Back pain is discomfort and pain caused by injury or illness between the shoulders and the hips. It’s not a disease on its own, but a symptom of various medical conditions, such as osteoporosis, sciatica, and general muscle strain.

65 million adults report a recent bout of acute (short-term) back pain, and 16 million suffer from chronic (persistent) back pain. Adults with back pain earn less income and spend more on healthcare than their counterparts without back pain.

Instead of living with back pain, improve your overall quality of life by getting your back pain treated. Just because it’s common doesn’t mean you have to live with it!

Let’s cover the common causes, risk factors, and the best treatment options for back pain.

What Causes Back Pain?

The most common causes of back pain are:

  • Muscle strain
  • Ligament injury
  • Osteoarthritis
  • Osteoporosis (and the compression fractures it causes)
  • Spinal stenosis (compression of the spinal nerve roots)
  • Sciatica (pinching of the sciatic nerve)
  • Scoliosis
  • Cauda equina syndrome
  • Herniated disc
  • Degenerative disc disease

What causes back pain in females? These are conditions that cause back pain that apply more to women than men:

  • Osteoporosis, which is more common in females
  • Osteoarthritis, which is more common in females
  • Pregnancy
  • Large breasts
  • Premenstrual syndrome (PMS)
  • Premenstrual dysmorphic disorder (PMDD)

Risk Factors for Back Pain

  1. Poor posture
  2. Older age
  3. Obesity, excess weight
  4. Lack of exercise
  5. Heavy lifting, especially when it’s part of your occupation
  6. Sedentary lifestyle
  7. Smoking
  8. Pregnancy
  9. Genetics

Back Pain Symptoms

Here are the symptoms you may feel when you have back pain:

  • Pain in the upper region of the back
  • Pain in the lumbar spine region (low back pain, or lumbago)
  • Neck pain, shoulder pain
  • Pain in the buttocks
  • Muscle spasm
  • Back soreness
  • Back stiffness
  • Pain or tingling sensation down one or both legs
  • Weakness in one or both legs

How do I know if my back pain is serious? Your back pain is serious if it is accompanied by any of the following symptoms:

  1. Incontinence
  2. Fever
  3. Unexplained weight loss
  4. Severe stomach pain
  5. Pain in both legs, instead of just one
  6. Issues with balance

Back pain should also be considered serious if it occurs shortly after an injury or accident (car accident, sports-related injury, fall, etc.).

Diagnosis for Back Pain 

Most healthcare professionals will ask about symptoms and perform a physical examination, medical history, and family history. But to diagnose the cause of your back pain, tests are often required.

Doctors tend to use the following tests to diagnose back pain:

  • X-rays reveal bone alignment or fractures, as well as signs of arthritis.
  • CT scans (computed tomography) are used to investigate the source of your back pain, such as injuries, infections, disc herniation, pinched nerves, and much more.
  • MRIs (magnetic resonance imaging) tend to over-diagnose because of their incredible detail. MRIs may be good for early detection of back pain conditions, but doctors tend to avoid them for simple cases of back pain.
  • Bone scans are rarely used, but can help a doctor look for bone tumors or compression fractures.
  • Blood tests show if an infection or other medical condition may be causing back pain.
  • Electromyography (EMG) can confirm nerve compression by herniated disk or narrowing of the spinal canal.

How do you know if back pain is in the muscles or discs? Back pain is muscle-related if your back hurts more when you’re moving than when you’re still. Back pain is disc-related if moving relieves pain, if bending forward hurts more than returning to an upright position, and if pain radiates past your buttocks into your legs.

Treatment for Back Pain

The below treatments are some of the best, evidence-based methods for relieving back pain. Always seek medical advice before you take back pain treatment into your own hands.

1. Chiropractic Care

Also called manual spinal manipulation, chiropractic care is a treatment plan in which a chiropractor adjusts spinal alignment and mobilizes the surrounding muscles and joints. 

Chiropractic care has been shown to effectively reduce back pain and neck pain. Research indicates that chiropractic care is better and more cost-effective than taking medicine and/or visiting a primary care physician.

After an adjustment, patients feel less pain, less disabled, less dependent on drugs, and more satisfied. This is because it aligns the parts of your spine that interfere with proper nervous system function.

Different chiropractors may have different methods. At Denver Upper Cervical Chiropractic, we employ gentle spinal manipulations mainly to the upper spine. We do not treat our patients like rag dolls. Our approach is gentle enough for newborns and grandmas.

2. Physical Therapy

Also called physiotherapy, physical therapy for back pain sufferers uses stretches and exercises that improve posture and musculoskeletal strength.

