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Chronic Back Pain

Everyday tasks can be a struggle,  but treatment options can help you manage your chronic pain and regain your quality of life.

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Chronic back pain

Chronic back pain

Chronic back pain is a common issue for many people, regardless of age. It can be incredibly challenging for those affected and is the leading cause of disability worldwide.

Prevalence and impact of chronic back pain on daily life

Chronic back pain affects ~20-30% of adults.

For younger adults (aged 18-34), this can arise from injuries or intense physical activity. 

Middle-aged individuals (aged 35-65) may experience back pain due to spine wear and tear, such as disc degeneration and osteoarthritis.

In older adults (aged 65+), chronic back pain is usually due to age-related spine changes like decreased bone density and degenerative disc disease.

Symptoms of chronic back pain

Persistent pain
Ongoing discomfort in the lower, middle or upper back.

Pain with movement
Increased pain when bending, lifting or twisting.

Radiating pain
Pain that travels down the legs or arms.

Muscle spasms
Sudden, painful involuntary contractions of the back muscles.

Numbness or tingling
Sensations of numbness, tingling or pins and needles.

Difficulty standing up straight
Trouble maintaining a straight posture or standing upright for extended periods.

Stiffness
Reduced flexibility or a feeling of tightness in the back muscles.

Fatigue
Overall tiredness or fatigue due to chronic pain impacting sleep and daily activities.

Emotional symptoms
Feelings of depression, anxiety or frustration as a result of dealing with persistent pain.

Causes and risk factors for chronic back pain

Chronic back pain can stem from a variety of causes, each affecting the spine and surrounding structures in different ways. One of the most common culprits is muscle or ligament strain. This can occur from heavy lifting, sudden awkward movements or even prolonged poor posture, which can stretch or tear muscles and ligaments in the back.

Another significant cause of chronic back pain is bulging or ruptured discs. The discs act as cushions between the vertebrae in your spine. When a disc bulges out of place or ruptures, it can press on nearby nerves, leading to pain that may radiate down the legs or arms.

Arthritis is also a major factor, especially in older adults. Conditions like osteoarthritis can wear down the cartilage that protects the joints in the spine, leading to pain and stiffness. In some cases, arthritis can cause narrowing of the space around the spinal cord, a condition known as spinal stenosis, which can further contribute to discomfort.

Osteoporosis is another condition that can lead to chronic back pain. This disease causes bones to become weak and brittle, increasing the risk of fractures in the spine. When a vertebra fractures, it can result in significant pain and reduced mobility. Several risk factors can increase the likelihood of developing chronic back pain.

Age is a significant factor; as people get older, the spine undergoes natural wear and tear, making pain more likely.

A lack of exercise can also contribute, as weak muscles may not support the spine effectively, increasing the risk of injury.

Excess weight puts additional stress on the spine, which can lead to pain over time.

Finally, smoking can negatively affect blood flow to the spine and contribute to disk degeneration, making smokers more susceptible to back pain.

Treatment options for chronic back pain

Heat and Cold Therapy: Heat relaxes muscles, while cold reduces inflammation and numbs pain. Alternating between using a heating pad and a cold pack can be particularly effective.

Over-the-Counter Pain Relievers: Over the counter medicines like ibuprofen or paracetamol can help alleviate pain and reduce inflammation. Always follow the recommended dosage and consult with a healthcare healthcare professional if you have any concerns.

Gentle Stretching and Yoga: Regular stretching can improve flexibility and relieve tension. Yoga, in particular, emphasizes mindfulness and body awareness, helping to reduce pain and enhance overall wellbeing.

Weight Management: Maintaining a healthy weight through a balanced diet and regular exercise can reduce strain on the back, helping to alleviate pain.

Physical therapy is a highly effective treatment for chronic back pain. A licensed physical therapist can develop a personalised exercise program and teach proper body mechanics and posture to help prevent further injury.

If non-surgical methods do not provide sufficient relief, medical interventions may be considered.

Prescription Medications
If over-the-counter options are ineffective, your doctor may prescribe stronger pain relievers, muscle relaxants or anti-inflammatory medications.

Injections
Corticosteroid injections or nerve blocks temporarily relieve pain by reducing inflammation or blocking pain signals. These can be particularly helpful for conditions like herniated discs or spinal stenosis.

Acupuncture, chiropractic care and massage therapy may offer additional relief and can complement other treatments by focusing on holistic healing.

Spinal cord stimulation is a minimally invasive option for managing chronic back pain, particularly for those who have not found relief from traditional treatments. This therapy involves implanting a small device near the spinal cord that sends electrical impulses to interfere with pain signals traveling to the brain. SCS can be an effective option for those with specific conditions, such as failed back surgery syndrome or neuropathic pain.

Surgery is generally considered a last resort when other treatments have failed to provide relief, and when there are clear underlying structural issues that can be addressed. Situations where surgical options may be appropriate include:

Herniated Discs: If a disc is compressing a nerve and causing significant pain or neurological issues, surgical options such as discectomy (removing the damaged disk) may be necessary.

Spinal Stenosis: When spinal narrowing causes pain, tingling, numbness and/or muscle weakness, procedures like laminectomy (removing a portion of the vertebra) can relieve pressure on the spinal cord and nerves.

Severe Osteoporosis: When fractures occur due to weakened bones, spinal fusion may be recommended to stabilize the spine.

Slipped Disc: When the soft, jelly-like center of a spinal disc pushes through a crack in its tough outer layer, surgical intervention may be required to relieve pressure on affected nerves.

See how Kim found her way to a life with less pain thanks to Spinal Cord Stimulation

Kim suffered from chronic back pain until she found relief with spinal cord stimulation. Learn more about Kim’s story and watch the video.

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This material is for informational purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.

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