Back hurts

Having back pain is very common. The pain usually sits in the lower back, ie in the lower back, but some also aches in the chest. For the most part, the pain goes away by itself but sometimes you may need treatment.

Different types of pain and back pain

The most common type of back pain is pain in the lower back called the lumbar spine. But you can also get higher up in the so-called chest.

Pain in the lower back

You may have various pain in the lower back:

  • Lumbar pain, lumbago, often begins with weak, gradually increasing pain and a feeling of fatigue. The pain usually increases when the back is loaded. Lumbago is often called “common back pain”.
  • Back shot, lumbago acuta, often comes suddenly, for example in connection with a lift or a side twist. You feel pain and a lock in the back with cramps in the back muscles. The pain can be cutting, chopping or grinding. It may feel like your back is getting off.
  • Lumbar pain with leg pain, lumbago sciatica, means that you have pain in the lumbar region and also feel a radiating pain in one leg down to the foot. Lumbago sciatica may consist of pain alone. Sometimes you can also get less strength in some of the leg muscles and the feeling in the leg can be affected. Sciatica means that there is an irritation or inflammation of the sciatic nerve. You may also have sciatica without back pain.

Chest pain

You who have chest pain often have pain between the shoulder blades.

The most common is that the pain comes from tension in the muscles, but the pain can also come from the skeleton. Sometimes, chest pain can also come from the lungs or heart, for example in a  heart attack ,  angina,  or a  blood clot in the lung .

Pain in the chest from muscles or skeletons

Chest pain coming from muscles and skeletons is often characterized by the following symptoms:

  • The pain radiates from the back to the chest.
  • You get sharp and spasmodic pain in the chest, often on the side.
  • The aches get worse when you move your arms, neck or deep breath.
  • The pain varies depending on your posture.

Chest pain due to heart and lung disease

Chest pain coming from the heart and lungs is often characterized by the following symptoms:

  • The pains are strong and depressing, often like a band around the chest.
  • The pain can radiate up to the neck and out into the arm. Usually on the left side but also on the right.
  • The trouble increases with physical exertion that requires the heart to work harder. It can be when you run or go fast. The pain then diminishes when you are at rest
  • You get breathing difficulties.
  • You are out of breath, pale and sweaty.
  • You get a high heart rate.

When should I seek care?

Contact a health care center if the back pain does not bring within two weeks. This is especially important if you are in middle age, ie from 55 years onwards.

If you have back pain and have any of the following symptoms of back pain, seek medical care directly at a health center or on-call clinic :

  • You do not feel when you are pissed, or peeing on you.
  • You have numbness or decreased sensation around the rectum or genitals.
  • You have numbness, tingling or weakness in both legs.
  • You suddenly get hurt after an accident, such as a car accident or a fall.
  • You have chest pain and abdominal pain.
  • You have a fever or are feeling really ill.

What can I do for myself?

The most important advice for temporary back pain is to continue to live as usual even if it hurts.

Move

Try to touch yourself as usual. For example, you can walk. You can also exercise at home . Exercises that work out the back muscles and abdominal muscles are good if they do not increase the pain. Swimming often works well, especially backstroke.

Resting can quickly cause the muscles to become weaker and function worse. It takes longer for back pain to go over if you lie more in bed than usual.

There are several different exercises specifically designed for temporary, sudden back pain. There is no scientific evidence that these exercises are better than if you just move as usual.

Avoid heavy lifting and lateral rotation

You should not lift or carry heavy when you have back pain. If you’re going to lift, think about this: 

  • Keep what you should lift close to the body.
  • Bend your legs instead of bending your back.
  • Avoid turning your back sideways.

Pain tablets can help you move as usual

Regular  non-prescription pain tablets  are good to use so you can sleep better and move properly. It is good to take the pain tablets for a limited period, one to two weeks, or less time if the problems go over faster. The purpose of the pain tablets is to enable you to move and live as usual, as far as possible.

A pillow under the lap can relieve back pain

It can be nice to lie down and rest with a pillow under the lap and legs laid on a stool. Even when you sit, it can be nice to have support for the lap, for example a rolled up towel or pillow.

Avoid sitting on low sofas and chairs. If you find it difficult to get out of bed, you may try to roll over first. Then you swing your legs over the bed edge to finally get up by pushing away with your hands on the main side.

It is usually better to stand or lie down than to sit.

The working environment can affect back pain

Try to be aware of how you stand and sit in your workplace. You may need to make some changes to relieve your back more. For example, you who have a sitting job may need a standing pulpit or a height-adjustable table. This can make it easier to do the job.

Also keep in mind that it is good to have soles with failure in if you walk and stand a lot on hard ground.

