Back pain overview

Back pain (Latin: dorsalgia) is pain felt in the back. It may be classified as neck pain (cervical), middle back pain (thoracic), lower back pain (lumbar) or coccydynia (tailbone or sacral pain) based on the segment affected. The lumbar region is the most commonly affected area. An episode of back pain may be acute, subacute 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 to the arms and hands as well as the legs or feet, and may include numbness or weakness in the legs and arms.
The majority of back pain is nonspecific and idiopathic. Common underlying mechanisms include degenerative or traumatic changes to the discs and facet joints, which can then cause secondary pain in the muscles and nerves and referred pain to the bones, joints and extremities. Diseases and inflammation of the gallbladder, pancreas, aorta and kidneys may also cause referred pain in the back. Tumors of the vertebrae, neural tissues and adjacent structures can also manifest as back pain.
Back pain is common; approximately nine of ten adults experience it at some point in their lives, and five in ten working adults are affected each year. Some estimate that as many of 95% of people will experience back pain at some point in their lifetime. It is the most common cause of chronic pain and is a major contributor to missed work and disability. For most individuals, back pain is self-limiting. Most people with back pain do not experience chronic severe pain but rather persistent or intermittent pain that is mild or moderate. Still, chronic back pain symptoms, defined as repeated or persistent pain for at least 3 months within the past 12 months, affected 34.4% of a nationwide sample of adults in mild form, 25.1% in moderate form, and 13% in (very) severe form. In most cases of herniated disks and stenosis, rest, injections or surgery have similar general pain-resolution outcomes on average after one year. In the United States, acute low back pain is the fifth most common reason for physician visits and causes 40% of missed work days. It is the single leading cause of disability worldwide. According to the World Health Organization, approximately 90% of all low back pain cases are non-specific, meaning that no clear structural cause can be identified.