The most common type of back pain is the low lumbosacral pain, which in medical terms is referred to as lumbago. It is due to the pathological changes in the lumbar and sacral vertebrae and the muscles, ligaments and intervertebral discs of the backbone. Similarly, you can have pain in the upper and middle part of your back.
Symptoms of back pain vary in nature and severity depending on its wide-ranging causes and the severity of the pathology.
Pain in the back persisting for more than three months is described as chronic. Any pain of lesser duration is classified as acute or subacute. Chronic back pain symptoms are more severe because the cause is more advanced and of a longer duration.
Neurological symptoms indicate the involvement of the nerves. Due to the pathological changes in the spine, the nerve root of an outgoing nerve can get compressed. This causes tingling and numbness in the area of nerve supply. Sciatica and cervical spondylosis are examples.
Back pain symptoms and signs explained
1) The onset of back pain may be sudden or gradual
The pain of sudden onset is either due to trauma or an acute strain/sprain of the back muscle or a back ligament, due to injury or excessive stretching of the back, as a result of an over enthusiastic physical activity.
This may cause the fibers of the back muscles to tear or the muscles can go into spasm
Gradual onset is a result of a gradually progressing pathology in the backbones, or the back muscles, or the back ligaments.
2) The duration of pain in the back
The pain may last for a few days or a few weeks or it may be chronic. Chronic back pain is of more than three months duration and is typically due to pathological causes.
Pain in lower back of a few days or few weeks is usually due to muscle pain caused by sprain/strain.
3) Sciatica: Lower back pain radiating to the lower extremities
Radiation of pain to the lower extremities is a symptom that the condition has become chronic, which can be due to the pressure exerted on the sciatic nerve by a prolapsed intervertebral disc (PID). The condition is referred to as sciatica.
The sciatic nerve is formed by 5 nerves L4 to S3 and runs down the buttocks along the back of the thighs and legs.
Other causes of sciatica include;
- Lumbar spinal stenosis (narrowing of the spinal canal in the lower back)
- Degenerative disc disease (degeneration or prolapse of the intervertebral disc)
- Spondylolisthesis (a condition in which one vertebra slips forward over another)
4) Back pain may be associated with tingling, numbness, and weakness
Tingling and numbness in the lower extremities are again due to a prolapsed intervertebral disc pressing on the lower nerve roots emerging from the spine.
5) Limitation of movements
Severe pain may limit the movements of the back and the lower extremities. This can make carrying out your daily activities difficult.
6) Back pain on sneezing and coughing
The back pain may worsen on sneezing or coughing. This is due to the tightening of the back muscles during sneezing. Normal muscles do not pain during sneezing, but the strained, over stretched muscles do.
7) Loss of control over bowels and bladder
In severe chronic cases, there may be difficulty in passing urine or stools. This happens when the spinal cord has been compressed by a prolapsed intervertebral disc or a collapsed vertebra interrupting the nerve supply to the urinary bladder and the lower bowels. You lose control over the bladder and bowels resulting in incontinence.
8. Accompanying fever
An accompanying fever with back pain will indicate an infection in the vertebral bones or a kidney infection. The temperature rise is high in case of severe infection. An infection elsewhere such as in the kidneys can cause radiating pain to the back.
9. Unexplained weight loss
With an existing back pain, if you have lost a significant amount of weight without any apparent cause such as a reduced diet or increased physical activity, you must seek a medical opinion to rule out cancer or hormonal disorders.
10. Back pain symptoms of breast cancer
Breast cancer can cause pain in the upper back. The pain is deep-rooted and feels as though it is coming from deep within. This pain does not relent with ordinary measures such as stretching or manipulative treatment of misalignments of the joints.
The pain is persistent and is due to the pressure exerted on the ribs and backbone by the tumor and increases as the tumor grows over time.
11. Back pain symptoms of kidney failure
Back pain due to chronic kidney disease or kidney failure is a dull ache felt on the side in the mid-back or lower back region. It can come on as a sharp shooting pain in case of kidney stones present in one of the kidneys.
12. Back pain symptoms due to an aneurysm
Abdominal aortic aneurysm can cause a severe shooting pain of acute onset in the middle or lower back area depending on where the aneurysm is located in the aorta. This type of back pain is more common among the elderly people above the age of 60 years. Co-existing abdominal pain makes the doctor look for reasons in the abdomen.
13. Back pain due to asthma
Normal breathing is effortless. In asthma, the breathing is labored – meaning requires effort. This accompanied by severe coughing puts a strain on the breathing muscles.
The primary breathing muscles include the diaphragm and the intercostal muscles – those that are present between the ribs. Both these muscles are present from front to the back of the torso.
This strain and the tension on the muscles due to the labored breathing causes pain in the middle back region.
