Back pain is one of the most common reasons people visit their doctor. It affects up to 80% of adults at some point in their lives. While back pain can originate from different structures in the back, two main culprits are disc and muscle issues. Knowing whether your back pain is coming from a disc or muscle problem can help guide treatment. Here’s how to tell the difference.
Disc Pain vs. Muscle Pain Symptoms
Disc and muscle pain share some common symptoms but also have distinguishing features.
Shared symptoms include:
- Aching, throbbing, or sharp pain in the back
- Pain that worsens with movement or prolonged positions
- Stiffness in the back
Symptoms more suggestive of a disc issue:
- Radiating pain into the buttocks or legs
- Numbness or tingling in the legs or feet
- Pain from sitting that improves when leaning forward
- Loss of bowel or bladder control (a medical emergency)
Symptoms more suggestive of a muscle issue:
- Pain localized to the back without radiation down the legs
- Muscle spasms or tightness in the back
- Pain triggered by sudden movements
- Pain that worsens with stretching or activity
What’s Causing the Pain?
Understanding what can cause disc and muscle pain provides more clues to the origin of your back pain.
Disc pain typically comes from:
- a herniated (slipped) disc pressing on a nerve
- degenerative disc disease from aging and wear and tear
- a tear in the outer part of the disc
Muscle pain often stems from:
- muscle strain from overuse, improper lifting, or awkward movements
- myofascial pain syndrome – muscle knots and spasms
- poor flexibility or weakness in core muscles
Warning Signs to See a Doctor
While most back pain resolves with rest, gentle stretches, ice/heat, and OTC medication, certain red flags warrant medical evaluation:
See a doctor if you have:
- Loss of bowel or bladder control
- Numbness in the groin or inner thighs
- Back pain with abdominal pain
- Fever, chills, or unexplained weight loss
- Pain after a major trauma like a car accident
- Pain that worsens when lying down
These signs can indicate a more serious issue like a spinal infection, fracture, cancer, or cauda equina syndrome. Better to be safe and get checked out.
Physical Exam and Testing
To deduce whether disc or muscle issues are responsible for back pain, the doctor will:
- Ask about symptoms and do a neurologic exam of strength, reflexes and sensation
- Palpate the back to pinpoint areas of tenderness
- Assess range of motion and watch for pain with movement
- Check posture and spine alignment
- Order imaging like an X-ray, CT, or MRI if concerned about spinal problems
Treatments for Disc and Muscle Pain
The treatment approach depends on whether the back pain is from a disc or muscle.
For disc pain, common treatments include:
- Rest to take pressure off the disc
- Ice and heat therapy
- Medications like NSAIDs, muscle relaxers, or steroids
- Physical therapy
- Epidural steroid injections
- Surgery for severe herniated discs
Muscle pain treatment may involve:
- Light activity to promote blood flow
- Applying heat to relax muscles
- Massage therapy to release muscle knots
- Gentle stretching and exercise to improve flexibility
- OTC pain relievers like acetaminophen or ibuprofen
- Muscle relaxant medications
No matter the cause, staying active, maintaining good posture, managing weight, and practicing stress-relief help prevent and reduce back pain flares. Core strengthening exercises specifically target the muscles supporting the spine for longer term relief.
When to Seek Follow-up Care
Make sure to follow up with your doctor if:
- Initial treatments aren’t helping within a couple weeks
- Pain worsens or spreads
- New concerning symptoms develop
- You experience more than 4-5 flare-ups per year
Seeking medical advice sooner for recurrent or worsening back pain allows for adjusting treatment plans to get you lasting relief.
Determining whether back pain stems from an injured disc or muscle strain directs how it should be managed. Discs and muscles share some common symptoms but also have distinguishing features in terms of pain location, triggers, timing, and radiation patterns. Doctors can examine you and order tests to discern the source. While discs and muscles need different therapies, remaining active and strengthening the back and core provide broad benefits. Don’t hesitate to follow up with your doctor if initial treatment fails to improve symptoms within a couple weeks or back pain flares keep recurring. Getting the right care helps resolve acute back pain and prevent future problems.