Back Pain That Gets Worse When Straightening It

Mid-back bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the back are common, given how exposed this area of the body is.

You can treat this at home with rest (exercise as tolerated) and ice (10-20 minutes at a time).

Rarity: Uncommon

Top Symptoms: back pain, constant back pain, mid back pain from an injury, swollen back, bruised back

Symptoms that always occur with mid-back bruise: mid back pain from an injury, constant back pain

Urgency: Self-treatment

Mechanical low back pain with sciatica

Sciatica is a general term describing any shooting leg pain that begins at the spine and travels down the outside of the leg. It is also called pinched nerve, lumbar radiculopathy, sciatic neuralgia, sciatic neuritis, or sciatic neuropathy.

By far the most common cause is a herniated or "slipped" disc in the lower spine. This means some of the cushioning material inside the disc has been forced outward and is pressing on a nerve root. Spasms of the piriformis muscle around the sciatic nerve, as well as the narrowing of the spinal canal called spinal stenosis, can also cause sciatica.

Symptoms include shooting leg pain that begins suddenly or develops gradually. There may be weakness, numbness, and a pins-and-needles sensation. In severe cases, there may be difficulty moving the foot or bending the knee.

Diagnosis is made through patient history, physical examination, and simple leg-raise tests.

Treatment involves physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants. In some cases, corticosteroid spinal injections and surgery may be tried. Massage and acupuncture are also sometimes helpful.

Low back strain

Low back strain

A strain is defined as a twisting, pulling, or tearing injury to a muscle, or to the tendon that connects the muscle to the bone. (A sprain is an injury to a ligament, which connects two bones together.)

Strains may be acute (happen suddenly) or chronic (show up gradually.) They are usually caused by overuse, improper lifting of heavy objects, or sports. Being overweight or having weak back muscles are both risk factors for back injury.

Symptoms may include a pop or tear at the time of injury; pain that is worse when moving; and sudden muscle cramping or spasm at the site of the injury.

Diagnosis is made through patient history, physical examination, and sometimes x-ray.

Treatment involves rest; ice packs; and over-the-counter pain relievers, followed by a gradual return to normal activities within two weeks. Prolonged immobility actually weakens the back and causes loss of bone density.

Proper lifting techniques, strengthening exercises, and good nutrition can be very helpful in preventing further injury.

Rarity: Common

Top Symptoms: lower back pain, back pain that gets worse when sitting, back pain that gets worse when straightening it, lower left back pain, lower right back pain

Symptoms that always occur with low back strain: lower back pain

Symptoms that never occur with low back strain: involuntary defecation, first time leaking urine, back numbness, toe numbness, foot numbness

Urgency: Self-treatment

Herniated (slipped) disk in the lower back

A herniated, ruptured, or "slipped" disc means that a vertebral disc – one of the soft pads of tissue that sit between each of the vertebral bones – has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.

The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to "slipping."

Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.

Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.

Diagnosis is made through patient history, neurological examination, and MRI scan.

Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.

Surgery to remove the herniated part of the disc – the part that was squeezed out of place – can also be helpful.

Rarity: Common

Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness

Urgency: Primary care doctor

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

Chronic low back pain

Chronic low back pain is a common condition. It is defined by low back pain lasting more than six weeks. Unfortunately, a clear cause can only be found in twenty percent of cases. The rest of the time, it is believed to be due to strain on the bones and muscles of the back from heavy lifting, prolonged sitting, or bad posture.

For back pain persisting longer than six weeks, it is recommended to make an appointment with a physician. Treatments may include a program of back exercises, as well as pain medicine such as ibuprofen (Advil) and acetaminophen (Tylenol). It is also recommended to stay active and carry on with the things you usually do as much as possible, to help you recover faster. Sitting or lying still for long periods can actually make the pain worse. Your joints may become stiff which will make it harder and more painful to move your back.

Ankylosing spondylitis

"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine.

In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthritis, leaving the lower spine inflexible.

The exact cause is unknown. It is thought to be an inherited, abnormal immune response that is triggered following damage to the lining of the intestines.

Most susceptible are those with a family history of ankylosing spondylitis and a history of intestinal damage from illness. However, anyone can be affected at any age.

Symptoms include pain and stiffness in the back and hips, and sometimes in the neck and shoulders. The pain will be worse during sleep and rest.

Early treatment can help to manage the symptoms, prevent complications, and improve quality of life.

Diagnosis is made through physical examination and x-rays.

Treatment involves nonsteroidal anti-inflammatory drugs; new forms of biologic medications; physical therapy; and, in some cases, surgery to repair damaged joints.