Lower back pain affects 90% of Americans at some time in their lives and is the leading cause of visits to the doctor. Low back pain is the most prevalent cause of disability in people under age 45. An estimated $100 billion is spent annually in the management of low back pain.
Spinal vertebrae are held together by muscles, tendons and ligaments. Between the vertebrae are discs, which act as “shock absorbers” and prevent the vertebrae from hitting one another when you walk, run or jump. They also allow your spine to twist, bend and extend. Since the lower back is the hinge between the upper and lower body and carries most of your weight, it is especially vulnerable to injury and is the site of most reported back pain. When lower back pain strikes, we become acutely aware of just how much we rely on a flexible, strong back.
Lower back pain (lumbar pain) is triggered by some combination of excessive movement, muscle strain misaligned vertebrae called subluxations, or injury to the muscles and ligaments supporting the spine. Many experts believe that over time, chronic muscle strain can lead to an overall imbalance in the spinal structure. This leads to a constant tension on the muscles, ligaments, bones, and discs, making the back more prone to injury or re-injury.
The causes of lower back pain tend to be interrelated. For example, after straining muscles, you are likely to use your back differently than usual. As other parts of your back work harder or move in unaccustomed ways to make up for the injured muscles, they also become more prone to injury.
LOWER BACK PAIN SYMPTOMS
Lower Back pain can be:
- Acute: lasting less than 3 months.
- Recurrent: a repeat episode of acute symptoms. Most people have at least one episode of recurrent lower back pain.
- Chronic: lasting longer than 3 months.
The term “lower back pain” is used to describe a spectrum of symptoms. Depending on the cause, lower back pain may be dull, burning, or sharp, covering a broad area or confined to a single point. It can worsen gradually or suddenly and may or may not be accompanied by muscle spasms or stiffness.
Leg symptoms can be caused by lower spine problems placing pressure on a nerve to the leg. The symptoms can occur on their own or along with lower back pain. Leg symptoms can include pain, numbness, or tingling, usually below the knee.
Weakness in both legs, along with loss of bladder and/or bowel control, are symptoms of cauda equine syndrome, which requires immediate medical attention.
Numbness and tingling are felt when nerve impulses are not traveling properly from the skin to the brain. A patient with back problems may also experience numbness in other parts of the body, especially the legs and feet. These symptoms, when reported, indicate some kind of nerve damage in the peripheral nervous system or the central nervous system (i.e. the spine or the brain) and requires prompt and serious attention.
While there are many causes of lower back pain, most cases of low back pain can typically be linked to either a general cause – such as muscle strain – or a specific and diagnosable condition, such as degenerative disc disease or a lumbar herniated disc.
In the US, lower back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience it at some point in their lives.
Ironically, the severity of the pain is often unrelated to the extent of physical damage. For example, lower back spasms from a simple back strain can cause excruciating lower back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can actually be completely painless.
Lower Back Pain – Low Back Pain in General
Lower back pain may be dull, burning, or sharp, covering a broad area or confined to a single point. It is often triggered by some combination of overuse, muscle strain, or injury to the muscles, ligaments, and discs that support the spine. Less commonly, it is caused by illness or spinal deformity.
A lower back pain problem that puts pressure on a nerve to the leg, such as a herniated disc, can cause leg symptoms, either on their own or along with low back pain. Leg symptoms can include pain, numbness, or tingling, usually below the knee, and/or weakness in one leg. Weakness and/or numbness in both legs, and sometimes loss of bladder and/or bowel control, are symptoms of cauda equina syndrome, a serious condition in which the bundle of nerve roots at the end of the spinal cord is squeezed. This requires immediate medical attention.|
Another Synopsis for Lower Back Pain – Low Back Pain can be:
- Acute, lasting less than 3 months.
- Recurrent, a repeat episode of acute symptoms. Most people have at least one episode of recurrent low back pain. Keeping the abdominal, back, and leg muscles strong helps protect the back from recurring injury.
- Chronic, lasting longer than 3 months. A combination of exercises, pain medicine, and developing skills for managing and coping with chronic pain is the recommended treatment for chronic low back pain.
Lower Back Pain and Low Back Pain – Cause
Most low back pain is triggered by some combination of overuse, muscle strain, and injury to the muscles, ligaments, and discs that support the spine. Many experts believe that over time muscle strain can lead to an overall imbalance in the spinal structure. This leads to a constant tension on the muscles, ligaments, bones, and discs, making the back more prone to injury or reinjury.
The causes of pain in the low back, or lumbosacral region, tend to add on to one another. For example, after straining muscles, you are likely to walk or move in different ways to avoid pain or to use muscles that aren’t sore. That can cause you to strain other muscles that don’t usually move that way.
The most common causes of low back pain are:
- Injury or overuse of muscles, ligaments, facet joints, and the sacroiliac joints.
- Pressure on nerve roots in the spinal canal. Nerve root compression can be caused by:
- A herniated disc, often brought on by repeated vibration or motion (as during machine use or sport activity, or when lifting improperly), or by a sudden heavy strain or increased pressure to the lower back.
- Osteoarthritis (joint degeneration), which typically develops with age. When osteoarthritis affects the small facet joints in the spine, it can lead to back pain. Osteoarthritis in other joints, such as the hips, can cause you to limp or to change the way you walk. This can also lead to back pain.
- Spondylolysis and spondylolisthesis, vertebra defects that can allow a vertebra to slide over another when aggravated by certain activities.
Spondylosis: Lower Back Pain and Low Back Pain in General
Spondylosis can be a confusing term to patients because it is often used in different ways by different doctors. Some use it as a term to describe general back pain and spinal degeneration, while others use it as an “umbrella” term to describe degeneration of the spine and low back pain.
Spinal stenosis, or narrowing of the spinal canal, which typically develops with age
Fractures of the vertebrae caused by significant force, such as from an auto or bicycle accident, a direct blow to the spine, or compressing the spine by falling onto the buttocks or head.
Spinal deformities, including curvature problems such as severe scoliosis or kyphosis.
Compression fractures. Compression fractures are more common among postmenopausal women with osteoporosis, or in men or women after long-term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.
Less common spinal conditions that can cause low back pain include:
Ankylosing spondylitis, which is a form of joint inflammation (arthritis) that most often affects the Bacterial infection.
Bacteria are usually carried to the spine through the bloodstream from an infection somewhere else in the body or from IV drug use. But bacteria can enter the spine directly during surgery or injection treatments, or as the result of injury. Back pain may be the result of an infection in the bone (osteomyelitis), in the spinal discs, or in the spinal cord.
Spinal Tumors or growths that develop on the bones and ligaments of the spine, on the spinal cord, or on nerve roots.
Paget’s disease, which causes abnormal bone growth most often affecting the pelvis, spine, skull, chest, and legs.
Scheuermann’s disease, in which one or more of the bones of the spine (vertebrae) develop wedge-shaped deformities. This causes curvature of the spine (rounding of the back, or kyphosis), most commonly in the chest region.
Failed back surgery syndrome, which mean that a person is still having significant symptoms after surgery.