Back pain is pain felt in the back. Back pain is divided into neck pain (cervical), middle back pain (thoracic), lower back pain (lumbar) or coccydynia (tailbone or sacral pain) based on the segment affected. The lumbar area is the most common area affected. An episode of back pain may be acute, sub-acute, or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain, or a burning sensation. Discomfort can radiate into the arms and hands as well as the legs or feet, and may include numbness, or weakness in the legs and arms.

There are many causes of back pain, including blood vessels, internal organs, infections, mechanical, and autoimmune causes. Approximately 90 percent of people with back pain are diagnosed with nonspecific acute back pain in which there is no identifiable underlying pathology.  In approximately 10 percent of people, a cause can be identified through diagnostic imaging. Less than 2 percent are attributed to secondary factors, with metastatic cancers and serious infections, such as spinal osteomyelitis and epidural abscesses, accounting for around 1 percent.

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The risk factors are related to a higher risk of developing low back pain:

• occupational activities
• pregnancy
• a sedentary lifestyle
• poor physical fitness
• older age
• obesity and excess weight
• smoking
• strenuous physical exercise or work, especially if done incorrectly
• genetic factors
• medical conditions, such as arthritis and cancer
• Lower back pain also tends to be more common in women trusted Source than in men, possibly due to hormonal factors. Stress, anxiety, and mood disorders have also been linked to back pain.

A physician will usually be able to diagnose back pain after asking about symptoms and carrying out a physical examination. An imaging scan and other tests may be required if:

• Back pain appears to result from an injury
• There may be underlying cause that needs treatment
• The pain persists over a long period

Back pain usually resolves with rest and home remedies, but sometimes medical treatment is necessary. If home treatments do not relieve back pain, a physician may recommend the medication, physical therapy, or both. Back pain that does not respond well to OTC painkillers may require a prescription NSAID. Codeine or hydrocodone, which are narcotics, may be prescribed for short periods. These require close monitoring by the doctor. In some cases, muscle relaxants may be used.

Surgery for back pain is typically used as a last hope, when serious neurological deficiency is evident. Surgery may sometimes be suitable for people with severe myelopathy or cauda equina syndrome. Causes of neurological deficits can include spinal disc herniation, spinal stenosis, degenerative disc disease, tumor, infection, and spinal hematomas, all of which can impinge on the nerve roots around the spinal cord. There are multiple surgical options to treat back pain, and these options vary depending on the cause of the pain.

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