There are few injuries more dreaded than injuries to the back. Often misunderstood, back pain is usually associated with old age or symptomatic of chronic health conditions. Aging men tend to regard any back pain as the first sign of frailty and a precursor to long years marked by less and less activity. But what really causes back pain, and how can men tell the difference between a simple backache and a more serious injury that requires attention and intervention by a physician?

To find out more about the intricacies of back pain, we turned to Dr. Timothy Keenen, an orthopedic spine surgeon at Pacific Spine Specialists in Tualatin, Ore. Dr. Keenen outlined the primary types of back injuries that men face, what causes them and how guys can know when to seek treatment.

Types of back injuries

Muscle strain or lumbar sprain: "Two of the most common causes of low back pain are muscle strain and lumbar sprain injuries," Dr. Keenen explains.  A strain results from the muscle fibers being abnormally stretched or torn, and a sprain occurs when the ligaments are torn from their attachments. Both present similar symptoms, so distinguishing one type of injury from the other can be difficult.

Disc injury: As our spines age, they become less elastic. A disc injury or herniated disc is caused by a disc rupture--when a portion of the disc is pushed outside its normal boundary between the vertebrae. This type of injury can be caused by a sudden fall, or be the result of long-term repetitive strain.

Spinal fracture: A spinal fracture, or vertebral compression fracture, occurs when the bones in the spine become so weak they fracture or collapse. Depending on the strength of your back and your bone density, a spinal fracture can be caused by something as extreme as a car accident or something as common as a cough or sneeze.

Causes of back pain

Improper lifting: "Lifting objects that are too heavy or lifting with improper technique may be the single most common cause of temporary back pain and more serious back injuries," Dr. Keenen stresses.  "Getting out of position during a lift or placing too much demand on your back muscles by lifting an object that's too heavy can cause muscle strain and herniated discs," he adds. Men can be especially vulnerable to improper lifting--either because of embarrassment in asking for help, or from jobs that require shorter bursts of more extreme physical activity.

Sports injuries: Nearly 20 percent of all sports-related injuries involve the lower back or neck. Activities that require repetitive impact, like running or weightlifting, usually affect the lower back or lumbar spine region. Classically male-dominated sports like football tend to be riskier to the neck or cervical spine.

Work-related injuries: The demands of work can also put our back health at risk, and even the safest work environments can't prevent every injury. According to Dr. Keenen, on-the-job back injuries usually go something like this: Three workers lift an object, and one person slips. The slip causes an injury to the first person and the increased strain causes injuries to the remaining two. For single lifters, improper posture and placing too much demand on the back muscles are the most common cause of back strain.


Dr. Keenen suggests core-strength conditioning as the best single preventative measure men can take. "Strengthening the abdominal wall and lower back muscles is essential to maintaining a healthy back as we age," he says. "Also, men and women should learn and practice proper lifting techniques to avoid common back problems. When lifting a heavy object, it's always better to keep the object as close to your body as possible to leverage core muscle strength. Lifting something at arm's length is riskier--not only because of the potential for back strain--but because of the greater likelihood of losing balance and falling," he adds.

When to see a doctor

With so many ways to injure the back and so many gradations of damage, how can guys know when it's time to man-up and see a doctor? According to Dr. Keenen, there's a relatively simple self-assessment men can take to answer that question:
Injuries with a clear cause: "If there was a mechanism to the injury--meaning a clear cause, like a car accident or a fall, then the safest bet is to always get checked out by a doctor," Dr. Keenen says.

Persistent or radiating pain: Pain that presents without a clear cause and doesn't go away after a week or so, or pain that begins to move to the calf, thighs, feet, or other extremities also warrants a visit to a physician for a closer look. Radiating pain that involves the lower extremities may indicate more serious nerve and spinal issues.

Pain with fever, chills or weight loss: "Any back injury that presents with a fever, chills or weight loss may point to an infection and should be checked out by a physician immediately," Dr. Keenen advises. For injuries that do require medical attention, patients should keep in mind that back pain can typically be treated through physical therapy, chiropractic intervention and rest. Even more serious back injuries, like herniated disks, can usually be addressed without surgery.

As men age, back and spinal issues may be impossible to avoid completely. But with a focus on good health and strength-building, and with an eye toward prevention, fear of injury doesn't have to unduly limit an active lifestyle. As with any health concern, it's always good to know your body's warning signs, take proper precautions and, when in doubt, see a doctor.

Kentin Waits

Kentin Waits is a freelance writer and marketing specialist based in Portland, Ore. His work has been featured in top-rated blogs such as Lifehacker, the Consumerist and MSN SmartMoney. When he's not writing, Kentin runs a small online antiques business.