Physical therapists also help to prevent future injuries through patient education and core muscle strengthening.

The stretches and exercises you learn may be difficult to remember if you are experiencing little or no pain. And once the pain comes back, it could take at least a day for the stretches and exercises to alleviate your pain.

So it’s important to remember to do your stretches and exercises learned at physical therapy, even if you aren’t experiencing back pain at that moment.

Also, obesity and excess weight are risk factors for low back pain. Exercise helps you maintain a healthy weight.

3. Spinal Decompression

Non-surgical spinal decompression therapy involves a gentle, slow stretching of the spine. Decompression creates a vacuum effect that can help retract herniated or bulging discs.

If your back pain is caused by disc problems, a decompression table is one of the only effective ways to reduce that pain.

We use a spinal decompression table in our office, and it’s shown huge success with our patients! Often, you’ll find these tables at the physical therapist or chiropractor’s office.

Triton DTS 6M table at Denver's best orthospinology chiropractor

4. Lifestyle Changes

The following lifestyle changes may relieve or prevent back pain:

  1. Quit smoking.
  2. Eat healthy, to maintain healthy body weight.
  3. Exercise, but avoid very high-resistance or intensity workouts. Swimming is great for the spine.
  4. Don’t sit for long periods of time. (If you have no choice because of work, watch my video with the best stretches to offset the pain this might otherwise cause.)
  5. Sit with good posture.
  6. Lift with your legs/knees, not your back.
  7. Get plenty of high-quality sleep.
  8. If you are depressed, seek medical advice. Depression and low back pain are associated with one another, though it is unclear which causes which. Since it’s the human body where everything is interconnected, the right answer is probably that they create bad synergy and affect each other.
  9. Reduce your daily stress levels. Not only does stress increase your awareness of pain, but stress can also cause tension and strain in your back muscles leading to back pain.

5. Over-the-Counter Medications

Many experts recommend pain-relieving pharmaceuticals to “treat” back pain. This is a pretty medieval solution to a complex problem.

I suggest identifying the root cause of back pain and treating that root cause, so you don’t have to take side effect-laden drugs.

Acetaminophen can relieve acute low back pain. Studies show it works moderately better than a placebo for back pain. Side effects include abdominal pain, nausea, changes in appetite, headaches, yellowing of the skin, and dark urine.

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen treat inflammation, which is often involved in back pain. Side effects of NSAIDs include stomach ulcers, indigestion, stomach aches, diarrhea, headaches, drowsiness, and dizziness.

These pain medications are for pain management only and should not be used for long-term treatment of back pain.

6. Prescription Medications

Doctors may prescribe you prescription medications, including extra-strength acetaminophen or NSAIDs. They may also prescribe opioids, such as oxycodone or hydrocodone, which interact with receptors on nerve cells in the body and brain to reduce pain.

However, you may have heard of the opioid epidemic. Opioids are famously over-prescribed and incredibly addictive.

Muscle relaxants reduce pain for a short period of time. But they are only recommended for back pain sufferers who also experience muscle spasms. The most common side effect is drowsiness.

Prescription antidepressants may relieve back pain even if the patient is not depressed. Antidepressants may lead to nausea, sexual dysfunction, fatigue, insomnia, diarrhea or constipation, and increased appetite/weight gain.

7. Injections

There are various injections your doctor may administer to treat back pain, depending on the root cause:

  • Epidural steroid injections reduce inflammation around the spinal nerves, relieving back pain.
  • Nerve block injections provide temporary pain relief for back pain by blocking neurological pain receptors.
  • Facet joint injections introduce anesthetic and steroids to the affected facet joint which helps relieve back pain.
  • Botox injections (botulinum A toxin) have been shown to improve chronic low back pain in about half of patients.

8. Acupuncture

Acupuncture is the strategic insertion of filiform needles into trigger points to relieve back pain and other conditions. Acupuncture works better than a placebo at treating chronic low back pain.

Dry needling is a modern, evidence-based practice very similar to acupuncture, except it is solely based on scientific research, not ancient traditional medicine.

9. Massage Therapy

Massage therapy is when a licensed professional manually manipulates muscles and soft tissues for stress reduction and pain relief. A massage should help ease tense or overworked muscles, a common cause of back pain.

If back strain is causing your back pain and it isn’t going away, look for a highly-qualified massage therapist today. I have a list on hand of great physical therapists in Denver that I recommend to patients.

10. Surgery

Surgical options are a last resort for most adults suffering from back pain. They may be necessary due to structural issues that cause pain, such as those resulting from an injury.

