Lower Back Pain Causes and Treatment
Lower Back Pain
The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.
The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.
Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain.
There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain.
St. Theresa's Hospital best quality Lower Back Pain Treatment in Hyderabad at most affordable cost
Dr. Divakar Reddy
MS ORTHO, JIPMER MRCS – EDINBURG
Symptoms & Causes of Lower Back Pain
Symptoms Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowly possibly coming and going and gradually get worse over time.
Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example:
- Pain that is dull or achy, contained to the low back
- Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica)
- Tightness in the low back, pelvis, and hips
- Pain that worsens after prolonged sitting or standing
- Difficulty standing up straight, walking, or going from standing to sitting
Other symptoms of lower back pain include:
- Stiffness: It may be tough to move or straighten your back. Getting up from a seated position may take a while, and you might feel like you need to walk or stretch to loosen up. You may notice decreased range of motion.
- Posture problems: Many people with back pain find it hard to stand up straight. You may stand “crooked” or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
- Muscle spasms: After a strain, muscles in the lower back can spasm or contract uncontrollably. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.
Causes Many injuries, conditions and diseases can cause lower back pain. They include:
- Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.
- Fractures: The bones in the spine can break during an accident, like a car crash or a fall. Certain conditions (such as spondylolysis or osteoporosis) increase the risk of fractures.
- Disk problems: Disks cushion the vertebrae (small spinal bones). Disks can bulge from their position in the spine and press on a nerve. They can also tear (herniated disk). With age, disks can get flatter and offer less protection (degenerative disk disease).
- Structural problems: A condition called spinal stenosis happens when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord can cause severe sciatic nerve pain and lower back pain. Scoliosis (curvature of the spine) can lead to pain, stiffness and difficulty moving.
- Arthritis: Osteoarthritis is the most common type of arthritis to cause lower back pain. Ankylosing spondylitis causes lower back pain, inflammation and stiffness in the spine.
- Disease: Spine tumors, infections and several types of cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysm.
- Spondylolisthesis: This condition causes the vertebrae in the spine to slip out of place. Spondylolisthesis leads to low back pain and often leg pain as well.
Diagnosis of Lower Back Pain
- Spine X-ray – which uses radiation to produce images of bones.
- MRI – which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan – which uses X-rays and a computer to create 3D images of bones and soft tissues.
- Electromyography (EMG) to test nerves and muscles and check for neuropathy (nerve damage), which can cause tingling or numbness in your legs.
Lower back pain usually gets better with rest, ice and over-the-counter pain relievers. After a few days of rest, you can start to get back to your normal activities. Staying active increases blood flow to the area and helps you heal.
Other treatments for lower back pain depend on the cause. They include:
- Medications: Your provider may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or prescription drugs to relieve pain. Other medications relax muscles and prevent back spasms.
- Physical therapy (PT): PT can strengthen muscles so they can support your spine. PT also improves flexibility and helps you avoid another injury.
- Hands-on manipulation: Several “hands-on” treatments can relax tight muscles, reduce pain and improve posture and alignment. Depending on the cause of pain, you may need osteopathic manipulation or chiropractic adjustments. Massage therapy can also help with back pain relief and restore function.
- Injections: Your provider uses a needle to inject medication into the area that’s causing pain. Steroid injections relieve pain and reduce inflammation.
- Surgery: Some injuries and conditions need surgical repair. There are several types of surgery for low back pain, including many minimally invasive techniques.