Though no two backaches are exactly alike, there are some standard differences between back pain that is caused by injury and back pain caused by arthritis. These differences can help doctors assess—and successfully treat—both of these challenging health problems.
In general, back injuries such as muscle sprains, disc bulges or herniated discs are much more common than arthritis affecting the back. Striking most of us at some point in our lives, back injuries typically trigger pain that is short-lived and focused in one area.
Back pain caused by arthritis, however, affects just 15 percent of people. This type of ache can range from dull to intense, can radiate from one part of the back to another, and can persist for a considerable amount of time.
Putting repeated stress on your back—or lifting something heavy or making one, sudden awkward movement—can strain your back’s muscles and your spine’s ligaments (the fibrous bands of tissue that connect two or more bones and prevent excessive movement in a joint).
Whether you suffer a back injury due to a fall, exercise, repeated manual labor, or playing contact sports, this can result in sharp pain and even muscle spasms that can last for 48 to 72 hours.
In most cases, back pain stemming from injury is categorized as acute (potentially severe, but short-lived). If just the muscles have been affected, it typically persists for up to seven weeks. If ligaments are also involved, it can continue for up to twelve weeks.
Damage to the spine itself (such as a blow that injures one of the discs cushioning the vertebrae) can lead to pain that persists for much longer. This typically happens when the injury is caused by violent force, such as the whiplash that occurs during a traffic accident.
Unlike aches caused by injury, arthritic back pains tend to plague patients even when they’re not using their backs (such as first thing in the morning, after they’ve had a full night’s rest). These pains may be accompanied by fatigue, stiffness or crackling or crunching sounds. Chronic and not just acute, this type of pain can persist indefinitely if left untreated.
Typically striking patients after age 40 and growing more common after age 60, arthritic back pains come in several different forms.
Osteoarthritis is the most common type of arthritis affecting the back. Usually due to aging and to everyday wear and tear, it can break down the cartilage that cushions the joints in the spine, and can sometimes lead to disc degeneration or to the formation of bony spurs that press on the nerves and cause pain. Osteoarthritis typically strikes the lower back, and can cause the space around the spinal cord to narrow, leading to a condition known as spinal stenosis.
Rheumatoid arthritis occurs when the immune system, which normally protects the body from infection, goes awry and mistakenly attacks the membranes that line the joints in the spine. This causes those joints to become stiff and swollen. Rheumatoid arthritis usually affects the upper regions of the back, triggering pain in the cervical spine or the neck. In some cases, it can cause the upper vertebrae to slide forward over the lower vertebrae leading to spinal instability—a condition known as spondylolisthesis.
Ankylosing spondylitis is a form of arthritis that makes spinal joints stiffen and swell. Over time, it can even cause joints to fuse together. This type of arthritis typically affects the hip joints and the sacroiliac joints near the pelvis, leading to pain in the hips, lower back, and buttocks. More so than other forms of arthritis, ankylosing spondylitis can affect younger people as well as older ones.
Treating Back Injury vs Arthritis
Whether you’ve hoisted a heavy box and strained your back muscles—or whether you’re experiencing the sporadic, diffuse twinges that can come with osteoarthritis—medical intervention can help.
Rest and physical therapy will often help with alleviating symptoms. Your doctor may recommend medication to treat a back injury such as an anti-inflammatory drug to treat arthritis.
If your back injury or your arthritis is so severe that it is interfering with your daily functioning, minimally invasive procedures may be appropriate. Talk to your back specialist about your options to determine if a minimally invasive procedure can help relieve your pain. Getting treatment will enable you to resume your daily activities—and to enjoy full freedom of movement—once again.