Back pain is considered chronic once it lasts for three months, regardless of the cause. In some cases, the cause may not be entirely understood, though the pain is very real.
The common types of chronic back pain generally fall into one of these four categories:
- Mechanical causes, including problems with the spine or surrounding muscles, such as scoliosis, a herniated disk or muscle tension.
- Back injury: this can be sudden and traumatic, such as a spinal fracture following a car accident, or it can be caused by repetitive strain over time, such as muscle strains caused by heavy lifting.
- Diseases or medical conditions can also lead to chronic back pain, either directly or indirectly. For example, arthritis can target the joints in the spine. Conditions such as pregnancy can place pressure on the spine and surrounding muscles, which can also lead to chronic back pain.
- Infections and tumors are the least frequent cause of low back pain. These include bone infections such as osteomyelitis, and tumors in the spine.
A diagnosis of chronic back pain may take many months, and may involve much testing. Wondering what you can expect at the doctor? Well, first, your doctor will probably take a history, which will include some of the following:
- When your pain began
- What your pain rating is (using a pain scale)
- Words that describe your pain (such as "burning" or "sharp")
- What makes your pain worse, and what relieves your pain (bring your pain journal!)
After the history, your doctor will examine your back, which may include palpation (checking for tender points or any obvious physical abnormalities), muscle strength testing and sensation testing. He may ask you to perform certain movements, such as bending or walking. For further examination, your doctor may order image testing or even blood tests.
Depending on its cause, chronic back pain can be treated in a number of ways, including:
- Medications, such as NSAIDs or opioids
- Muscle relaxants
- Physical therapy
- Heat and/or ice
- Traction or realignment
- Complementary or alternative treatments, such as acupuncture or massage
- Steroid injections
- Nerve blocks
- Surgery (usually reserved for severe cases)
Related article: Is it Safe to Exercise With Chronic back Pain?
Like many chronic pain conditions, living with chronic back pain on a day-to-day basis is not easy. In addition to your usual treatment regime, there are some simple coping strategies that can make your daily life easier, and may improve your quality of life. These include:
- Keeping a pain journal. A pain journal can be a valuable tool for coping with back pain. Almost anything goes in your journal. You can note the times of day or activities after which your back pain seems worse or better, and use these notes to recognize patterns. You can also vent your feelings about your pain.
- Learn to relax. For most people, stress increases muscle tension, which can increase the intensity of your back pain. Since eliminating stress is next to impossible, it is important that you learn to relax. Relaxation can decrease muscle tension and anxiety, possibly helping you get your pain under better control.
- Accept Your Pain. You have chronic back pain. You don’t have to be happy about that, but you can learn to live with it. Finding a way to make peace with your condition can improve your quality of life.
Medline Plus. Back Pain. Accessed 4/6/10. http://www.nlm.nih.gov/medlineplus/backpain.html
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Back Pain. Accessed 4/6/10. http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp