Back pain (back pain): location, remedies and exercises

Who has never felt a twinge or tingling in the back region? Regardless of age and stage of life, we are susceptible to suffering from back pain , popularly known as back pain.

A survey carried out in São Paulo, by Hospital das Clínicas, brought the numbers that, in 2018, 4 out of 10 people suffered from back pain, which is also one of the main reasons for absence from work.

The causes for these pains would be overweight, stress , wrong posture and the way we position ourselves to handle the cell phone and computer.

But back pain can also arise for other reasons, being one of the indications that another disease may be developing in the body.

Check out the main information about back pain:

Contents

What is back pain?

Back pain, popularly known as “back pain”, is pain located in the spine region, which can be due to trauma or structural changes in the body.

This pain may come from muscles, bones, nerves, joints or other structures of the spine, which is divided by 7 cervical vertebrae (neck), 12 thoracic (middle back, dorsal region), 5 lower back (lower back), 5 sacral and 2 or 3 coccyx.

It can also be related to postural problems, in which bad habits (such as sitting in the wrong way) end up contributing to the pain developing in different degrees.

Read more:  Poor posture in front of screens causes damage to the neck and shoulders

It can also be constant or intermittent, as well as stay in one place or move and even spread to other regions.

Depending on the case, it may not have its origin in the spine itself, but come from another problem or organ in the body.

Back pain can occur at different ages and stages of life, being more common in adults, the elderly and pregnant women. It can be classified into 3 degrees: acute, subacute and chronic.

Treatment for back pain consists of using medications, physiotherapy and alternative treatments.

Back pain can be found in the International Classification of Diseases (ICD-10), by the code  M54 and by its subtopics:

  • M54.0 : Panniculitis affecting regions of the neck and back;
  • M54.1 : Radiculopathy;
  • M54.2 : Cervicalgia;
  • M54.3 : Sciatica;
  • M54.4 : Lumbago with sciatica;
  • M54.5 : Low back pain;
  • M54.6 : Pain in the thoracic spine;
  • M54.8 : Another back pain;
  • M54.9 : Back pain , unspecified.

Types of back pain

There are three types of back pain that differ by the time the pain remains, they are:

Acute

Acute back pain is characterized by the duration of symptoms in less than 6 weeks. Recovery and pain disappear within a month.

Subacute

This type of back pain lasts 6 to 12 weeks, and usually improves in up to 3 months.

Chronic (persistent)

Chronic back pain can appear and last for 12 weeks or more. In this case, where the pain lasts for a longer time, the tendency to disappear is difficult because the cause needs to be studied by a specialist and diagnosed correctly, to then start the treatment.

What are back pain and low back pain?

Back pain and low back pain are the same thing: back pain.

However, back pain is a broad term for all pain that occurs in the back, whereas low back pain occurs specifically in the lower back (lower part of the spine close to the buttocks).

Thoracic and lumbar back pain

Thoracic back pain and lumbar back pain demonstrate the location of the spine where pain occurs. In thoracic back pain, pain occurs at the back of the chest (a structure that houses the lungs and the heart).

Lumbar back pain occurs in the part of the spine called the lumbar or “lumbar” (lower back), located between the waist and the buttocks. The lumbar region is responsible for carrying the largest load on the spine.

Stitches in the back: what can it be?

Often, stitches can occur in the back, close to the lungs, stomach or dorsal region.

It is possible that they occur on the left side of the chest or on the upper part, above the ribs. If they are sporadic, they may just be a reflection of the body and not mean anything serious.

However, when they are frequent, becoming uncomfortable pain, it is necessary that the condition is evaluated by a doctor.

The stitches can indicate a series of factors, according to the location and frequency that occur. From inflammation in the stomach to changes in the heart.

In general, more serious conditions are associated with shortness of breath, difficulty breathing or irradiation of pain to limbs (arms and legs).

Another possibility is stabbing pains related to physical exertion.

In such cases, it is possible to notice occurrences when the person practices activities, especially without warming up or stretching. In addition, there are contractures or involuntary movements of the muscles.

Causes: what causes back pain?

Generally, what causes back pain comes from muscles, joints, nerves, bones or other structures close to the thoracic spine. The causes can be:

Traumatic

This is the case of muscle strains, fractures or contusions in the dorsal region, activities in inappropriate positions, exaggerated physical effort (the most common cause) or falls, which cause back pain.

Degenerative

It occurs when the degeneration of vertebral bodies, intervertebral discs and facet joints ( spondylosis ) due to natural aging.

Biochemical and biomechanical changes during the aging process are the cause of pain, but it is necessary to analyze the case as there may be some other condition involved.

Read more: Spondylosis: what treatments are available?

Structural changes

Back pain can arise due to an abnormality or changes in the structure of the spine, the main factors being Scheuermann’s disease and the post-traumatic type.

Scheuermann’s disease is characterized by deformity in the curvature of the spine in adolescents, especially in boys.

The post-traumatic type is related to cases of fracture sequelae, in which the pain is caused by the deformity in the structure and instability.

Infections

Infections in the spine can occur due to some bacteria or fungus. The most common conditions involve osteomyelitis (inflammation in the bones) and herpes zoster infection (the causative agent of chickenpox).

These conditions need to be treated with care, as they can compromise bone, disc, or spinal nerves.

Tumors and neoplasms

Benign or malignant tumors can cause back pain. When they appear, it is common for the patient to complain of fatigue , weight loss and even anorexia .

Bone structures throughout the body may be compromised, but it is, in general, the spine most affected.

For the doctor to make the diagnosis, he takes into account the characteristic of the pain, the age of the patient and whether there was any case in the family.

Metabolic changes

The osteoporosis is the major metabolic cause for back pain because it reduces bone mass and increases the likelihood of fractures.

When can back pain be the lung?

Although most cases of back pain are related to posture or lack of stretching, some cases can be triggered by lung problems.

In general, it is enough to identify if the pain or discomfort occurs during breathing (inhalation and exhalation).

In general, this occurs in cases of colds and flu, which are usually limited and do not cause major complications. But they can also occur in more severe conditions, such as pneumonia and significant respiratory changes, such as pulmonary embolism .

What diseases cause back pain?

Some pathological conditions can trigger back pain , such as appendicitis, bladder or urinary tract infections, endometriosis, gall bladder, tumors in the abdominal region, ovarian cysts and endometriosis. In addition, normal and frequent conditions, such as menstruation itself, can also be the source of pain.

These pains can be caused by inflammatory disorders or hormonal changes.

Risk factors: will everyone suffer from back pain?

Back pain or just back pain can be felt by anyone throughout life, but some factors allow the condition to appear. In addition to poor posture, which has a direct relationship with pain, smoking can be related to increased muscle and joint pain.

Other conditions include:

  • Sedentary lifestyle;
  • Fall;
  • Pregnancy;
  • Age;
  • Overweight;
  • Obesity;
  • Excessive or wrong physical exercise;
  • Genetics;
  • Diseases like arthritis and cancer.

Symptoms: how to identify back pain?

When back pain arises, in addition to back pain, it may be accompanied by other symptoms, such as:

  • Stitches;
  • Burning sensation in the spine;
  • Difficulty breathing.

In addition, it can appear as pain radiating to limbs, also affecting mobility and locomotion.

In addition, it can appear as pain radiating to limbs, also affecting mobility and locomotion.

Depending on the cause of the pain, other symptoms may accompany the back pain, appearing associated. Like:

  • Pain on the left side that radiates to the limbs, with tingling;
  • Back pain and stomach pain (similar to colic);
  • Pain in the upper (upper) back and headache;
  • Pain in the upper back and lung;
  • Pain in the middle of the back and difficulty breathing;
  • Back pain and chills;
  • Pain in the right side of the back and shortness of breath;
  • Back pain and fever.

These conditions need to be investigated by the health professional, as they may be related to infections, respiratory diseases and cardiac conditions.

It is worth noting that in these cases, the joint symptoms may often not be due to pain, but may be manifesting together.

That is, shortness of breath or difficulty in breathing is not always because the pain is limiting the movement of the rib cage, but because there are pulmonary changes.

Where is the pain located?

The location in the spine that is experiencing the pain can help indicate what is causing it, such as:

Nonspecific spinal pain

This manifestation of back pain still has an unknown cause, but it appears to be the most common to occur in people. The pain usually occurs below the nape of the neck, in the trapezius muscle (center of the back).

Pain in the upper back (shoulders)

When the pain occurs in the upper part of the back, close to the shoulders, it may be due to tiredness , stress, stiff neck or some unusual movement that has injured this part of the body.

Pain in the middle of the back

The pain felt in the middle of the back can be related to the kidney. It can usually be a stone in this organ, which results in cramps and pain, preventing the person from moving quickly and even walking.

It can also be a back problem such as a herniated disc , in which the pain can cause reflexes to the ribs.

Right or left back pain

When right or left back pain occurs it is indicative of a muscle injury. It may have been caused by excessive physical exercise, falling, effort at work depending on the profession (bricklayers, gardeners, etc.) or poor posture.

Back pain with reflex in the legs

This type of back pain occurs at the end of the spine, close to the buttocks. The person may feel the pain in the form of tingling or pricking, even sitting or walking the pain remains. It may be a sign of a parrot’s beak (wear of the vertebrae) or an inflamed sciatic nerve.

Back pain when breathing

Back pain when breathing is associated with lung activity that can cause pain. One of the characteristics of this type of back pain is the sensation of shortness of breath or pain when taking a deep breath, which can happen due to the flu , smoking or even lung infection.

Pain in the middle of the back between the lungs and the spine

Despite being a very specific location, the pain in the middle of the back between the lungs and the spine can be caused by different conditions. Some related to orthopedic issues, such as nerve compression of the spine, herniated disc and even muscle changes, affecting the balance of the spine.

In addition, the pain in the middle of the back between the lungs and the spine can be triggered by factors that are often not associated quickly, such as congestion, reflux problems (which end up attacking the esophagus and causing pain near the chest) and cardiac changes.

Pain in the left and right side: is it normal?

In general, pain is always a signal from the body that something is wrong. Sometimes it can be just a warning of poor posture or poor sleep. But in others, it may be an alert for muscle or spinal problems.

Traumas, blows, excessive weight are usually easier to be related to pain in the left and right side of the back.

But it may also be that a pain located in the upper part is involved with lung or respiratory changes.

Back pain in pregnancy: what to do?

It is common to hear reports of back pain during pregnancy and, in general, it is normal for this to occur.

Due to the weight of the belly, there is an effort by the back muscles to maintain the balance and posture of the pregnant woman.

The cartilage and the joints that make up the spine tend to get swollen, this can also cause pain.

It is common for back pain to appear in the last months of pregnancy, but nothing prevents it from appearing in the first few months.

Regardless of when the pain arises, it is recommended to report to the obstetrician who accompanies the pregnancy so that he also makes sure that everything is right with the mother and baby.

Generally, pregnancy pain is treated preferentially with therapies and activities that can prevent or ameliorate it. Some examples are: swimming, water aerobics, walking, stretching, pilates and yoga.

Read more: Can pregnant women take acetaminophen? Know the dosage and risks

Diagnosis

The diagnosis can be made by a general practitioner or orthopedist.

Before starting any treatments, the doctor will need to obtain an accurate diagnosis of back pain.

Generally, the doctor will assess the entire spine, identifying whether there are deformities, muscle contractures and possible limitations of certain movements, which helps to identify the cause of the pain. If necessary, you can perform tests, such as:

X-ray

Popularly known as X-ray , it is an exam done by means of images, using a small dose of radiation, which allows the best definition of the internal structure of the body.

The exam is quick and painless.

Nuclear magnetic resonance

Made in a large tube-shaped device, the person lies down on a kind of stretcher that moves into the machine.

When the equipment is correctly positioned, a magnetic field is created which results in high definition images.

Thermography

This exam performs an analysis of the body areas, using the skin temperature. It is ideal for locating and evaluating inflamed areas, for example, the back or joints.

Computed tomography

Computed tomography is a kind of x-ray that can capture images of the entire body in 360 degrees.

In this way, the lesion can be seen from any angle, helping with diagnosis and treatment.

Back pain: is there a cure?

It depends . Back pain when it is acute and subacute can be treated with medication and the pain resolved.

But chronic cases are not. However, there are several treatments that can improve the quality of life, preventing crises from occurring.

What is the treatment for back pain?

Treatment for back pain should take into account the specific condition of the patient and the causal factors of back pain.

In 90% of cases, the problem can be remedied by the physiotherapist, without the use of medication or surgery.

To relieve back pain there are different treatments that can help. They depend on the location of the pain (concentrated or throughout the spine) and type (acute, subacute, chronic).

When pain is acute, medications are indicated for relief.

Specialist monitoring is always necessary, which can indicate, when necessary, injectable medications, alternative treatments such as chiropractic , acupuncture, transcutaneous electrical nerve stimulation (TENS) and also specific physiotherapy.

In some cases, such as herniated discs or pain from physical trauma, treatment may be by surgery.

Learn more about each type:

Rest

Resting helps recovery, as lying down comfortably for the spine reduces pressure on the intervertebral discs and lumbar muscles.

The ideal is to rest for 3 to 4 days, according to medical advice.

Physiotherapy

In the case of back pain, it is common for the physiotherapist to work with exercises that help strengthen the spine and correct the posture, thus helping with mobility and pain relief.

This method can be done in different ways, using devices and instruments such as ball, light weights, elastics and stretches.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation or TENS uses a low-frequency electrical current, which is applied to the skin in the region where the pain occurs.

The equipment works in an analgesic way, controlling and relieving pain.

In general, it is used after the physiotherapy session, as a way to help recovery or accelerate muscle strengthening.

Surgery

In some cases, it may be necessary to perform surgery so that the condition no longer affects the patient’s life.

Cases that may normally require surgery are: hyperalgic low back pain, cauda equina syndrome, infectious low back pain, spondylolisthesis, neurogenic claudication, among others.

How to reduce pain?

It is possible to combine, along with medical treatment, some activities that reduce pain and promote health for the whole body, including:

Chiropractic

Chiropractic is a technique that uses your hands to exercise in the painful area.

This type of treatment does not use drugs or surgery, only the strength of the hands and movements help to relieve the patient’s pain during the development of the session.

Read more: Chiropractic: what is it and how much does it cost?

Acupuncture

This technique has existed for millions of years in the East, in countries like China and Japan the practice is common. It consists of a therapy that uses small and thin needles in the skin, focusing on the region where the person feels the pain.

The needle remains for a specific time, in which it relieves symptoms and leaves the patient feeling better.

Massage

Massage is a good choice to help with pain, as it makes the blood circulate in the region where the pain persists, causing relief.

This type of technique can be done in different regions of the body and in different ways, you can use your hands or machines adapted for massage. Some sessions can help eliminate pain.

Yoga or Pilates

Both techniques are known to work the body, in a way that strengthen the muscles and help in relieving pain.

Pilates can be done solo, in which the body is used and objects such as ball and light weights or with equipment, in which the person performs the movements and moves the device with the body.

Yoga combines breathing and relaxation techniques with stretching. Both yoga and pilates can help and bring many benefits, the choice is up to you.

Medicines: what is the best medicine for back pain?

To cure back pain, non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants are usually recommended – but always with medical guidance and recommendation. Between them:

  • Non-steroidal anti-inflammatory drugs ( Atrofem , Tylenol , Flanax );
  • Muscle relaxants ( Miorrelax , Dorflex , Coltrax ).

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Read more: What is muscle relaxant and what is it for?

Home remedy and options for back pain

There are some home treatments that can help in relieving back pain, they are:

Relaxing tea

Ingesting teas can aid in the treatment and relief of pain, especially those related to stress or tension.

The basil , for example, has antiseptic properties, detoxing and calming. For those who have a lot of pain, the ideal is to take it twice a day, but if the pain is moderate once a day it helps.

Add 10 basil leaves and boil with water in a kettle. Wait for the tea to cool down (ideally, take it warm), strain it and drink it.

If you like ginger , you can add it to the tea, as it can also help reduce pain.

Hot compress

The compress, when made hot, is able to cause the dilation of blood vessels, causing the blood flow to be improved, relieving pain in cases of injuries and inflammation.

To do it, take a towel and moisten it in hot water, remove the excess water and place it on the painful back area.

Keep the towel for at least 15 minutes or until you feel it cool, then moisten again and replace it until you feel pain relief.

Back Pain Exercises: What Can It Relieve?

Some light exercises can be done to help fight back pain, they are:

Remembering that any practice should be reported to the doctor and should not replace the professional’s recommendations.

Spine mobilization (cat stretching)

On a mat or on the floor, stay in position on four supports with your palms on the floor and your knees as well. Slowly arch your spine, like a curve, and return to the starting position.

Knee to chest

Remain lying in a straight place, it can be on a mat or on the floor, on a rug.

Lift your leg and bring your knee up to your chest and hold with your arms for 20 seconds. Lower the leg and repeat the same movement with the other, doing 2 times with each leg.

Board

Lie on a flat surface and support your elbows on the floor, leave your fists closed or if you prefer, use your hands to help maintain your posture.

Slowly raise the balls of your feet so that the entire hip rises and the body is straight and aligned. Stay in position for one minute, then rest.

Lumbar Stretching

Lie on the mattress, floor or mat. Bend your knees, bring your legs together and slowly let them fall to the right side. The arms should be open and the head looking forward.

Stay in this position for 30 seconds, then switch to the left side.

Back pain prevention

Feeling back pain is not good, but there are ways to prevent these pains from happening to you:

Maintain the ideal weight

Always try to maintain the ideal weight for your height and body type, taking into account genetics and tests (cholesterol, lack of vitamins , etc.).

When there is overweight, the region of the spine may be too much, causing the dreaded pain. Therefore, try to maintain a weight that provides you with a healthy life.

Strengthen your muscles

Exercise is always beneficial to our health and one of the points that can be worked on is the strengthening of muscles

Among the routine exercises, adapt some that can help with posture, thus preventing future pain. There are several types of low impact exercises that strengthen your muscles, such as walking, swimming, yoga, etc.

Read more: Physical exercise metabolism: how do we gain muscle mass?

Be careful when sitting

If you work or sit for a long time, you need to stay in a way that does not damage your spine and that your posture is adequate.

After a sitting period, get up, walk a little, or stretch.

Attention to the mattress

The way you sleep can influence back pain due to the mattress. It happens that it loses its firmness over time, so that one side may become lower and the other higher.

This ends up leaving the spine askew, which can cause pain. So be aware of the way you sleep and how your mattress behaves when you lie down to rest.

Living together: tips to reduce pain

Back pain harms the daily life of those who have it, but there are options to avoid pain and have a good quality of life:

Correct posture

To avoid pain, pay attention to your posture. When sitting, position yourself so that your spine is straight and your knees are bent 90 degrees.

Avoid carrying heavy bags or backpacks, this causes an overload in the spine and causes the onset of pain.

Also be careful when picking up objects that have fallen on the floor or are at a low level, instead of just bending your spine, lower your whole body, crouching down. In this way, injuries and spinal blocking are avoided.

Strengthen your muscles with physical activity

Exercising brings countless benefits, one of which is to strengthen the muscles, especially the back.

By practicing a physical activity that aids in the strength of the muscles, it is possible to avoid future pain and promote well-being.

Also, be aware of your weight, because when we are overweight we demand more of the spine, which can overload it.

Attention at bedtime

Pay attention to your mattress. Over the years, it can happen that the mattress sinks with its weight becoming one side different from the other and that is the source of the pain.

Make sure the health of your mattress and also the type of pillow you are using to sleep on.

When the pillow is too high or too low, it can cause pain in the neck and head.

Prognosis

It is estimated that 65% to 80% of the world population develops back pain (back pain) at some stage in their life. In general, the pain does not become disabling, although it is often prolonged.

On average, pain pictures have the following improvement rate:

  • Acute: 60% of people recover in one month;
  • Subacute: 90% recover within three months;
  • Chronic: There is little chance of disappearing completely.

But if the pain persists for longer, attention is needed as your body may be giving you an alert that another health problem is developing. The best thing to do is to see a doctor.

Complications: what can back pain cause?

Pains that persist for a longer time, such as a few weeks or months, tend to worsen a person’s quality of life.

Nonspecific pain, in many cases, is benign and does not pose risks. But in others, where the pain remains and does not respond to treatments, some of the complications can be:

  • Loss of strength in the limbs (arms, legs);
  • Paraplegia (damage to spinal structures);
  • Sexual dysfunction;
  • Loss of quality of life.

Common questions

Is it normal to have pain in the middle of the back, between the lungs and the spine?

The region located in the middle of the back, between the spine and the lungs can be affected by different conditions, such as:

  • Problems in the vertebrae themselves (damage to joints due to trauma);
  • Muscle problems (inflammation or tension);
  • Damage to the ribs (beats and trauma);
  • Changes in the diaphragm (tension or damage due to trauma or stress);
  • Pulmonary changes;
  • Digestive disorders.

All of these problems can cause pain in the central region of the back. Only a professional can determine the source of the pain and what are the best treatments.

Back pain when breathing. It is severe?

The painful sensation when breathing can be related to trauma, bad sleep or physical activities. But it can also be due to breathing problems.

Therefore, when experiencing any discomfort related to breathing, especially if there are no recent traumas or falls, it is necessary to seek medical help.

Why do we feel back pain during menstruation?

During menstruation, a number of hormones are acting on the body. Some of them may be responsible for discomfort, such as pain and stitches in the back. Prostaglandin is a substance that causes uterine contractions to flake the endometrium (ie, cause bleeding). This creates pain.

Sometimes, it is more similar to colic itself. But it can occur as a pain in the back, with stitches and contractions that radiate through the lumbar region.

How is pneumonia back pain?

When a case of pneumonia occurs, the disease affects the region in which the lungs are located.

Pneumonia causes a lot of coughing and difficulty in breathing deeply, which causes back and chest pain due to the effort made when coughing or breathing, mainly because the lungs are inflamed.

What are the symptoms of the inflamed spine?

Symptoms of lumbar disc herniation, popularly called an inflamed spine, include: pain in the lower back (which may have a reflex to the thigh, leg and feet) pain when moving or straining, tingling in the thigh, leg and feet , sensitivity and loss of muscle strength.

How to relieve back and neck pain?

Through simple exercises that stretch and strengthen the spine, it is possible to relieve and prevent pain.

Specific stretches and low-impact physical activities, attention to posture when sitting and bending down, in addition to reducing the weight carried in backpacks can be tactics capable of relieving pain.

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