FAQ’s on Back pain Acute and Chronic
What is back pain?
Back pain is one of the most common medical complaints. It is defined as pain in the back, and can originate from the structures in the back, such as the bones, tendons and joints, nerves, among others. Other organs may also cause pain that radiates to the back. While most causes of back pain can be treated easily, it is still recommended that you consult a physician.
Back pain can have different kinds of quality. There may be sharp, piercing pains that indicate nerve or muscular involvement. The pain may also be described as dull, vague and chronic.
What is the difference between acute and chronic back pain?
Acute back pain lasts for less than 12 weeks, and chronic back pain lasts for more than 12 weeks. Physicians may sometimes classify back pain as “subacute” in the second half of the acute period (i.e., lasting for 6 to 12 weeks). Both will have a range of different causes, as well as varying presentations and appropriate treatments.
What causes acute back pain?
Acute back pain is usually of sudden onset, and typically follows strain or injury from physical injuries. Most causes of this acute back pain are related to damaged tissues in the back, and resolve within three to six months with therapy and medications. Acute pain may also progress to chronic pain if untreated/unresolved.
It is also important to remember that back pain may just be referred from another organ, and indicate problems elsewhere, such as from Urinary Tract Infections (UTIs).
What causes chronic pain?
Chronic back pain can either have easily identifiable causes or no clear pain generator. The
first category is caused by structural conditions such as spinal stenosis, osteoarthritis, degenerative disc disease, and inflammatory disease. These cases may warrant surgical treatment of the defects. The second category may indicate an old injury that has insufficiently healed. It may also be caused by repeated stressors from everyday activity such as poor posture, being seated all day in the office, etc.
Chronic back pain has been shown to be associated with poorer quality of life, higher pain intensity, and greater fear of movement.
What are my treatment options to relieve low back pain?
The treatment of acute back pain is to address the underlying trigger condition. Since most cases are caused by acute muscle injury or strain, this is managed through treatment with anti-inflammatory and analgesic medications. Physical therapy may provide beneficial outcomes as well.
If the back pain is chronic and caused by structural defects such as stenosis, disc herniation, osteoarthritic degeneration, etc. you may be advised to undergo corrective surgery. The exact surgical procedure will depend on the underlying cause of the back pain. You should be aware that taking the surgical option entails a postoperative recovery and rehabilitation period. Steroid injections have been shown to reduce chronic back pain, and there are promising innovations such as the injection of hyaluronidase and anti-nerve growth factor.
Adorno ML, Brasil-Neto JP. (2013). Assessment of the quality of life through the SF-36 questionnaire in patients with chronic nonspecific low back pain. Acta Ortopedica Brasileira. doi: 10.1590/S1413-78522013000400004.
Antunes RS, de Macedo BG, Amaral Tda S, et al. (2013). Pain, kinesiophobia and quality of life in chronic low back pain and depression. Acta Ortopedica Brasileira. doi: 10.1590/S1413-78522013000100005.
Leite VF, Buehler AM, El Abd O, et al. (2014). Anti-nerve growth factor in the treatment of low back pain and radiculopathy: a systematic review and a meta-analysis. Pain Physician. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24452657
Pimentel DC, Elabd O, Benyamin RM, et al. (2014). Anti-Tumor Necrosis Factor Antagonists in the Treatment of Low Back Pain and Radiculopathy: A Systematic Review and Meta-analysis. Pain Physician. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24452656
Rahimzadeh P, Sharma V, Imani F, et al. (2014). Adjuvant hyaluronidase to epidural steroid improves the quality of analgesia in failed back surgery syndrome: a prospective randomized clinical trial. Pain Physician. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24452659