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For In-Depth information on low back pain, click here.
Definition
Low back pain is an ache or discomfort in the area of the lower part of the spinal column. The lower spinal column consists of many small bones that surround and protect the spinal cord and nerves. Low backpain is very common, affecting most adults at some point in their lives.
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Causes
There are many possible causes for low back pain, including:
- Sprain or strain of muscles or ligaments in the area (most common cause of back pain)
- Herniated disc, or ruptured disc — the cushions between the bones of the spine bulge out of place
- Disc degeneration, caused by aging or arthritis
- Spinal stenosis — narrowing of the spinal canal in the lumbar area
- Spondylolisthesis — slippage of a bone in the low back
- Fractures due to trauma or osteoporosis
- Fibromyalgia — a condition that causes muscle aches and fatigue
- Ankylosing spondylitis — a hereditary disorder involving the spine
In rare cases:
- Benign or malignant tumors
- Infections
- Problems of the digestive tract
- Arterial problems such as hardening of the arteries
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Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Family members with back problems
- Pregnancy
- Obesity
- Lack of regular exercise
- Smoking
- Injury
- Pre-existing back injury due to:
- Lifting a heavy object
- Improper lifting
- Sudden movement, bending, or twisting
- Prolonged sitting or standing
- Bad posture
- Vibration from vehicles or heavy equipment
- Prior back surgery
- Psychological factors
- Low job satisfaction
- Interpersonal relationship problems
- Depression
- Fatigue or sleep deficit
- Drug or alcohol abuse
- Stress
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Symptoms
Pain is usually localized in the low back. If a nerve is irritated, the pain may extend into the buttock or leg on the affected side, and weakness or numbness may be present.
More serious symptoms associated with back pain that may require immediate medical attention include:
- Pain that doesn't improve, or worsens, with rest
- Pain that is severe or that has gotten dramatically worse
- Progressive weakness in a leg or foot
- Difficulty walking, standing, or moving
- Numbness in the genital or rectal area
- Loss of bowel or bladder control
- Burning or difficulty with urination
- Fever, unexplained weight loss, or other signs of illness
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Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. In particular, the doctor will examine your back, hips, and legs and usually will test for strength, flexibility, sensation, and reflexes.
Other tests may include:
- X-ray — a test that uses radiation to take a picture of structures inside the body, especially bones
- CT Scan — a type of X-ray that uses a computer to make pictures of structures inside the body
- MRI Scan — a test that uses magnetic waves to make pictures of structures inside the body
- Blood Tests — such as complete blood count or sedimentation rate
- Urine Test — to check for urinary infection or blood in the urine
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Treatment
Treatment options include:
Bed Rest — resting on a firm mattress or pad on the floor for one-to-two days, followed by a gradual return to daily activities. Research indicates that longer bed rest may slow the healing process.
Medication
- Pain relievers like acetaminophen (tylenol), aspirin, or ibuprofen
- Muscle relaxers for muscle spasm
- Cortisone pills or injections
- Antidepressants for chronic pain
Physical Therapy
- Hot or cold packs
- Stretching and strengthening exercises
- Education about back problems
- Massage
- Ultrasound treatments or electrical stimulation
Surgery — May be needed if nerve problems develop or other treatments fail to provide relief. Common procedures are discectomy, laminectomy, and spinal fusion.
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Prevention
The following steps may help you avoid low back pain:
- Sleep on a firm mattress.
- Exercise regularly, at least 30 minutes most days of the week. Good choices include walking, swimming, or exercises recommended by your doctor or physical therapist.
- Lose weight if you're overweight.
- Stop smoking.
- Practice good posture to reduce pressure on your spine.
- Avoid sitting or standing in one position for prolonged periods.
- If you must remain standing for long periods, rest one foot at a timeon a small stool to relieve pressure on your low back.
- When lifting, hold the object close to your chest, maintain a straight back, and use your leg muscles to slowly rise.
- Consider job retraining if your work requires a lot of heavy lifting or sitting.
Copyright© 2000 HealthGate® Data Corp. All rights reserved.
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