Other parts of your work environment that can also affect back pain are well-being and stress. How you feel comfortable in your work affects the risk of having back problems.

Treatment of back pain

There are several different treatments of back pain for you who have back pain.

Physiotherapy, chiropractic and naprapathy

A physiotherapist , chiropractor or a naprapat can examine you, analyze your problems and help you find the causes of your pain.

You can also get manual treatment. This means that you get treatment done with your hands. But the most important part of the treatment of back pain is exercise and physical activity. The physiotherapist, naprapat or chiropractor will try out a workout program that is right for you. You can also get help with getting started. Then you can continue with the exercise program on your own. 

Here you can search for receptions near you.

Drug

Prescription-free pain tablets  can help if you are so sore that you have difficulty moving. Pain tablets may also be needed if you have trouble sleeping due to the pain.

A doctor can also give you personalized advice on prescription painkillers and how to best use them. For example, muscle relaxants can work if you have acute problems. Such drugs should be used with caution and only for a limited period as there is a risk of addiction.

The effect of painkillers is limited in the case of  long-term problems . There may be a risk of side effects and drug dependence if you use strong painkillers for a long time. Talk to a doctor about which drugs are suitable for your back pain.

Sometimes different types of injections are also used. But so far, there is only weak scientific evidence that they are effective.

Psychological treatment, KBT

How you feel and how you perceive the pain is of great importance in how you handle your situation. The best part is if you get help with both exercise training, medicines that provide good relief and pain management.

You can get psychological treatment of back pain with  cognitive behavioral therapy, KBT, with the help of, for example, a psychologist. Then, individually or in groups, you can learn more about how to live a good life despite having back pain. During treatment, you get to work with your thoughts, beliefs and behaviors when you are in pain. You get help to make reasonable demands on your body, to dare to move without being afraid, and to reduce the negative thoughts. Often the treatment consists of a series of conversations with practical tasks to perform between the meetings.

Operation

Sometimes an operation can help. A  herniated disc  pressing on a nerve root may for example be fine after surgery. But most disk hernias go back after a while. Therefore, it may be wise to wait for surgery for a few months.

Surgery can also be an option for those who have had back pain for a long time and who have not recovered well after other treatments. Then it is usually about back pain, which is because the  spinal discs  have collapsed. Then it is a so-called sternal operation or so-called disk prosthesis operation over one or two disks.

Some can even get so bad in the lumbar spine without special cause that an operation is needed.

Multimodal pain treatment

Those who have had back pain for more than three months may be entitled to so-called multimodal pain treatment. Then different methods are used at the same time to relieve the problems. The treatment lasts for a couple of months and you often get to meet both physical therapist, occupational therapist, doctor and curator or psychologist during that time. This includes lectures on how to manage pain and stress, and individual discussions about your situation. You can also try different types of exercise to find something that fits, and can get exercises done at home.

A doctor will determine if the treatment is appropriate for you.

Other treatments

When it comes to treatment with massage, acupuncture, tens, corset, cold, heat, shortwave diathermy or ultrasound, there is so far no evidence that they help with temporary back pain.

What happens in the back when I get hurt?

The spine is made up of vertebrae that lie on top of each other. Between the vertebrae are slices of cartilage called disks. The counters act as shock absorbers and contribute to a certain mobility between the vertebrae. There are facet joints on both sides of the vertebrae. They bind the vertebrae of the spine together and also contribute to stability and mobility. The vertebrae are held together by ligaments and muscles.

The pain is often due to changes in the counters and facet joints

Lumbar pain is most likely due to the discs and facet joints. For example, there may be age changes in the counters and facet joints. They can become worn or inflamed. 

Back pain can also come from muscles and ligaments. Many people who sit a lot at work or at home get aches in the back muscles. 

Back pain can cause tension and muscle cramps

When the pain is felt in the back, you get an increased tension in the muscles around the area that hurts. The excitement is muscle spasms. This can make it even more painful. You can have such a strong muscle spasm that your back looks sloping. Then it can be difficult to walk, sit or lie down. The pain and cramp usually last for a few days, up to a week.

Endorphins can cause you less pain

The body has systems that can cause you less pain. Among other things with the help of so-called endorphins. Endorphins are morphine-like substances found in our bodies. The amount of endorphins in your body increases as you move and decreases when you rest or are still.

Causes of back pain

There are many reasons why you may have back pain and pain.

Some postures can cause back pain

There is a connection between back pain and certain postures. You who work in any of the following postures are at risk of getting back pain:

  • You work on shaking and vibrating surfaces for a long time.
  • You have sedentary and monotonous postures.
  • You have bent and twisted postures when you lift things.
  • You lift heavy. 

Many studies have been done on work with other types of posture and back pain, but the results are not clear. Back pain is common at all ages, even in people who do not have heavy or back-loading jobs and in the unemployed.