7 common surgeries for back pain:

  1. Spinal fusion
  2. Laminectomy (AKA spinal decompression)
  3. Discectomy
  4. Disc replacement
  5. Foraminotomy
  6. Vertebroplasty and kyphoplasty
  7. Nucleoplasty (AKA plasma disk decompression)

How to Prevent Back Pain

  1. Stretch every morning and before doing any physical activity.
  2. Regularly do low-impact aerobic exercises. These improve your back pain in the short-term. They also help you maintain a healthy weight in the long-term, which is important since excess weight is a major risk factor for back pain.
  3. Build muscle strength, particularly in your core around your lower back.
  4. Quit smoking. It increases your risk of low back pain, possibly because nicotine more quickly degrades your discs.
  5. Try not to sit for long periods of time. Prolonged sitting often leads to back pain.
  6. Practice good posture. Practice a little bit each day, and eventually good posture will be second nature to you.
  7. Avoid heavy lifting. Do not apply to jobs which require constant heavy lifting.
  8. Lift with your legs, if you must lift. Keep the back straight and only bend at the knees.
  9. Try yoga. It promotes good posture and strengthens important core muscles.

Back pain can be brought on or worsened by sitting for long periods of time. The best way to combat it is to practice daily stretches to counteract a sedentary lifestyle and prevent chronic or acute back pain.

When to See A Doctor 

When should I be worried about lower back pain? You should be worried about lower back pain only if:

  • you’ve experienced persistent low back pain for at least a month,
  • it hasn’t improved or is severe, and
  • you exhibit another warning sign, such as old age, young age, fever, sudden weight loss, or incontinence.

Seek immediate medical attention if your back pain accompanies fever, unexplained weight loss, or new issues with your bladder or bowels. These may indicate a serious condition.

If back pain pops up after a fall or a traumatic injury, visit your doctor ASAP.

Upper back pain is associated with an increased risk of kidney problems or cancer, more so than lower back pain.

On any given day, it is estimated 12% of human beings are experiencing low back pain. Just because it’s normal doesn’t mean you shouldn’t seek treatment. Fortunately, back pain can often be treated with chiropractic care.

Click here to set up your appointment with Denver Upper Cervical Chiropractic. Our patients’ success stories speak for themselves. (We reserve Fridays for out of town patients.)

New patient? Click here to learn what to expect and how to move forward.

  1. Bussières, A. E., Gauthier, C. A., Fournier, G., & Descarreaux, M. (2020). RE: Spinal Manipulative Therapy for Low Back Pain–Time for an update. Full text:
  2. Bryans, R., Decina, P., Descarreaux, M., Duranleau, M., Marcoux, H., Potter, B., … & White, E. (2014). Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Journal of Manipulative and Physiological Therapeutics37(1), 42-63. Full text:
  3. Liu, L., Skinner, M., McDonough, S., Mabire, L., & Baxter, G. D. (2015). Acupuncture for low back pain: an overview of systematic reviews. Evidence-Based Complementary and Alternative Medicine2015. Full text:
  4. Oh, H. J., Jeon, C. B., Jeong, M. G., & Choi, S. J. (2017). The effects of spinal decompression therapy on pain and disability in patients with chronic low back pain. The Journal of Korean Physical Therapy29(6), 299-302. Full text:
  5. Shi, Z., Zhou, H., Lu, L., Pan, B., Wei, Z., Yao, X., … & Feng, S. (2018). Aquatic exercises in the treatment of low back pain: a systematic review of the literature and meta-Analysis of eight studies. American journal of physical medicine & rehabilitation97(2), 116-122. Abstract:
  6. Robertson, D., Kumbhare, D., Nolet, P., Srbely, J., & Newton, G. (2017). Associations between low back pain and depression and somatization in a Canadian emerging adult population. The journal of the canadian chiropractic association61(2), 96. Full text:
  7. Liu, L., Skinner, M., McDonough, S., Mabire, L., & Baxter, G. D. (2015). Acupuncture for low back pain: an overview of systematic reviews. Evidence-Based Complementary and Alternative Medicine2015. Full text:
  8. Green, B. N., Johnson, C. D., Snodgrass, J., Smith, M., & Dunn, A. S. (2016). Association between smoking and back pain in a cross-section of adult Americans. Cureus8(9). Full text:
  9. Mabry, L. M., Ross, M. D., & Tonarelli, J. M. (2014). Metastatic cancer mimicking mechanical low back pain: a case report. Journal of Manual & Manipulative Therapy22(3), 162-169. Full text:
  10. Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., … & Buchbinder, R. (2012). A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism64(6), 2028-2037. Abstract: