The Most Common Cause for Back Pain

Orthopaedic & Spine Center

by Jeffrey R. Carlson, MD

Back pain is the number one reason for which people will seek medical treatment in their lifetime, as research indicates.  Most people believe that if they have back pain, something must be wrong with the discs in their spine.  Thankfully, that is not the case, as the conditions that impact the spine and vertebrae (spine bones), such as herniated discs, pinched nerves or spinal stenosis, typically do not result in significant back pain.

Back strain or sprain

The majority of back pain that I see is caused by simple muscle, tendon or ligament strain.  The muscles, tendons and ligaments of our back are the work-horses that keep us upright, provide support for our spine and allow us to move in various ways. They can take much abuse over the years, without complaining or failing us.

During the course of our lives, we sustain “mini” injuries to these tissues.  We lift a heavy weight inappropriately, stretch too far, work or play too hard. The microscopic tears or strains may not cause pain or disability at the time inflicted, but can add up over the years.  All of a sudden, we lift, turn or twist a certain way and our back muscles start to spasm, throb and hurt like never before.  This is the excruciating pain we know colloquially as “throwing our back out”.  Although the pain may feel like we have fractured our spine bones or ruptured a disc, it is almost always due to muscle, tendon or ligament strain.

Even though the pain can be severe and acute, most people recover from this type of strain in just a few weeks with conservative treatment.  Just a few years ago, we thought that bed rest was the best treatment for a back strain.   We now know that this is unhelpful and can even make the problem worse.  Treatment includes anti-inflammatory medication, anti-spasmodic (muscle relaxant) medication, and possibly non-narcotic pain medication.  Patients are advised to modify their activities to accommodate their back strain, but not to lie in bed all day.  Ice and heat can be used, as well as hot baths or showers.

As with any muscle strain, healing takes time and patience.  However, 99% of us will heal perfectly well in just a few weeks.  Surgery is NEVER recommended for simple back pain caused by muscle, tendon or ligament strain.