14. Back pain radiculopathy symptoms
Lumbar radiculopathy refers to a disease, which involves the lumbar spinal nerve root. This presents as pain, numbness, or weakness of the buttock and leg muscles. It is the most common cause of low back pain caused by compression of the spinal nerve root. Lumbar radiculopathy is more commonly referred to as sciatica.
15. Back pain accompanied by nausea and vomiting
Back pain is often associated with nausea and vomiting, which occur at the same time. The causes include
- Biliary Colic
- Chronic Pancreatitis
- Kidney Stones
- Digestion Distress
16. Back pain after eating due to an ulcer
If you have a chronic gastric or duodenal ulcer, it can cause you to have referred pain in the middle of the back that typically presents after eating. The pain can be quite severe of stabbing nature when an ulcer lying on the posterior surface of the stomach or duodenum perforates.
17. Back pain symptoms before and after menopause
Low back pain during the menopause transition affects a large number of women especially those with an unhealthy lifestyle that includes a sedentary routine and an unhealthy diet.
Women with an increased BMI (overweight and obese women) are at an increased risk of developing menopausal back pain.
This pain can be quite severe and it radiates down the back of the legs.
It can prevent a woman from carrying on her routine work. The main causes include:
- Stress and anxiety, which most women experience during that time cause tightening of muscles and those with weak back muscles due to no physical activity and an unhealthy diet can experience menopausal back pain.
- Hormonal changes which lead to estrogen deficiency during menopause.
18. Back pain symptoms due to heart attack
The pain of heart attack may radiate to the back or the heart attack can primarily present with a squeezing type of pain in the upper part of the back towards the left. This typically happens when the infarct is situated on the inferior wall of the heart.
19. Can gas cause back pain?
Bloating or gas in the stomach can cause back pain. Gas primarily occurs due to eating gas-forming foods like beans, cauliflower, broccoli, other cruciferous vegetables and high-fat or greasy foods. It can also occur due to frequent swallowing of air as in smokers.
Another cause of a backache accompanied by gas can be gall bladder problems.
The pain can vary in nature and severity. It can be sharp and stabbing or it can just be a dull ache.
20. Back pain symptom of lung cancer
A growing malignant tumor in the either of the lungs causes pain in the upper or the middle part of the back. The pain can be either on the left side or the right depending on which lung the tumor exists.
The back pain is continuously present every day even at rest and becomes worse on lying down. It is also aggravated when you take a deep breath. As the tumor increases in size, the pain worsens.
There are two ways in which lung cancer can cause back pain. First, the growing tumor presses directly on the structures of the backbone.
Secondly, back pain can also be due to the metastases (secondaries) to the backbone. About 40% of lung cancer cases spread to the backbone.
21. Symptoms due to respiratory diseases such as pneumonia and pleurisy
Lungs being in close proximity with the spine at the back can cause back pain symptoms when they develop a major pathology. Examples include pneumonia and pleurisy.
Pneumonia can present as a sharp pain in the upper back and the giveaway is accompanying high fever, difficulty in breathing, chest pain, and persistent cough. At times, accompanying respiratory symptoms may develop late and back pain may be the only symptom, making early diagnosis difficult.
The main symptom of pleurisy is a sharp shooting pain in the chest, which can radiate to the shoulders and the upper back. The pain worsens when you breathe, sneeze or cough.
The pain can be on the left side or right depending on which lung is affected.
22. Vertebral fracture symptoms
- Osteoporosis (bone thinning) is a condition that makes your bones weak and is the main cause of compression fractures of the vertebra. It is seen more in the elderly above the age of 65 years and more so in menopausal women. These fractures occur more commonly in the lower thoracic and the upper lumbar vertebrae – T10 to L1.
- Besides compression fractures, injuries to the spine due to a vehicle accident, a fall, or while playing sports can lead to fractures.
- Other causes that weaken your bones and make them susceptible to fractures include diseases of the spine, such as cancer, infection, and avascular necrosis.
Symptoms of vertebral fracture include
- Acute pain in the middle and lower back radiating to the hip, thighs, and the legs. This pain can then turn chronic
- Loss of control over urine and stools
- Numbness, tingling, and weakness indicating compression of the nerves at the site of the fracture.
23. Slipped disc symptoms
A slipped disc occurs when the intervertebral disc protrudes from its place and exerts pressure on the spinaL cord or the nerves emerging from it. It is more common in older adults.
Slipped disc symptoms depend on which part of the spinal cord has been affected and at which level of the vertebral column the disc has slipped.
- pain and numbness on one side of the body
- pain radiating to the arms or more commonly the legs
- pain becomes worse on standing or sitting
- pain aggravated even on walking short distances
- tingling, pain or burning sensations in the area supplied by the affected nerve
- pain increases at night
The varieties of reasons that cause the back pain symptoms are wide-ranging and mostly serious. Read this article on when to worry and see the doctor.