Low Back Pain
What is it?
Low back pain is pain, often accompanied by
stiffness, in the lower part of the back. Back
pain is usually referred to as acute, which means
the pain occurs suddenly, but lasts for only a
short period of time, or chronic, which means
symptoms last for a long period of time, or come
and go.
Who gets it?
Low back pain is one of the most common causes
of missed work, and can affect anyone of any age,
race, or sex.
What causes it?
The back includes the area from below the neck
to the tailbone. Low back pain usually occurs when
there is an injury to the ligaments or muscles
that hold the vertebrae in the lumbar spine in
place. The lumbar spine is the segment of the
spine that is located above the pelvis, and the
vertebrae are the bones of the spine. Injury can
be caused by overuse, or a sudden or awkward
movement that strains or sprains the ligaments,
muscles, or joints of the lower back. Low back
pain caused by strain or sprain is consider acute.
Other causes of acute low back pain include a fall
that injures the back and violent sneezing or
chronic violent coughing.
Low back pain is also a symptom of many
diseases and disorders that affect the bones and
joints of the spine. This type of low back pain is
chronic, and can be caused by arthritis,
osteoporosis, obesity, a malignant tumor or cancer
in the spinal area, a type of arthritis called
ankylosing spondylitis, a herniated (bulging)
disk, or a pinched sciatic nerve. Chronic low back
pain can also occur in people whose work involves
heavy lifting, bending, and long periods of
standing on a daily basis, and during pregnancy.
Any type of pain that is out of proportion to an
injury or lasts for a long period of time with no
apparent cause may be psychiatric in nature.
What are the symptoms?
Symptoms of low back pain depend upon the cause
of the pain. Back pain can be localized, with the
discomfort confined to one specific area; diffuse,
which means the pain is spread over a larger area
and comes from deep in the tissues; radicular,
which means it radiates from a nerve and beyond
the lower back area, such as down the legs; or
referred, meaning the pain is actually caused by
an inflammation in a nearby area, such as the
kidneys. Low back pain is often accompanied by
stiffness and difficulty with normal movement,
muscle spasms, and pain that becomes worse with
any type of straining. If the spine or nerves
around the spine are injured, symptoms can also
include loss of bladder or bowel control, numbness
or tingling in the arms or legs, or difficulty
moving the legs. These type of symptoms require
immediate medical treatment. The nerves from the
spinal cord are a pathway to all parts of the
body, so back pain can cause pain or weakness
beyond the back. For example, the sciatic nerve
can cause pain from the lower back, through the
buttocks, thigh, calf, and foot. This is called
sciatica, and is an example of radicular back
pain. Low back pain is usually relieved by rest.
However, when pain continues even when the patient
is lying down, it could be caused by some type of
malignancy (cancerous tumor) in the spinal area.
Back pain caused by ankylosing spondylitis is
worse when sitting or lying down and feels better
with movement.
How is it diagnosed?
To diagnose the cause of low back pain, your
doctor will take a complete medical history and
perform a thorough physical examination, including
testing your range of motion in your back and
legs. In many cases, localized low back pain can
be diagnosed upon examination and based upon your
activities leading up to the pain. If your
symptoms suggest the pain could be caused by some
type of cancer, inflammation, tumor, fracture, or
infection, he or she may order tests such as a
computed tomography (CT) scan, x-rays, or magnetic
resonance imaging (MRI) to look for the cause.
What is the treatment?
Localized low back pain is treated at home with
muscle relaxants, aspirin, ibuprofen, or other
anti-inflammatory medications to reduce
inflammation and pain. Your doctor may prescribe
other types of pain medications for severe pain.
Pain may also be relieved by moist heat, such as
from a hot shower or hot water bottle, or cold
packs, or a combination of the two. Your doctor
will recommend rest, followed by a gradual return
to movement and moderate exercise or physical
therapy. It is extremely important to stretch and
warm up properly before beginning any physical
activity to avoid re-injury. If you tend to have
repeated injuries in the same area, your doctor or
a physical therapist can teach you special
exercises to strengthen the lower back muscles.
Acute low back pain usually lasts for anywhere
from a few days to a few weeks, depending upon the
severity and the cause. The treatment for chronic
low back pain depends upon the cause. Doctors
usually recommend a combination of
anti-inflammatory and pain reducing medications,
with physical therapy and lifestyle changes. Other
effective forms of pain management include
massage, biofeedback, acupuncture, yoga, and
chiropractic treatment. Surgery is recommended
only for herniated disks, severe cases of
sciatica, some tumors, and other disorders
involving the spine. Psychotherapy is recommended
where chronic pain is determined to be related to
anxiety or depression.
Self-care tips
In many cases, you can prevent low back pain by
maintaining a healthy weight, not smoking,
following a doctor-approved exercise program,
having good posture, and knowing the proper way to
lift and move heavy objects.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
