Neck/Back Pain

Guide to Low Back Pain

If you have suffered from low back pain, you are not alone. According to the NIH, about 80% of adults experience low back pain at some point in their lifetime. Low back pain is usually acute and lasts for a few days to a few weeks. If pain lasts for more than 12 weeks than it is considered chronic and there may be a non-mechanical underlying issue.  

Causes

There are many causes of low back pain, most of which are mechanical meaning they have to do with the muscles, bones, joints and discs of the back. Here are some potential causes of low back pain.

  • Sprains and strains are the most common cause of acute back pain. They occur when ligaments, tendons or muscles of the lower back are overstretched or torn.
  • Intervertebral disc degeneration is when the discs between vertebrae lose integrity and cushioning ability. This is a natural process of aging, but can occur through injury or trauma as well. 
  • Vertebral fractures can occur if there was an injury to the back
  • Herniated or ruptured discs can occur when an intervertebral disc becomes compressed and bulges outward or ruptures, causing low back pain. 
  • Radiculopathy is when there is pressure on the spinal nerve root which causes pain, numbness, or a tingling sensation that radiates to other areas of the body that are connected to that nerve. 
  • Sciatica is a form of radiculopathy caused by compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot. 
  • Spondylolisthesis is a condition where a vertebra slips out of place and pinches the nerves exiting the spinal column. 
  • Spinal stenosis is a narrowing of the spinal column that puts pressure on the spinal cord and nerves that can cause pain or numbness with walking and over time leads to leg weakness and sensory loss. 
  • Skeletal irregularities include scoliosis, lordosis, and other congenital anomalies of the spine. These abnormalities can cause straining of muscles and joints in the back

Low back pain can also be caused by other non-mechanical conditions as well. If you are suffering from back pain, visit your doctor to determine the cause and to make sure there is not a more serious underlying condition.

 

Treatment

There are many treatments used for low back pain with varying degrees of efficacy. These are some of the most common treatments.

  • Hot and cold pads can be used in the initial onset of back pain to provide temporary relief and reduce inflammation or stiffness.

  • Medication is often used to decrease the pain of an initial flare-up. Medications such as anti-inflammatories, steroids and muscle relaxants can ease the initial pain within a few days. However, one should not rely on medications long-term if the cause of back pain is mechanical.

  • Physical therapy is one of the most effective ways to treat and prevent lower back pain. During an acute episode, the therapist will focus on releasing muscle tension and increasing mobility. As the acute pain subsides, the therapist will work with the patient on exercises to strengthen the core muscles and stabilize the spine to prevent future injury. The therapist can also assist with posture and alignment in your daily life.
  • Epidural steroid injections are an option for treating back pain associated with nerve inflammation that does not respond to physical therapy or medication. It involves a corticosteroid and a local anesthetic being injected into the epidural space around the spinal cord. This treatment should not be used long-term for treating back pain.
  • Surgery is an option for specific, urgent conditions or if all other conservative measures fail and a patient is still having pain that is affecting their daily life. The type of surgery depends of the specific cause of back pain and should be discussed with an orthopedic spine surgeon or neurosurgeon depending on the condition.

 

Prevention

Unfortunately, once you have low back pain, you are likely to experience it episodically. Luckily, there are many ways prevent it from recurring or to minimize the severity of an episode. Here are a few:

  • Physical therapy. One of the best ways to avoid lower back pain is to strengthen the core muscles. When your core muscles are strong, they can stabilize the spine and keep it in alignment. Guidance from a therapist is helpful to know what exercises to do for your activity level. The therapist can transition you to a home exercise program once you’ve got the basics. 
  • Ergonomics & Posture. Slouching strains the lower back by increasing the unnatural curvature of the spine. It’s important to sit and work on equipment that doesn’t cause you to bend or slouch for long periods of time. Make sure work surfaces are at a comfortable height. Sit in a chair with good lumbar support and proper position and height for the task. Keep shoulders back. Make sure your feet are not hanging and are either firmly on the ground or a stool. 
  • Shoeware. Wear comfortable, supportive shoes regularly. Stilettos once in a while are okay, but wearing them every day can lead to problems 
  • Sleeping Position. Sleeping on your stomach is very straining for the back since it is forced into an unnatural curve for hours. Sleeping on one’s back or side with a pillow tucked between your knees is best. Make sure your mattress is not too soft. 
  • Lift from the Knees. In general, don’t lift heavy object often. But if necessary, ben at the knees, tighten your core when lifting and keep the object close to your body. 
  • Nutrition. A balanced diet will help keep you at a healthy weight. Excessive weight can strain lower back muscles and joints. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps keep bones healthy as well.
  • Quit smoking. We all know smoking is generally bad for your health in many ways. Regarding the lower back, smoking can reduce blood flow to the area which can exacerbate disc degeneration.