Consumer Reports: The major causes of back pain

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Not all back injuries are created equal. Here are some of the most prevalent conditions and symptoms from Consumer Reports.

- Muscle injuries. Overstretched or injured muscles, tendons or ligaments can result in strains, sprains or spasms. Poor posture, prolonged sitting, strenuous work and repetitive action, such as throwing a ball or weeding a garden, can stress so-called "soft tissues" in your back.

- Degenerative changes. As you age, the gellike disks cushioning the bones of your spine and the cartilage lining the joints can begin to wear. Consumer Reports explains that that allows the bones to rub against one another, causing osteoarthritis. Some degeneration of this kind is harmless and unavoidable.

- Herniated, or slipped, disks. Lifting, pulling, bending or twisting puts pressure on the disks. That pressure can cause them to bulge or slip. When a bulging disk in the lower spine irritates the sciatic nerve, the sharp pain, called sciatica, is often excruciating and can radiate down a leg even when there's no back pain.

- Spinal stenosis. The spine responds to degenerative changes by growing new bone in the joints and thickening the ligaments to provide better support. But over time, those bone spurs and thickened ligaments narrow the space around the spinal cord and can irritate nerves. Symptoms include numbness, weakness or cramping in the back, buttocks, arms or legs.

- Spinal instability. When disks and joints wear, they don't do as good a job supporting the spine. As a result, vertebrae move more than they should. In some cases, a bone slides forward, causing a condition called spondylolisthesis. Symptoms often come and go suddenly, sometimes shifting from one side of the body to the other, and can include a feeling of weakness in the legs with prolonged standing or walking.

WHEN PAIN STRIKES

Call your doctor if it's accompanied by symptoms that can indicate a serious problem, including unrelenting pain, especially after a hard fall or an accident; weak or numb legs; loss of bladder or bowel control; fever, chills or infection; unexplained weight loss; and a history of cancer. If none of those apply to you, Consumer Reports suggests these steps to provide quick relief:

- Apply heat. Try a warm shower, a hot-water bottle or a heating pad or wrap. There's less evidence for icing, though some people say it feels good.

- Get comfortable. Try lying on your back with your legs up on a chair or on your side with a pillow between your bent knees, sitting with a pillow behind your back, or standing with one foot on a stool.

- Stretch. Do slow, gentle moves, such as pulling your knees to your chest while lying down or bending slightly backward while standing.

- Don't stay down. Walk every few hours.

- Consider an OTC pain reliever. While new advice emphasizes nondrug measures, anti-inflammatories such as ibuprofen (Advil or generic) or naproxen (Aleve and generic) are OK for a week or so and work better for back pain than acetaminophen (Tylenol and generic).

To learn more, visit ConsumerReports.org.

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