Lower Back Pain: Symptoms, Diagnosis and Treatment
What is Considered Lower Back Pain?
Low back pain refers to any pain due to a condition in the lower back that usually involves the lumbar or sacral segment of the spine. It may sometimes also be associated with conditions of the hips or pelvic area. These conditions can range from muscular bruising to spinal fractures. Other common causes of chronic lower back pain can be the narrowing or abnormal growth of facets and sections of the spinal cord, resulting in pressure on the spinal nerves. Although lower back pain can occur as a result of the normal aging process, a person's lifestyle can sometimes cause or exacerbate it.
Treatment for lumbar or sacral pain can range from physical therapy to corrective surgery, including Endoscopic Discectomy and fusion procedures.
How Common is Lower Back Pain?
Conditions in the lumbar and sacral areas of the spine are among the most common. This area of the spinal column receives the largest share of the body's load. Therefore, it is more likely to develop an orthopedic condition. Conditions such as pinched nerve or disc degeneration are common in the lower back. Unfortunately, it is also the tendency for conditions in this part of the spine to worsen or escalate if left untreated.
Back pain can occur because of different reasons, and sometimes it is not quite obvious what causes the pain. Strains sometimes result in back pain, for example, after lifting heavy things. The first one is arthritis of the spine, which is the degeneration of spinal joints. Usually, the cause of this is natural wear and tear.
Back injuries are another source of lower back pain. Such injuries can happen due to a number of reasons, ranging from car accidents to awkward movements.
Herniated or bulging discs are not painful themselves, but the slipped disc can press on nearby nerves, causing pain.
There are some other reasons for back pain, but those are the most common ones. If you experience back pain for some time, it’s best to consult a doctor to determine the diagnosis and choose the proper treatment.
As pain can be caused by different conditions, it is important to understand the cause correctly, and you might need different treatments based on your diagnosis. In some cases, a special training program can help ease the pain, but sometimes the only option is to have surgery or take pain-relieving medications.
During the first diagnosis phase, your doctor will ask questions about the symptoms, severity, and duration of the pain. Also, there will be a physical exam to check for broken bones or other damage.
Imaging studies such as X-rays, MRI, CT scan, EMG, etc., help your provider get clear images of the vertebrae, discs, muscles, ligaments, and tendons.
Next: Lower Back Pain Diagnose
Usually, lower back pain goes away after a couple of days of rest. Some home remedies, which we’ll cover later, can also help. For more severe cases, medications, physical therapy, injections, and surgery are often recommended.
Some conditions like bulging or herniated discs don't cause any symptoms and may be detected by accident during imaging scans for another health condition. But with the vast majority of spine conditions causing lower back pain, there are a number of treatments.
- Prescription and over-the-counter drugs such as non-steroidal anti-inflammatory medications (NSAIDs), muscle relaxants or narcotics;
- Physical therapy that includes instruction on how to properly lift, dress, walk and perform other activities, how to strengthen muscles and how to increase flexibility in the spine and legs;
- Chiropractic manipulation of the spine;
- Steroids that are given by pill, injection or intravenously to control pain and reduce swelling around the disc;
- Surgery, including minimally invasive and 'open' approaches.
Treatments are often combined to increase the chance of success, for example, prescription drugs can be combined with conventional treatment options like physical therapy or with acupuncture, yoga, etc.
There are several home remedies that can help ease the pain. Applying cold or heat packs to the aching spot can relieve some pain. Sometimes, gentle massage also helps.
Many patients are offered to have a course of physical therapy to strengthen and stretch muscles in the lower back. Exercises can either help you ease pain, or strengthen your muscles and joints and prevent pain in the future. Such exercises can help relieve pressure on the nerve and therefore relieve low back pain. In any case, adding exercises for low back pain to your fitness plan can benefit you.
Consult with a doctor to create a proper training program and to ensure you perform all exercises with the correct technique.
Generally, people are advised to walk for 20-30 minutes daily. You can strengthen your back muscles with exercises such as pelvic tilt, carefully performed side bends, the bridge, and knee pulls.
Surgery is typically the last choice when other options didn’t provide enough relief. Usually, it is advised to those in whom the pain hasn’t improved with at least six weeks of nonsurgical treatment and symptoms require strong pain medicine or interfere with normal activities, and weakness, loss of motion or abnormal sensitivity is present.
There are several surgeries to ease low back pain. A herniated disc can be removed, the two surrounding vertebrae can be fused, or the space around the spinal cord can be widened.
A discectomy is a surgery during which a surgeon removes a herniated disc from the lower back to reduce pressure on a spinal cord nerve causing pain. Normally, endoscopic spine surgery is an option for people who have herniated or bulging discs, and therefore experience pain and other unpleasant sensations such as weakness or numbness. The first option for such a patient is to try conservative treatments, but if there was no visible result, surgery can be recommended.
As with many other issues, lower back pain is easier to prevent than to treat.
There are various lifestyle changes to help prevent such a problem. They include maintaining a healthy body weight to control the amount of pressure on your vertebrae and having a balanced healthy diet rich in vitamin D, Zinc, Calcium, and water.
Quitting smoking and drinking is also a good idea, as nicotine slows down regeneration processes and badly influences your overall health.
Use proper lifting techniques. Do not bend at the waist. Bend your knees while keeping your back straight, and use your strong leg muscles to help you support the load.
Another two tips are incorporating some movement into your life to increase muscle strength and flexibility, and choosing ergonomic furniture. Using proper tables and chairs is extremely important if you have a sedentary lifestyle and need to spend most of your time sitting. In this case, also try to stand up and perform some exercises once in a while to get some movement. In your training, try to focus on flexibility and abdominal muscle strength. Even though these tips can help you prevent back issues, some degree of wear and tear is natural and can happen nonetheless.
But you should remember that in many cases back pain is caused by an injury that could easily be prevented, as there are ways to reduce the chance of dangerous accidents.
The first step is to wear quality protective equipment during sports and physical activity. If you ride a motorcycle or like to ski, it makes sense to invest in the best-quality gear you can afford, as sometimes it saves lives, not just your back muscles and bones.
An important thing to remember is proper sizing, so try not to order protective gear online, but instead go to the offline shop to ensure that you have a perfect fit. Otherwise, the equipment might not work properly, or not work at all.
Refraining from certain activities can reduce the chance of injuries. For example, you should drive smart and strictly follow the rules, especially those involving not driving if you’ve used drugs or alcohol. Of course, always wear a seatbelt in the car.
Another tip is to make your home a safer place. Try to keep clutter away from the floor, so that you don’t step on it and fall. Fixing lighting is another way to make your home safer.