What is back pain?

The spine is made up of a group of bones in your back called vertebrae, which protect the spinal cord. Each vertebra has a large oval area facing the inside of the body (vertebral body), two bones coming out of the vertebral body on either side of the spine (pedicles), smaller bones attached to the inside of each pedicle to protect the back of the spine (lamina), a small bone at the back of the spine (spinous process), and two more bones on the outside of each lamina where muscles sit (transverse processes). On the inside of each transverse process is a structure called the facet joint that allows one vertebra to connect to another above or below it so the spine can move. The vertebrae have an opening in the center of the bones that surrounds and protects the spinal cord, called the spinal canal. This opening is made by the position of the vertebral body, the pedicles, and the lamina.

The vertebrae are named based on where they are located in the back. Cervical vertebrae are found in the neck, thoracic vertebrae in the upper back, and lumbar vertebrae in the lower back. The sacrum is below the lumbar vertebrae and is made up of 5 fused bones. Below that, your tailbone is made up of 3 fused bones called the coccyx. In between most of the vertebrae are gel-like shock absorbers called disks. Nerves that lead to the rest of the body pass through openings (foramina) in the bones.

Back pain may be caused by:

• Injuries or overuse, which most often affects muscles, joints and ligaments
• Poor posture
• Overweight
• Poor body mechanics when lifting
• Pressure on spine nerves, due to:
  • Changes with aging, such as disk thinning or rupture, narrowing of the spinal canal, or osteoarthritis
  • Osteoporosis, when the bones get brittle from lost calcium
  • Any bone fracture in the back
  • Structure problems you were born with, such as scoliosis
  • Infection
  • Tumors

How can I take care of myself when I go home?

How long it takes to get better depends on the cause of your back pain, your treatment, how well you recover, your overall health, and any complications you may have.

Management

• Your provider will give you a list of your medicines when you leave the hospital.
  • Know your medicines. Know what they look like, how much you should take each time, how often you should take them, and why you take each one.
  • Take your medicines exactly as your provider tells you to.
  • Carry a list of your medicines in your wallet or purse. Include any nonprescription medicines and supplements on the list.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Reduce swelling
  • Prevent side effects, such as nausea or constipation, from other treatments
• You may need to continue a rehabilitation program after you leave the hospital to help you recover from back pain and its treatment. Most rehabilitation programs include:
  • Physical therapy to help you regain muscle strength and teach you ways to move safely
  • Occupational therapy to help you learn safe ways to do the tasks that you did before your back pain started
  • If your nerves are damaged and you have trouble with your bowel or bladder, therapy may include skin, bladder, and bowel care and training.
• If you have had surgery, to care for your incision:
  • Keep your incision clean.
  • If you are told to change your dressing on your incision, wash your hands before changing the dressing and after disposing of the dressing.

Appointments

• Follow your provider’s instructions for follow-up appointments and routine tests.
• Talk with your provider about any questions or fears you have.

Diet, Exercise, and Other Lifestyle Changes

• Follow the treatment plan your healthcare provider prescribes.
• Get plenty of rest while you’re recovering. Try to get at least 7 to 9 hours of sleep each night.
• Eat a healthy diet.
• Drink enough fluids to keep your urine light yellow in color, unless you are told to limit fluids.
• Exercise as your provider recommends.
• Don’t smoke. Smoking delays healing.
• Lose weight if you need to and keep a healthy weight.
• Find ways to make your life less stressful.
• Follow activity restrictions, such as not driving or operating machinery, as recommended by your healthcare provider or pharmacist, especially if you are taking pain medicines or muscle relaxants.

Call emergency medical services or 911 if you have new or worsening:

• Back pain with numbness, tingling, pain, or weakness in one or both legs or arms
• Loss of bladder control
• Loss of bowel control
• Trouble with muscle movements, such as moving arms and legs

Do not drive yourself if you have any of these symptoms.

Call your healthcare provider if you have new or worsening:

• Back pain
• Depression
• Lightheadedness
• Loss of balance or coordination
• Loss of bladder control
• Loss of bowel control
• Numbness in your legs, feet, arms, or hands
• If you had surgery, signs of infection around your surgical wound. These include:
  • The area around your wound is more red or painful.
  • Your wound area is very warm to touch.
  • You have blood, pus, or other fluid coming from the wound area.
  • You have a fever higher than 101.5° F (38.6° C).
  • You have chills or muscle aches.
• Swelling in your legs, ankles, or feet