Low back pain, also known as lumbago, is one of the most common chronic conditions facing American adults; it is estimated that over 80% of people will experience low back pain at some point in their lifetime. In addition to causing disruptive pain and discomfort, low back pain is also one of the leading causes of disability today, meaning it is as much a public health issue as a personal health one.
What are the symptoms of low back pain?
People experience low back pain in a variety of ways. For some, it’s a dull ache that never goes away, while other people experience a stabbing or shooting sensation that comes and goes, often with certain movements or postures. It can also be chronic or acute, meaning it can have a sudden onset following an accident or injury, or it can develop and worsen on its own over time. Generally speaking, if your pain lasts for more than three months it is considered chronic. If you are experiencing more severe symptoms, such as loss of bowel or bladder control, numbness in the groin or leg, or muscle weakness in the extremities, you need to seek medical treatment immediately, as these could be symptoms of an emergent condition.
What causes low back pain?
The lumbar spine consists of highly-interconnected bones (called vertebrae), muscles, nerves and ligaments, anatomy which allows the spine to provide support, strength, and flexibility to the musculoskeletal system. This intricately complex structure is undoubtedly a feat of evolutionary engineering, but it also leaves the spine relatively weak and susceptible to injury. Low back pain happens when one or more of the anatomical components of the spine is weakened, damaged or outright destroyed by disease or injury. These changes to the anatomy of the spine can be caused by the natural process of aging, postural issues, obesity, injury, or disease; certain occupations or recreational activities, especially those that require heavy lifting or manual labor, could also be to blame.
Some common medical conditions that cause low back pain include:
- Herniated Discs – vertebral discs are small, spongy shock absorbers located between the vertebrae of the spine. They can weaken over time or rupture due to injury, causing the jelly-like center, called the nucleus, to push out and impinge on nerves and/or the spinal cord.
- Degenerative Disc Disease – describes the effect of the natural process of aging on the vertebral discs. As we grow older, the water content of our vertebral discs decreases, making them less pliable and more susceptible to injury. Injured discs can lead to pain, numbness and weakness.
- Sciatica – pain caused by an impingement of the sciatic nerve, which runs from the spinal cord through the sacrum and the hip, and down the leg. This impingement causes pain and weakness in the low back, hip, buttocks, and leg.
- Stenosis – describes a narrowing of the spinal canal, which puts pressure on the spinal cord and the nerves that branch off from the spinal cord to the rest of the body. Stenosis can lead to pain, tingling, numbness, and weakness in the extremities serviced by the affected nerve.
How is low back pain diagnosed?
The first step towards diagnosing what is causing your low back pain is scheduling an appointment with a physician whose practice is focused on treating disorders of the spine. At the time of your appointment, he or she will complete a full review of your individual and family medical history; conduct a thorough physical examination, including palpation and movement, strength, and reflex tests; and order and review any necessary diagnostic tests, like x-ray, MRI or CT scans. The results of their examination and the necessary diagnostic tests will help your physician pinpoint the cause of your pain and develop a treatment plan aimed at eradicating it.
How is low back pain treated?
Once the cause of your back pain has been diagnosed, there are a number of therapies or procedures that can be incorporated into a holistic treatment plan. These include physical therapy, TENS units, massage therapy, yoga, chiropractic care, acupuncture, medication management, lumbar epidural injections, trigger point injections, lumbar facet injections, radiofrequency ablation, and sacroiliac injections. Based on your age, activity levels, the specifics of your injury and any complicating comorbidities, your physician will work with you to develop a treatment plan that can help get your pain under control and your life back on track.
Can low back pain be prevented?
It is possible to avoid low back pain by taking preventive steps before the pain arises. Adopting an exercise regimen that includes core strengthening and flexibility can help stabilize and support the spine, preventing structural issues from developing and causing pain. Similarly, focusing on your posture and ensuring you keep your back straight throughout the day, especially when sitting for extended periods of time, can help reduce pressure points in the vertebral column. It is also critically important to maintain good form when lifting heavy objects by focusing on using your legs—not your back—for most of the work. Finally, maintaining a healthy weight will help eliminate unnecessary strain and pressure from weakening your spine and making its anatomy more susceptible to damage.