Back pain is a common complaint. Four out of five people in the United States will
experience low back pain at least once during their lives. It's one of the most common
reasons people go to the doctor or miss work.

On the bright side, you can prevent most back pain. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.

Your back is an intricate structure composed of bones, muscles, ligaments, tendons
and disks \u2014 the cartilage-like pads that act as cushions between the segments of your
spine. Back pain can arise from problems with any of these component parts. In some
people, no specific cause for their back pain can be found.

Back pain most often occurs from strained muscles and ligaments, from improper or heavy lifting, or after a sudden awkward movement. Sometimes a muscle spasm can cause back pain.

your spine. Sometimes, the soft material inside a disk may bulge out of place
or rupture and press on a nerve. But many people who have bulging or
herniated disks experience no pain from the condition.

hands, knees and lower back. In some cases arthritis in the spine can lead to a
narrowing of the space around the spinal cord, a condition called spinal
stenosis.

abnormal way. If the natural curves in your spine become exaggerated, your
upper back may look abnormally rounded or your lower back may arch
excessively. Scoliosis, a condition in which your spine curves to the side, also
may lead to back pain.

bundle of nerve roots that serve your lower back and legs. It can cause
weakness in the legs, numbness in the "saddle" or groin area, and loss of
bowel or bladder control.

Most back pain gradually improves with home treatment and self-care. Although the
pain may take several weeks to disappear completely, you should notice some
improvement within the first 72 hours of self-care. If not, see your doctor.

Diagnostic tests aren't usually necessary to confirm the cause of your back pain.
However, if you do see your doctor for back pain, he or she will examine your back
and assess your ability to sit, stand, walk and lift your legs. He or she may also test
your reflexes with a rubber reflex hammer. These assessments help determine where
the pain comes from, how much you can move before pain forces you to stop and
whether you have muscle spasms. They will also help rule out more serious causes of
back pain.

If there is reason to suspect that you have a tumor, fracture, infection or other specific
condition that may be causing your back pain, your doctor may order one or more
tests:

tumors or compression fractures caused by osteoporosis. In this procedure,
you'll receive an injection of a small amount of a radioactive substance (tracer)
into one of your veins. The substance collects in your bones and allows your
doctor to detect bone problems using a special camera.

electrical impulses produced by the nerves and the responses of your muscles.
Studies of your nerve-conduction pathways can confirm nerve compression
caused by herniated disks or narrowing of your spinal canal (spinal stenosis).

Most back pain gets better with a few weeks of home treatment and careful attention.
A regular schedule of over-the-counter pain relievers may be all that you need to
improve your pain. A short period of bed rest is okay, but more than a couple of days
actually does more harm than good. If home treatments aren't working, your doctor
may suggest stronger medications or other therapy.

Your doctor may prescribe nonsteroidal anti-inflammatory drugs or in some cases, a
muscle relaxant, to relieve mild to moderate back pain that doesn't get better with
over-the-counter pain relievers. Narcotics, such as codeine or hydrocodone, may be
used for a short period of time with close supervision by your doctor.

Low doses of certain types of antidepressants \u2014 particularly tricyclic antidepressants, such as amitriptyline \u2014 have been shown to relieve chronic back pain, independent of their effect on depression.