In fact, at least four out of five adults will experience low back pain at some point in their lives. Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like your mid or upper back, a hernia in the groin or a problem in the testicles or ovaries. It is important to note that many types of low back pain have no known anat
omical cause, but the pain is still real and needs to be treated.
Where does the pain come from?
The following parts of the spinal anatomy can cause this type of pain:
- The large nerve roots in the low back that go to the legs and arms may be irritated
- The smaller nerves that innervate the spine in the low back may be irritated
- The large paired lower back muscles (erector spinae) may be strained
- The bones, ligaments or joints may be injured
- The intervertebral disc may be injured
Possible causes of lower back pain
Lower back region bears most of the weight of your body. The back pain most often occurs from strained back muscles and ligaments, improper or heavy lifting, or after a sudden awkward movement. Sometimes a muscle spasm can also cause back pain. Often, there's an accumulation of the stress with one particular event unleashing the pain. In many cases, there may not be an obvious cause. There are several other conditions not related to muscles and ligaments that can cause lower back pain and some of the most common are:
Herniated disk - This is a serious condition that occurs when disk material presses on a nerve. It can cause several complications.
Sciatica - This condition often occurs when a herniated disk causes pressure on the sciatic nerve causing sharp, shooting pain through the buttocks and back of the leg.
Spinal stenosis - This common but serious condition occurs when the space around the spinal cord and nerve roots narrows due to arthritis and bone overgrowth.
Spondylosis - Spondylosis is a type of arthritis affecting the spine. It is believed that it is caused by some degenerative changes in the spine that often come with aging.
Spondylolisthesis - This condition occurs when one vertebra in the spinal column slips forward over the other. It can cause severe nerve damage and strong back pain.
There are also several other more rare, conditions that can cause low back pain and some of the most common are:
Cauda equina syndrome
This is a very serious neurological problem causing weakness in the legs, numbness in the "saddle" or groin area and a loss of bowel or bladder control. It is caused by the damage in the lowest parts of the spine called cauda equina or “horse tail”!
Cancer in the spine
A tumor on the spine can press on a nerve causing back pain. These tumors are very rare but it is possible that they can cause very strong back pain.
Infection of the spine.
Several possible spine infections can cause strong back pain.
Injury
It is reasonable to assume that any kind of damage to the bones, ligaments, or muscles of the back can cause severe pain.
The most common symptoms
Beside the pain in the lower back parts, patients often experience several other symptoms such as:
- Pain that lasts longer than one month
- Numbness
- Muscle weakness
- Accident or injury
- Fever
- Weight loss
Risk factors for developing low back pain
You are at a particular risk for low back pain if you:
- Work on construction or have another job requiring heavy lifting, lots of bending and twisting, or whole body vibration
- Have a bad posture
- Are pregnant
- Are over age 30
- Smoke, don't exercise, or are overweight
- Have arthritis or osteoporosis
- Have a low pain threshold
- Feel stressed or depressed
Back pain from organs in the pelvis or elsewhere include:
- Bladder infection
- Kidney stone
- Endometriosis
- Ovarian cancer
- Ovarian cysts
- Testicular torsion
Diagnosis of low back pain
Diagnostic tests aren't usually necessary to confirm the back pain. However, several tests could help localize the pain, determine to what degree a patient is able to move without the pain and whether he has muscle spasms. They will also help rule out the more serious causes of back pain.
X-ray
This method is still very good for diagnosing the common back pain causes associated with bones. The X-ray images show the alignment of your bones and whether you have a degenerative joint disease or broken bones. The problem is that these X-ray images won't directly show the problems in your spinal cord, muscles, fibrous tissues (fascia), nerves or disks.
Magnetic resonance imaging (MRI) or computerized tomography (CT) scans
These are probably the best possible diagnostic tools for low back pain. These scans can generate images that may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
Bone scan
In rare cases, the bone scan may be used in order to detect the bone tumors or compression fractures caused by osteoporosis. Osteoporosis is a degenerative disease of the bones caused by the lack of calcium, aging and some hormonal changes. During the procedure, patient receives an injection of a small amount of a radioactive substance (tracer) into one of the veins.
Nerve studies (electromyography, or EMG)
This test measures the electrical impulses produced by the nerves and the responses of your muscles. Studies of nerve-conduction pathways can confirm nerve compression caused by herniated disks or narrowing of the spinal canal (spinal stenosis). It is also a very good and effective diagnostic tool!
Prevention measures
Exercise is important for preventing any kind of back pain. Regular low-impact aerobic activities which don't strain or jolt your back can increase strength and endurance in your back and allow your muscles to function better. Both abdominal and back muscle exercises help condition these muscles so that they work together as a natural support of the back. Flexibility in the hips and upper legs aligns pelvic bones to improve the feelings in the back.
Through exercise you can:
- Improve your posture
- Strengthen your back and improve flexibility
- Lose weight
- Avoid falls
Quit smoking. Smokers have diminished oxygen levels in their spinal tissues, which can slow down the healing process.
Healthy weight. It is logical that being overweight puts an unnecessary strain on your back muscles. If you're overweight, trimming down can prevent the back pain.
Tips for preventing back pain
- Do not lift any objects that are too heavy or have an awkward shape on your own.
- Spread your feet apart to give a wide base of support.
- Stand as close to the object you are lifting as possible.
- Bend at your knees, not at your waist.
- Tighten your stomach muscles as you lift the object up or lower it down.
- Hold the object as close to your body as you can.
- Lift using your leg muscles.
- As you stand up with the object, do not bend forward.
- Do not twist while you are bending for the object, lifting it up, or carrying it.
- Avoid standing for long periods of time. If you must stand at your work, try using a stool. Alternate resting each foot on it.
- Do not wear high heels. Use cushioned soles when walking.
- When sitting at work, especially if using a computer, make sure that your chair has a straight back with adjustable seat and back, armrests, and a swivel seat.
- Use a stool under your feet while sitting so that your knees are higher than your hips.
- Place a small pillow or rolled towel behind your lower back while sitting or driving for long periods of time.
- If you drive long distance, stop and walk around every hour.
- Bring your seat as far forward as possible to avoid bending. Don't lift heavy objects just after a ride.
- Quit smoking.
- Learn to relax. Try methods like yoga, tai chi, or massage.
Self care
Back pain usually improves on its own, or with home treatment, within a few weeks, unless there's a serious medical condition causing the pain. Several self-care procedures can help to treat the pain at home.
Constant moving
Although many people don’t know it, prolonged bed rest isn't a good idea for back pain. It is proven that light activity speeds up the healing and recovery.
Apply cold, then heat
It is proven that sources of heat and cold, such as a hot bath and hot or cold compresses can soothe sore and inflamed muscles. All doctors recommend that, immediately after injuring your back, ice should be applied several times a day, for up to 20 minutes at a time.
Use pain relievers
Several experts claim that patient shouldn’t suffer from any kind of pain. That’s why non-steroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin, Aspirin, others) and other medications such as acetaminophen (Tylenol, others) should be used in order to control pain, swelling and stiffness.
Consider using a support brace or corset.
This type of mechanical support can be very helpful. Braces, corsets or back belts are available over the counter at pharmacies and medical supply stores. It is proven that they can provide warmth, comfort and a degree of support to the back. However, you should know that back muscles may weaken with prolonged use of a brace or corset. It's best to use a brace or corset only for short periods or during back-straining activities.
Acupuncture
Some people with low back pain report that acupuncture helps relieve their symptoms. This procedure involves inserting sterilized stainless steel needles into the skin at specific points on the body.