Lower Back Pain

 

What is lower back pain?

Numerous illnesses, injuries, and disorders can cause low back pain; however, back injuries to the muscles or tendons are the most common cause.

Mild to severe pain is possible. Sometimes discomfort might make it hard or impossible to work, sleep, walk, or perform daily tasks.

Physical therapy (PT), pain medication, and rest are usually effective in treating lower back discomfort. Injections of cortisone and manual therapies (such as osteopathic or chiropractic manipulation) can reduce pain and facilitate healing. Some illnesses and injuries to the back require surgery to be repaired.

How common is lower back pain?

Approximately 40% of individuals will experience lower back discomfort at some point in their lives. It's among the most frequent causes for which patients see medical professionals.

Lower back discomfort is more common in certain people than in others. The following are risk factors for lower back pain:

• Age: Back discomfort is more common in those over 30. As we age, the disks—soft, rubbery tissue that cushions the spine's bones—wear down. Pain and stiffness may arise from the weakening and wear down of the disks.

• Weight: The risk of back discomfort is higher in those who are overweight, obese, or carry excess weight. Overweight puts strain on disks and joints.

• General health: Back sprains and strains can result from weak abdominal muscles that are unable to support the spine. Individuals who lead sedentary lifestyles, smoke, or consume large amounts of alcohol are more likely to experience back discomfort.

• Lifestyle and Work: Engaging in heavy lifting or bending tasks at work or other repetitive tasks can raise your risk of back injury.

• Structural issues: Disorders that alter the posture of the spine, including scoliosis, can cause excruciating back pain.

• Disease: Low back pain is more common in those with a family history of osteoarthritis, certain cancers, and other diseases.

• Mental health: Anxiety and despair can cause back pain.

Symptoms and Causes

What are the symptoms of lower back pain?

Lower back pain symptoms might develop gradually or unexpectedly. Pain can often be triggered by a particular action, like leaning over to pick something up. At times, the source of the discomfort might not be apparent to you.

Your lower body or the backs of your legs may experience severe, dull, aching pain (sciatica). You can hear a "pop" as your back tenses up during an exercise. Pain usually gets better when you lie down, and it usually gets worse in specific positions (like bending over).

Other symptoms of lower back pain include:

• Stiffness: You might find it difficult to move or erect your back. It could take some time to get up from a seated position, and you could feel as though you need to stretch or go for a stroll to help you loosen up. You can experience less range of motion.

• Posture issues: It might be difficult for many persons with back pain to stand up straight. Instead of having your torso in line with your spine, you can stand "crooked" or bowed. Your lower back may appear to be flat rather than bent.

• Spastic muscles: Following a strain, the lower back's muscles may contract erratically or spasm. Severe discomfort can result from muscle spasms, which can also make standing, walking, or moving difficult or impossible.

What causes lower back pain?

Many injuries, conditions and diseases can cause lower back pain. They include:

• Back sprains and strains: The most typical cause of back discomfort is a strain or sprain in the back. Should you lift something too heavy or not safely, you run the risk of hurting your muscles, tendons, or ligaments. Some people sneeze, cough, twist, or bend over, which puts strain on their backs.

• Fractures: In an event, such as a vehicle crash or a fall, the bones in the spine may break. Osteoporosis and spondylolysis are two disorders that raise the risk of fractures.

• Disk issues: The vertebrae, or tiny spinal bones, are cushioned by disks. It is possible for disks to protrude from the spine and put pressure on a nerve. Moreover, they may tear (herniated disk). Discs may become flatter and provide less protection as they age (degenerative disk disease).

• Problems with structure: When the spinal column is too small to accommodate the spinal cord, a disorder known as spinal stenosis develops. Severe sciatic nerve pain and lower back pain might be brought on by something squeezing the spinal cord. The curvature of the spine, known as scoliosis, can cause discomfort, stiffness, and trouble moving.

• Arthritis: The most frequent kind of arthritis that causes lower back discomfort is osteoarthritis. Ankylosing spondylitis results in inflammation, stiffness, and pain in the lower back.

