Low Back Pain: Causes and Treatment

Low Back Pain is a symptom, not a disease. It is only a manifestation of an illness concerning the anatomy of the spine that involves bones, muscles, joints and nerves. However, there are times when pain is perceived on the lower back but the abnormalities are on the hips, chest and abdomen. This is referred pain. There are several underlying reasons for low back pain. Some of these are outlined below.

Nerve Roots are often sources of pain when impinged. Impingement is due to bulging of the intervertebral disc. The central portion of the disc, which is a gel-like substance, protrudes and pushes against the nerve root. This pain is usually felt as a sharp shooting pain.

Spondylosis is a condition wherein the intervertebral discs lose moisture as a result of aging. Loss of moisture will result in decrease of disc height. The result is a tendency for the disc to rupture. Minor trauma can lead to inflammation and nerve root impingement.

Spinal Stenosis, also called spinal canal narrowing, is due to disc degeneration. The opening where nerve roots exit becomes narrow. Nerve roots can be impinged with resulting pain when standing for a long time.

Cauda Equina Syndrome is when the spinal cord is directly impinged. The disc material directly compresses the spinal cord. As a result, the person can experience pain, and there may be bowel or bladder dysfunction.

Musculoskeletal Pain Syndromes are also common underlying illnesses that have direct impact on the lower back. Among these are Fibromyalgia and Myofascial Pain Syndrome. Fibromyalgia Pain Syndrome comprehensively include pain felt throughout the body. It is characterized by widespread muscle aches and stiffness. In contrary to Fibromyalgia, Myofascial Pain Syndrome is localized. Pain and tenderness will be felt on areas called trigger points. Pain may radiate but only along the distribution of a nerve involved.

Spondylitis, a noninfectious inflammation of the spine, can also cause pain and marked stiffness in the spine.

The symptom of pain can be confined at the lower back or it can possibly radiate to the leg. Physical activities and prolonged sitting can make it worse. Weakness can be felt with numbness on the area supplied by an impinged nerve.

Seeking medical advice is very important. The following conditions in the presence of low back pain should be reported to a doctor for a thorough evaluation:

A recent trauma such as motor vehicular accident and a fall can be contributory factors. An underlying fractured bone on your back can be the cause of the pain felt. For people over 50 years of age, any mild trauma should be reported. Osteoporosis is considered to be a risk in developing low back pain. A low back pain that gets worse at rest should also be reported as this may signal a malignant or infectious underlying disease of the back. Bowel and bladder incontinence are also conditions that a doctor should know.

Low back pain is diagnosed after a thorough history and physical examination plus a series of medical examinations and tests. As there are lots of possible causes, a doctor will ask very important questions. A doctor may ask: How did the pain start? Are there positions that aggravate your symptoms? Were you lifting an object when you felt the pain? Your doctor may also ask about your past medical history, asking about related diseases and recent surgeries you had. Physical examination entails observation of how you walk and assessment of your reflexes and sensation. Neurologic and orthopedic special tests will also be done to identify possible body structures involved. Medical examinations may include blood tests, imaging such as x-rays and MRI, nerve conduction studies and electromyogram.

Treatment aims to improve activities of daily living. Nonprescription drugs may provide relief from pain such as ibuprofen, acetaminophen, topical agents and rubs. Though there are possible benefits of bed rest, doctors discourage prolonged bed rest as it can promote decreased muscle tone, blood clots especially on the legs, and even depression. A bed rest not exceeding 48 hours would be ideal. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) have proven to be beneficial. Steroids can be used but not for prolonged period as these drugs still remain controversial about their side effects. If low back pain seems to be progressive and it can only be relieved by actual decompression of nerve, surgery can be an option. However, for acute low back pain cases, surgery is discouraged. Other treatments include physical therapy, acupuncture, transcutaneous electrical nerve stimulation and spinal manipulation. However, the guidance of a medical practitioner should always be sought regarding these.

It is important to know the cause of your low back pain before treatment. Knowing the cause means knowing the right treatment. These facts will guide you when you visit your doctor. Ask your doctor about all of your treatment options.

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