|Low Back Pain
Low back pain is an ache or discomfort in the area of the lower part of the back and spinal column. The lower spinal column consists of many small bones that surround and protect the spinal cord and nerves. Low back pain is very common, affecting most adults at some point in their lives.
There are many possible causes for low back pain, including:
- Sprain or strain of muscles or ligaments in the area (most common cause of back pain)
- Herniated (ruptured) disc–the cushions between the bones of the spine bulge out of place
- Disc degeneration, caused by aging or arthritis
- Spinal stenosis–narrowing of the spinal canal in the lumbar area
- Spondylolisthesis–slippage of a bone in the low back
- Fractures due to trauma and/or osteoporosis
- Fibromyalgia–a condition that causes muscle aches and fatigue
- Ankylosing spondylitis–a hereditary disorder involving the spine
- In rare cases:
- Benign or malignant tumors
- Arterial problems such as hardening of the arteries
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
- Family members with back problems
- Lack of regular exercise
- Preexisting back injury due to:
- Lifting a heavy object
- Improper lifting
- Sudden movement, bending, or twisting
- Prolonged sitting or standing
- Bad posture
- Vibration from vehicles or heavy equipment
- Prior back surgery
- Other factors which may negatively influence back pain include:
- Psychological factors, such as low job satisfaction
- Fatigue or sleep deficit
- Drug or alcohol abuse
Pain is usually localized in the low back. If a nerve is irritated, the pain may extend into the buttock or leg on the affected side, and muscle weakness or numbness may be present.
More serious symptoms associated with back pain that may require immediate medical attention include:
- Pain that doesn't improve, or worsens, with rest
- Pain that is severe or that has gotten dramatically worse
- Progressive weakness in a leg or foot
- Difficulty walking, standing, or moving
- Numbness in the genital or rectal area
- Loss of bowel or bladder control
- Difficulty with urination
- Fever, unexplained weight loss, or other signs of illness
The doctor will ask about your symptoms and medical history, and perform a physical exam. In particular, the doctor will examine your back, hips, and legs and usually will test for strength, flexibility, sensation, and reflexes.
Other tests may include:
X-ray–a test that uses radiation to take a picture of structures inside the body, especially bones
CT Scan–a type of x-ray that uses a computer to make pictures of structures inside the body and gives a good picture of the vertebrae and the spinal canal
MRI Scan–a test that uses magnetic waves to make pictures of structures inside the body and shows the intervertebral discs and any abnormality of the discs
Blood Tests–such as complete blood count or sedimentation rate
Urine Test–to check for urinary infection or blood in the urine
Treatment options include:
Bed Rest–resting on a firm mattress or pad on the floor for 1-2 days, followed by a gradual return to daily activities. Research indicates that longer bed rest may slow the recovery process.
- Pain relievers such as acetaminophen (Tylenol), aspirin, or ibuprofen
- Muscle relaxants for muscle spasm
- Cortisone injections
- Antidepressants for depression due to chronic pain
- Hot or cold packs
- Stretching and strengthening exercises for back and abdominal muscles
- Education about how to deal with back problems
- Ultrasound treatments or electrical stimulation
- Relaxation training
- Chiropractic or osteopathic manipulation
Surgery–may be needed if nerve problems develop or other treatments fail to provide relief. Common procedures are discectomy, laminectomy, and spinal fusion.
The following steps may help you avoid low back pain:
- Sleep on a firm mattress.
- Exercise regularly, at least 30 minutes most days of the week. Good choices include walking, swimming, or activities and exercises recommended by your doctor or physical therapist.
- Lose weight if you're overweight.
- Stop smoking.
- Practice good posture to reduce pressure on your spine.
- Avoid sitting or standing in one position for prolonged periods.
- If you must remain standing for long periods, rest one foot at a time on a small stool to relieve pressure on your low back.
- When lifting, hold the object close to your chest, maintain a straight back, and use your leg muscles to slowly rise.
- Consider job retraining if your work requires a lot of heavy lifting or sitting.