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Back Pain
Reviewed by the PMC Medical Team · Promise Medical Centre
Overview
Back pain, most commonly affecting the lower back (lumbar region), is one of the most frequent reasons adults seek medical care worldwide and in Nigeria, affecting people across all occupations — from market traders and okada riders to office workers and manual labourers. It ranges from a dull, persistent ache to sudden, sharp pain that limits movement. Most cases are "mechanical" in origin, related to muscles, ligaments, discs, or joints of the spine, and improve within a few weeks with simple care. However, back pain can occasionally signal a more serious underlying condition that needs prompt evaluation.
Symptoms
• Dull, aching, or sharp pain in the lower, middle, or upper back
• Pain that worsens with bending, lifting, standing, or prolonged sitting
• Muscle stiffness or reduced range of motion
• Muscle spasms
• Pain that radiates to the buttock or down one leg (sciatica), sometimes with tingling or numbness
• Pain that improves with rest (mechanical back pain) or, less commonly, pain that is worse at rest or at night (which may suggest a different cause)
When to See a Doctor
Most back pain improves within a few days to weeks with rest, gentle activity, and over-the-counter pain relief, and doesn't require an emergency visit. See a doctor if pain persists beyond 2–3 weeks, is severe, or interferes with daily activities or work.
Seek immediate emergency care ("red flag" symptoms) if back pain occurs with:
• Loss of bladder or bowel control, or numbness around the groin/buttocks (possible cauda equina syndrome — a surgical emergency)
• Weakness, numbness, or tingling in one or both legs
• Back pain following a significant fall, accident, or trauma
• Fever, chills, or unexplained weight loss alongside back pain (may suggest infection or malignancy)
• Pain that is worse at night or when lying flat
• History of cancer, osteoporosis, or long-term steroid use with new severe back pain
Causes
Most back pain is "non-specific" or mechanical, arising from strain or minor injury to muscles, ligaments, or spinal joints — often from lifting heavy loads improperly, sudden awkward movements, or poor posture. Other causes include:
• Herniated or bulging intervertebral discs pressing on nearby nerves
• Degenerative disc disease and osteoarthritis of the spine, common with ageing
• Muscle or ligament strain from overuse or poor ergonomics
• Spinal stenosis (narrowing of the spinal canal)
• Vertebral compression fractures, especially in osteoporosis
• Less commonly: spinal infection, kidney problems, or tumours
Risk Factors
• Age (risk increases from the mid-30s onward)
• Occupations involving heavy lifting, prolonged standing, or repetitive twisting (e.g. porters, market traders, drivers)
• Prolonged sitting with poor posture (office and desk-based work)
• Obesity and excess body weight
• Sedentary lifestyle and weak core/back muscles
• Smoking, which reduces blood flow to spinal discs
• Psychological stress and depression
• Pregnancy
Complications
• Chronic pain lasting more than 3 months, affecting quality of life and productivity
• Reduced mobility and physical function
• Sciatica with persistent nerve-related leg pain, weakness, or numbness
• Sleep disturbance
• Anxiety and depression related to chronic pain
• Rarely, permanent nerve damage if cauda equina syndrome is not treated urgently
Prevention
• Maintain good posture when sitting, standing, and lifting
• Lift heavy objects by bending the knees, not the back, and keep the load close to the body
• Exercise regularly to strengthen core and back muscles
• Maintain a healthy body weight
• Avoid prolonged sitting; take regular breaks to stand and stretch
• Use a supportive mattress and ergonomic seating where possible
• Quit smoking