By LEENA KAMAT, MD
Back pain is one of the most common reasons people go to the doctor or miss work. According to the National Institute of Neurological Disorders and Stroke, back pain is the most common cause of job-related disability. At least 80 percent of Americans will experience back pain in their lifetimes. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down the leg or limited flexibility or range of motion.
Most back pain is the result of an injury, such as muscle strain due to sudden movements or poor body mechanics while lifting heavy objects. Back pain can also be the result of certain diseases, such as cancer of the spinal cord, a ruptured or herniated disc, sciatica, arthritis, or infections of the spine. Acute back pain can last anywhere from a few days to a few weeks, while chronic back pain is pain that lasts longer than three months.
Anyone can develop back pain, even children and teens. Research has yet to prove what contributes to back pain. However, the following risk factors might put you at greater risk of developing back pain: age, lack of exercise, excess weight, improper lifting, and smoking. Back pain is more likely to occur in individuals between the ages of 30 and 50. This is partly due to the changes that occur in the body with aging since the fluid content between the vertebrae in the spine reduces. Also, as we age, we lose some muscle tone, which makes the back more prone to injury. This is why strengthening your back muscles and using good body mechanics are helpful in preventing back pain.
Back pain often develops without a specific cause. Conditions commonly linked to back pain include: muscle or ligament strain, bulging or ruptured disks, arthritis, or osteoporosis. The evaluation for back pain should include a complete focused medical history looking for red flags, which include, but are not limited to: neurologic deficits, fever, trauma, and indications of a serious underlying condition. It is also important to rule out non-spinal causes of back pain, such as pyelonephritis, pancreatitis, gastrointestinal causes, and pelvic disease. Fractures are an uncommon cause of back pain; they are associated with risk factors such as osteoporosis and steroid use.
Radiological imaging may help in establishing a cause for a patient's back pain. Imaging options include plain radiographs, CT, MRI, or nuclear medicine bone scan. Conventional radiographs of the spine can help excluding neoplasm, infection, or ankylosing spondylitis. CT and MRI are cross-sectional imaging and the method of choice in diagnosing spinal stenosis, herniated discs and facet joint abnormalities.
Studies have shown that uncomplicated back pain is a benign self-limited condition that does not warrant imaging. For cases that would be considered complicated status and may warrant imaging would include the following red flags: recent trauma, unexplained weight loss, unexplained fever, immunosuppression, history of cancer, IV drug use, prolonged use of corticosteroids, osteoporosis, age >70, focal neurologic deficit progressive or disabling symptoms, and duration greater than 6 weeks. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments.
The radiologists from Radiology Specialists of Florida at Florida Hospital are very well trained and experienced. We have radiologists trained in musculoskeletal, neurological, and nuclear medicine imaging that can help assist in diagnosing and/or treating causes of back pain. We keep up to date on the latest technology and information so that we can offer patients the best care.
The Florida Hospital Care Network delivers seamlessly connected healthcare services for all ages. Quality Imaging and Diagnostic starts today.
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Leena Kamat, MD, is a board certified diagnostic radiologist, sub-specialized in breast imaging for Radiology Specialists of Florida at Florida Hospital. She earned her medical degree at the University of Florida, College of Medicine and following graduation completed her residency at the University of South Florida and a fellowship in breast imaging at the Moffitt Cancer Center.