Common causes include:

• Disc herniation:
  • Disc herniation also called as Sciatica (Arq-un-nisa in Urdu). This condition usually follows after a person lifts a heavy object. The pain is sudden in onset and very severe. The pain may also travel to the legs and may be accompanied by either weakness in the legs or numbness and tingling sensations in the legs.
• Fracture of the vertebrae or spine:
  • Fracture of the spine or vertebrae usually occurs in the setting of a trauma or a road traffic accident. It can also occur in old age as a result of weak bones or osteoporosis, cancer of the bones, TB of the spine, or disturbed hormones.
• Infections:
  • Infections that involve the spine commonly present with severe back pain. These include Caries Spine or Spinal Tuberculosis and other bacterial infections. It is not uncommon to have severe back pain in patients who have viral infections like dengue fever (also called bone-breaking fever) and Coronavirus infection.
  • Patients may also have severe back pain if they have infection of the paraspinal muscles as in patients with psoas abscess.
• Muscle Spasm:
  • Occassionally, the underlying cause is not severe, however the pain is very severe. Muscle spasm can cause severe pain in the back. This can occur when a person sits or lies down in an abnormal posture or do a heavy exercise after a long time.

What should you do if you have severe back pain?

• Before trying any home remedies, you should know when it could be an emergency and you should consult a doctor urgently. If you have any of the following symptoms, do not try home remedies. Go straight to the emergency!
  • Pain with weakness, numbness, or tingling of the feet or legs
  • Pain with high grade fever
  • Pain accompanied by weight loss
  • Back pain and difficulty in passing urine or urinary incontinence, severe constipation not relieved with medications or fecal incontinence.
  • Pain and swelling at the back
• If you have a mild to moderate severity pain without any of the above features, you can try any of the following home remedies:
  • Stretching exercises
  • Massage with olive oil or OTC pain relieving medicines such as ketorolac, diclofenac, or piroxicam gels. You can also apply ice to relieve inflammation.
  • Can take OTC muscle relaxants or anti-inflammatory drugs such as ibuprofen and acetaminophen. Muscle relaxants that may help include cyclobenzaprine, methocarbamol, ternaline, and baclofen.
  • Eat healthy. Take enough dairy products like milk, yogurt, and butter.
  • Take vitamin D supplements especially if you are deficient.