The spine changes with age

Your back changes as you get older. With age, for example, the joints often get thinner cartilage. It is called cartilage wear or osteoarthritis. The leg at the edges of the joints then becomes stronger. The edges of the vertebrae also become more knotty over the years. It’s called spondylosis. The dishes also age and become thinner and collapse.

There is no clear connection between these age changes and back pain. You can have a lot of changes in the X-ray image without any hassles and you can have a lot of trouble from the back without any changes in the X-ray image.

Herniated                                       

Disk herniation  means that one of the spinal discs has broken and bends towards the spinal canal. It is common and usually does not hurt. But if the disc presses against the spinal cord or nerve roots, you may get back pain or sciatica, which is a radiant pain in the leg. In rare cases, hernias can cause numbness in the genital area and you will find it difficult to hold on when you need to pee or poop. Then it is important to seek care directly.

Other causes of back pain

Sometimes, but it is unusual, back pain may be due to these diseases that you may have in the back:

  • Vertebral compression . Osteoporosis, osteoporosis , can compress the vertebrae. It can cause severe pain that usually subsides after some time.
  • Spinal stenosis means that the canal for the spinal cord has become more narrow. It causes pressure on the nerves in the spinal cord. Then you often get sore buttocks, thighs or calves when walking, running or walking on stairs. The cause is usually the age changes around the vertebrae.
  • Spondylolysis is a change that is sometimes seen by x-ray. This means that there is a gap in the bone arches that surround the spinal cord.
  • Bechterew’s disease is a rheumatic disease. It means that you get inflammation in the muscles and joints, especially in the spine. The disease often starts with pain in the lower back or buttocks and stiffness in the back, often in the mornings.
  • Forestier’s disease or DISH is a rheumatic disease. The most common symptoms are back pain and stiffness. Some have joint problems, especially in the elbow joints, shoulders, hips, knees and ankles.
  • Spondylite and discs. Spondylitis is an infection of a vertebra most often caused by bacteria. Diskite is a bacterial infection in a disk. The symptoms are severe back pain, fever, sickness and possible weight loss. Both diseases are very rare.
  • Cancer diseases can cause  metastases  in the spine. Prostate cancer and breast cancer are common causes of skeletal metastases.

So another investigation goes on

You can have a physical examination with your doctor  . You can often answer the following questions:

  • Do the back problems vary in strength?
  • Are the back problems exacerbated by various movements?
  • Does back pain affect work and leisure?
  • Do you recognize the back problems from before? Have the pain changed or not?
  • Will the back pain come at the same time as pain from other parts of the body, such as the stomach?
  • Does the pain radiate into any bone?
  • Are your back pain alleviated by pain tablets?

You can also answer the following questions:

  • Have you or have you had any serious illness, such as cancer?
  • How do you feel about your family and friends?
  • How are you doing at work, when you do everyday tasks and when you are in other tasks or roles that you have in life?
  • How have the back pain affected you in your everyday activities?
  • What thoughts and fears have your back pain caused?

It is important that you try to describe how the back pain has affected your everyday activities and how you experience your back pain yourself. Sometimes special questionnaires are used, especially for those with long-term back problems. It can give your doctor greater understanding of your situation.

Some need to be examined by an orthopedic surgeon

Sometimes you may need more examinations by other specialists, such as a rheumatologist or orthopedic surgeon. For example, if the doctor suspects that the back pain is due to a particular illness. Then referral to other specialists may be needed.

Assessments at orthopedics are made above all if the complications are so severe that the doctor is considering an operation. 

X-rays are usually not necessary

An X-ray examination can be important if there is a suspicion of a serious illness. X-ray examinations are usually not meaningful for temporary back pain that lasts for a few weeks.

However, in case of more long-term problems, it may be good to do an X-ray examination. It is especially good for excluding serious diseases of the skeleton. Most often, magnetic camera examination, MRI , is now used , since the doctor can then also see soft parts such as muscles and discs.

Computed tomography  is another option that also provides good images for suspected disk hernias or a serious back injury.

Age changes and disc changes can be found in people from the age of 20-30. These changes are visible on X-rays, but that doesn’t mean that something is wrong or that it hurts.

Living with back pain

The pain can affect your physical and mental performance, as well as sleep and sex life. This can make you feel worse and become depressed. You can also get a sense of hopelessness.  

The relationship with relatives and workmates can be affected. Partly because of your impaired ability to cope with chores at home and at work, and partly because you feel mentally worse from the pain. The pain can also create concern and thoughts that something is seriously wrong. The pain will then be more difficult to manage. Then it is important that you get help with getting rid of your concerns. Tell a doctor about your concerns and that you want help with managing it.

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