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Diagnosing back pain

Oh, your aching back.

If it's any consolation, you're not alone. In a three-month period, about 1/4 of adults in the United States experience at least 1 day of back pain, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

Fortunately, most people who seek help from their doctors for back pain find relief. Most back pain requires simple, conservative treatment. 

Causes of back pain

Your back is a complex structure, notes the American Academy of Orthopaedic Surgeons (AAOS), consisting of:

  • Vertebrae. These are the bones in your spine that are stacked one on top of another.
  • Disks, which are the shock-absorbing material between the vertebrae.
  • Spinal cord and nerves.
  • Small joints to give you mobility and flexibility.
  • Muscles and ligaments.

Pain can be caused by problems in any of the above.

According to the AAOS and NIAMS, some of the more common causes of back pain include the following, listed from the most to the least common:

Back strain or sprain. Sprains and strains can be caused by excess weight, weak muscles or strenuous activity, according to the AAOS.

Wear and tear. Osteoarthritis and other so-called degenerative processes are often related to aging.

Herniated or slipped disk. As you age, the shock absorbers between your vertebrae harden and can crack or rupture. Sometimes a disk pushes out and presses on a nerve.

Compression fracture. This occurs when a vertebra, weakened by osteoporosis, crushes or fractures under pressure.

Less common causes for back pain include bone cancer, diseases of the spine such as spondylolysis or spondylitis, infection, or neurological problems.

Diagnosing back pain

Finding the specific cause for back pain can be difficult.

Your doctor will likely ask questions such as when the pain started, where it is located, and what aggravates or relieves it.

A physical examination might include testing reflexes and strength in your back and legs, and examining your posture, stance and walk.

Your doctor also might ask you to undergo:

Blood tests to look for infection or cancer.

X-rays to look for trauma or diseases of the spine.

Computerized tomography (CT) scanning, which offers more detailed images than x-rays. The scanner is shaped like a large doughnut, which you pass through while on a table. You might be given a contrast material either by injection or to drink. The contrast material makes certain structures visible to the scanner. A CT scan can be especially helpful in finding osteoarthritis or other bone abnormalities.

Magnetic resonance imaging (MRI), which uses radio waves and magnetic fields to produce images. You lie on a table and enter a long tube, where the imaging takes place. MRIs are often used to find herniated disks or tumors.

Talk to your doctor

Call your doctor if you have pain in your back. It is most likely easily treated.

reviewed 5/13/2016

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