issue that affects millions of people. Most cases can be managed effectively with early care and lifestyle adjustments, but neglecting persistent symptoms may lead to serious complications that impair quality of life. Raising awareness about the causes, prevention strategies, and when to seek medical attention is key to ensuring a healthier, more active life.
By: Dr Badreyya Al-Harmi (Public Health Consultant)
