Lower Back Pain Causes, Symptoms and Treatment: Lower Back is the lumbar region of your spine which starts after the end of the rib cage and extends up to the centre of the hip joint. Almost everyone experiences lower back pain in their life and it can usually go away on its own. It usually occurs in people after the age of 30 years because the discs which are present between each vertebrae start degenerating with age.
A sedentary lifestyle can lead you to have lower back pain before the age of 30 years. If your pain does not go away on its own then you will need to visit your doctor as there may be some underlying problem or disorder which is causing the pain. Lower Back Pain can lead to a number of symptoms such as pain when sitting for long periods, pain radiating to one or both legs and numbness or weakness.
Lower back pain can be diagnosed by finding the cause of the condition which can vary in different persons. The treatment of lower back pain is generally focused on the cause and intends to treat it. The treatment plan is designed to fit the needs of each individual separately.
Lower Back Pain
Lower Back Pain refers to pain which starts in the Lumbar region of your spine and its surrounding muscles and tissues. This can occur in anyone in any age group but it is most commonly seen in older patients. This condition can affect the quality of the life of the patient and can lead to severe discomfort.
Lower Back Pain can lead to a number of symptoms which interfere with the daily life of the patient such as pain while sitting down or getting up from a seated position, radiating pain and other symptoms. If these symptoms are not treated in early stages, they can increase over time and lead to more problems. It is hard to diagnose the cause of lower back pain as there are many systemic and mechanical factors which affect the proper functioning of your Lumbar spine.
However some diagnostic tests are available to diagnose the condition. The article below will give you all the details related to Lower Back Pain, its symptoms, possible causes, diagnostic tests, treatment protocols and preventive measures.
Symptoms of Lower Back Pain
Lower Back Pain can present a number of symptoms which affect the normal life of the patient. Some of the common symptoms associated with Lower Back Pain are given below.
- Dull aching pain which persists for more than a week
- Pain is usually present over the spine
- Pain can travel to your buttocks, legs and feet
- Numbness and tingling sensation in parts where the pain travels to
- Worsening of pain after prolonged sitting
- Worsening of pain after getting up from a position of prolonged sitting
- Stiffness in back after getting up from a lying position
- Lack of bowel or bladder control
- Fever and chills
- Severe pain in your abdomen
- Unexplained weight loss
- Pain which comes and goes away but gets worse over time
These symptoms are usually seen in patients however they may vary in different patients. In most of the cases, the pain develops gradually and slowly and worsens over time. This means that the patient only realises that there is a problem when the problem has passed the early stages.
Causes of Lower Back Pain
There are many conditions which can lead to an onset of Lower Back Pain. The most common cause is a mechanical issue or soft tissue injury. The causes can be classified on the basis of their onset time in two categories- Acute and Chronic.
- Acute Causes-
- Muscle Strain- This condition occurs when the muscles around the Lumbar Spine are stretched too much and tears. This can occur due to sudden and sharp movements, lifting heavy objects and Sports injuries.
- Ligament Sprain- In this condition, the ligaments, which connect one bone to the other, become stretched and tear. This can occur when you have poor posture for long periods of time, when you lift a heavy object with poor posture or when you move suddenly which puts pressure on your spine.
- Chronic Causes-
- Disc herniation- The disc which is present between two vertebrae is a jelly-like structure which acts as a shock absorber. This disc can sometimes move out of its place and impinge on a nerve root which can cause inflammation of the nerve root. This produces severe pain in the region of impingement and along the distribution of the nerve.
- Disc Degeneration- The disc can start degenerating over time as it loses its hydration with age. The disc cannot resist the forces and can even tear up which can lead to severe pain in the region.
- Facet Joint Dysfunction- There are two facet joints behind the disc at every motion of the spine. When these joints do not work properly then it can lead to facet joint pain or pain along with the disc.
- Sacroiliac Joint Dysfunction- The Sacroiliac Joint connects the sacrum to the pelvis. This joint is extremely strong and acts as a shock absorber. If there is any inflammation in this region then it can lead to Lower Back Pain and loss of movement in the joint.
- Osteoarthritis- This occurs when there is damage to the disc and the facet joints due to wear and tear. It can lead to pain, inflammation, instability and stenosis. It can occur at multiple points of the spine over time. It is also known as Spondylosis.
- Spinal Stenosis- This condition occurs when the Spinal canal becomes narrow and the nerve roots become irritated.
- Spondylolisthesis- In this condition, the vertebrae may slip over the adjacent vertebrae leading to impingement of the nerve roots. It can also lead to instability in the back.
- Trauma- Any kind of trauma to the back can lead to Lower Back Pain. This kind of pain usually develops after an accident or a fall.
- Deformity- There are many congenital and acquired deformities of the spine which can lead to pain in the Lower Back Pain. These include Scoliosis, Kyphosis and Lordosis.
- Compression Fracture- This condition occurs when the vertebrae cannot withstand the forces and caves in on itself. This causes sudden and sharp pain. It is mostly seen in the elderly and in patients of Osteoporosis.
Diagnosis of Lower Back Pain
An early and accurate diagnosis can help significantly in the management of the symptoms of Lower Back Pain and to completely cure it. The diagnosis is made by using the following tests.
- Patient History- Your doctor will first take a detailed history about your symptoms, when did they start, which factors trigger them and which factors calm them, your sleeping habits, any recent injuries and how long have you had your symptoms for.
