Understanding Lower Back Pain

It is estimated that 8 out of 10 people across the world suffer from lower back pain at some stage of their lives. There are various reasons for the pain to develop and, depending on the cause, the pain can fade away with rest, physical therapy and medication. However, this is not always the case. In the worst case, surgical repair may be required.

What Is Lower Back Pain?

Irrespective of the cause, lower back pain can range from mild to severe and it may be occasional or continuous. The pain can be a distraction or a minor impediment, or it could make movement and activity impossible. Several risk factors could contribute to the onset of the pain. These include:

• Age: As people age, the soft rubbery disks that act as cushions for the spine wear away. As this happens, the possibility of back pain or stiffness increases.
• Weight: People who are overweight or obese are more likely to have lower back pain. The excess weight they carry places extra stress on the spine and the intervertebral disks.
• Lifestyle: Lack of exercise can cause the abdominal muscles to weaken which in turn reduces the support for the spine resulting in back sprain and pain. Other factors such as stress, smoking, excessive alcohol consumption, drug misuse, etc. can all cause lower back pain.
• Occupation: Jobs that require lifting heavy objects or long hours of standing place unwanted stress on the back.
• Injury: Physical injury caused by accidents or sporting activities can cause back pain.
• Disease: A family history of osteoarthritis, certain forms of cancer and other hereditary diseases can increase the risk of lower back pain.

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Causes

The causes of lower back pain are many but the most common are:

• Sprains caused by muscle, ligament or tendon injury.
• Fractures
• Damage or wear on the disks that cushion the vertebrae.
• Structural problems such as curvature of the spine which can cause pinching of the spinal cord, leading to severe pain.
• Diseases and medical conditions such as spondylolisthesis, arthritis, and tumours of the spine.

Prevention

There are several actions a person may take to reduce the possibility of developing lower back pain. These include:

• Maintaining a healthy weight so that excessive pressure is not placed on the spine.
• Exercises to strengthen the abdominal muscles to give additional support to the spine.
• Training in how to lift heavy objects and in how to avoid unwanted stress on the spine by posture correction and learning how to do essential tasks in a way that will reduce stress on the lower back.

Symptoms of Lower Back Pain

Lower back pain may come on suddenly without warning or it may develop gradually. A specific action such as bending down may cause the pain or there may be no discernible reason for it to start. The pain can often become worse when the body is placed in certain positions and may improve in others such as when lying down. The pain may be dull and localized or it may radiate from the point of origin to other parts of the body.

Among the other common symptoms are:

• Stiffness: Moving or straightening the back may be difficult. Getting up from a seated position may be painful and the movement could be awkward. The overall range of back flexibility may be reduced. There could be an increased need to stretch or walk about to keep the back flexible.
• Spasms: Even normal movements may cause the muscles of the lower back to contract uncontrollably, leading to sharp spasms of pain.
• Posture: Lower back pain can result in a change in posture. This could make it hard to stand up straight. In such cases, the torso may be out of alignment with the spine, and the lower back may appear flat, instead of having the normal curved appearance.

Diagnosis

The cause of the pain must be established so that appropriate treatment may be given. The doctor will begin with a physical examination and questions about the patient's medical history. This will be followed by tests to further narrow down the causes. These include, but are not limited to:

• X-rays
• CT Scans
• MRI
• Electromyography (EMG) to check for nerve damage
• Blood and urine tests may also be ordered

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Treatment

Once the diagnosis is complete, the doctor will decide on the best course of treatment. This could include the following:

• Rest and medication to relieve the pain and instructions on how to prevent future occurrences.
• Prescription medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
• Physiotherapy to strengthen the back muscles so that the strain and stress on the spine are reduced.
• Injections of steroids to bring down inflammation and reduce pain.
• Manipulation in the form of chiropractic adjustments and/or osteopathic manipulation to realign the spine. Massaging may also be recommended.
• If noninvasive methods of treatment are not effective, surgery may be the right option. There are several surgical procedures that may be used and an orthopedic surgeon will determine which one is right depending on the individual case. It may be possible to use minimally invasive techniques to reduce the recovery time from the surgery.

The fact that lower back pain is such a common medical issue does not mean that it can be ignored. An occasional spell of pain after unusual physical activity is normal, but if the pain does not fade away in a few days with rest and physical therapy or if the pain recurs frequently or is chronic (constant but it may be of varying intensity), the cause must be diagnosed and appropriate treatment given. The best place to have a diagnosis done to receive the required treatment is a multispecialty hospital where there will be a dedicated orthopedics and spine department with specialists and the best treatment, equipment and services available. There will also be other departments such as physiotherapy that will be able to contribute, if required, to the treatment and recovery.

Do not fear lower back pain but do not ignore it. The sooner a problem is diagnosed and treated, the faster the recovery and the return to normal mobility.