• Disease: Back discomfort can be brought on by infections, spinal tumors, and other cancers. Back discomfort might also be caused by other conditions. Kidney stones and abdominal aortic aneurysms are two examples of this.

• Spondylolisthesis: This disorder results in the slippage of the spine's vertebrae. Leg and frequently low back discomfort are caused by spondylolisthesis.

Diagnosis and Tests

How is lower back pain diagnosed?

Your doctor will examine you physically and inquire about your problems. Your healthcare professional could request imaging tests to look for injuries such as broken bones. Your doctor can see clear images of your muscles, ligaments, tendons, disks, and vertebrae thanks to these investigations.

Your provider may order:

• Spine X-ray, which creates images of bones by using radiation.

• MRI, which produces images of bones, muscles, tendons, and other soft tissues using radio waves and a magnet.

• CT scan, which produces three-dimensional images of soft tissues and bones using X-rays and a computer.

• You can test your muscles and nerves with electromyography (EMG) to see if you have neuropathy, or damaged nerve tissue, which can cause tingling or numbness in your legs.

• Your doctor might also prescribe blood or urine testing, depending on what's causing the pain. Certain diseases that cause back pain, such ankylosing spondylitis, have genetic markers that can be found in blood tests. Kidney stones can cause flank pain, which is checked for using urine tests (the sides of the low back).

Management and Treatment

What are the treatments for lower back pain?

Generally, ice, rest, and over-the-counter pain medications help with lower back pain. Following a few days of recuperation, you can resume your regular activities. Being active promotes healing by increasing blood flow to the area.

The reason of lower back pain will determine additional therapy. Among them are:

• Medication: Nonsteroidal anti-inflammatory medicines (NSAIDs) or prescription medications may be suggested by your physician to treat pain. Some drugs ease tense muscles and stop back spasms.

• Physical therapy (PT): PT can help your muscles become stronger so that your spine is supported. Moreover, PT increases flexibility and lowers the risk of reinjury.

• Manipulation with hands: A number of "hands-on" therapies can ease tense muscles, lessen discomfort, and enhance alignment and posture. You might require chiropractic adjustments or osteopathic manipulation, depending on what's causing your pain. Additionally helpful in relieving back pain and restoring function is massage treatment.

• Injections: Your doctor will inject medicine into the painful area using a needle. Injections of steroids reduce inflammation and ease discomfort.

• Surgery: To treat certain ailments and injuries, surgery is required. For low back discomfort, various surgical procedures are available, including numerous minimally invasive ones.

Prevention

Can I prevent lower back pain?

Lower back discomfort resulting from disease or structural issues with the spine cannot be prevented. However, back pain-causing injuries are preventable.

To reduce your risk of a back injury, you should:

• Keep a healthy weight: Carrying too much weight strains the disks and vertebrae.
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• Become stronger in your abs: Pilates and other workout regimens help to build the core muscles that support the spine.
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• Lift correctly: Use your legs, not your back, to lift objects to prevent injuries. Keep bulky objects near your body. When lifting, try not to twist your torso.

Outlook / Prognosis

What is the outlook for people with lower back pain?

The source of the discomfort determines the prognosis. The majority of back sprains and strains heal and don't cause long-term health problems. However, many will experience another recurrence in less than a year.

Some sufferers experience persistent back discomfort that may not improve even after several weeks. The symptoms of degenerative diseases like osteoporosis and arthritis in older adults may worsen with time. People with a variety of ailments and diseases can live pain-free with the help of surgery and other treatments.

Living With

When should I see my healthcare provider about lower back pain?

Painkillers and rest are usually helpful in treating lower back discomfort. Intractable back pain could indicate a more serious ailment.

See your provider if you have:

• Pain that remains after receiving at-home care for around a week.

• Your legs or buttocks may hurt or tingle, or you may feel weak or numb.

• Severe discomfort or spasms in your muscles that prevent you from doing everyday tasks.

• Fever, weight loss, issues with the bladder or bowel, or other symptoms that don't make sense.