- Physical Examination- Your doctor will first check for any swelling, joint abnormalities, and tenderness along the affected region. They will then check the range of motion of your affected and related joints to look for positions and patterns in the occurrence of pain. Then your doctor will check your reflexes in order to determine the extent of damage to nerve roots.
- Nerve Studies- Your doctor will perform a neurological examination in order to determine how fast your nerves can transfer information. This may include a pin prick test, light touch and other tests.
- Imaging Tests- Your doctor will conduct an X-Ray, CT scan or an MRI scan in order to determine the location of the affected area and to take a look at the affected structures. This will help them to determine the extent of damage to the affected region and the surrounding structures.
- Leg Raise Test- This test is conducted by asking the patient to slowly lift their leg as high as possible while lying down. The doctor notes down the angle at which the symptoms start. This helps them to narrow down the cause of Lower Back Pain.
Treatment of Lower Back Pain
The treatment of Lower Back Pain is generally planned in three forms- Conservative treatment, Physical Therapy and Surgical Interventions. Conservative treatment and Physical Therapy are used in combination while surgical interventions are used in chronic cases or cases which do not respond to the other two protocols.
- Medication- The following medications are used most commonly in order to treat Lower Back Pain.
- Painkillers- These medications include NSAIDs such as Ibuprofen, Naproxen sodium and they work to reduce the pain. They block the nerves which take up the sensation of pain to the brain.
- Topical Painkillers- These medications can include creams, patches, ointments and salves. These release pain relieving chemicals through the skin.
- Narcotics- Opioid drugs such as oxycodone and hydrocodone can be prescribed for shorter periods.
- Antidepressants- Antidepressants such as Duloxetine, amitriptyline have shown promise in the relief of Chronic Lower Back Pain.
- Muscle Relaxants- Muscle relaxants are prescribed when muscle strain is suspected. They may lead to dizziness and sleepiness in the patient after prolonged usage.
- Physical Therapy-
- Heat/Ice Therapy- Heat therapy is mostly used in chronic cases. The patient may feel relaxation by applying heat over the affected area for 10 to 15 minutes. Ice therapy is used when the cause of Lower Back Pain is due to inflammation in the tissues. Alternate heat and ice therapy can be used for faster recovery as the heat relaxes the tissue and the ice prevents them from becoming irritated.
- Activity modification- You will be told to avoid the activities that aggravate your symptoms. You can also include periods of rest in between activities in order to reduce the stress on your back.
- Stretching- Almost every patient is taught the stretching of their affected muscles as it reduces the muscle tightness and promotes relaxation. You will be advised to hold a stretch for at least 20 to 30 seconds and to stop immediately if you experience any kind of pain.
- Strengthening exercises- Strengthening exercises for your core muscles and back muscles will also be advised so that your muscles can withstand the forces they experience with day-to-day activities.
- Low impact Aerobic exercises- Low-impact aerobic exercises will increase the blood flow to every part of your body and allow you to recover faster from any type of injury. These exercises can include stationary bikes, walking or hydrotherapy.
- Surgical Intervention- Surgical interventions are used when the patients do not respond to conservative treatment methods. The following procedures are used most commonly.
- Cortisone injections- Cortisone injections are used to relieve radiating pain. These injections are injected in the spinal cord and nerve roots. This also decreases the inflammation around the tissues.
- Radiofrequency ablation- Radio waves are passed into the affected tissues by a needle which damages the small fibre nerves. This stops the sensation of pain from travelling to the brain.
- Implanted nerve stimulators- Artificial Nerve Stimulators are implanted under the skin which act to block the pain signals from travelling along the nerves.
- Decompression surgery- A decompression surgery is performed when there is severe compression of the nerve and it removes anything which might be causing the compression. This can include part of the herniated disc or an abnormal bone growth.
Prevention of Lower Back Pain
There are many ways which can prevent Lower Back Pain in a person. Some of the common methods to prevent Lower back pain are given below.
- Regular exercise- Exercising regularly can help you to maintain good muscle strength and overall health. This will prevent any kinds of muscle strains and sprains due to any sudden movements.
- Improve muscle strength- Work on your muscle strength and build up your abdominal so that these muscles can share the workload of the back muscles.
- Maintain a healthy body weight- Being overweight puts undue stress on the back of the person which can lead to many deformities and Lower back pain.
- Quit smoking and drinking- Smoking and drinking increases the risk of Lower back pain. Decreasing the amount of cigarettes that you smoke per day and drinks that you drink per day can improve your overall health and decrease the risk of Lower Back Pain.
- Improve your posture- Maintaining a good posture can also prevent the onset of Lower back pain. This reduces the stress on the back muscles and allows them to distribute the forces evenly.
FAQs Related to Lower Back Pain
Lower Back Pain refers to pain which starts in the Lumbar region of your spine and its surrounding muscles and tissues. This can occur due a number of acquired and congenital conditions but it is most commonly due to mechanical and soft tissue injury.
You can relieve your Lower back pain by applying heat and ice therapy on it. You can also take over the counter painkillers to relieve pain and start mild stretching and exercises in order to improve your muscle strength.
This depends on the cause of your Lower back pain. However most patients benefit from walking hence you can try it to treat your Lower back pain. You can also use the methods mentioned in the article above.