Causes and Treatments of Lower Back Pain
What separates us from other mammals is that we are supine, meaning we stand, walk, and sit upright. What holds us upright is our spine, which has four parts: cervical, thoracic, lumbar and the coccyx. The lower back consists of five lumbar vertebrae (bones). Intervertebral discs between each vertebrae act as cushions and shock absorbers. Ligaments and tendons hold the vertebrae in place, and about 31 nerves pass through the spinal cord, allowing messages to pass between the brain and the body to control movement and other activities.
Lower Back Pain
About 2.6 million Britons seek medical help from doctors for lower back pain, which costs the United Kingdom 119 million workdays per year and economic losses of about £ 12.3 billion. Lower back pain is defined as pain, muscular tension, and stiffness above the buttock region, with or without leg pain.
Lower back pain can be classified as specific or non-specific. Your lower back pain is specific if you can pinpoint the reason for your pain. If you have no idea why you’re in pain, you’re probably suffering from non-specific pain.
Types of Lower Back Pain
Classifying lower back pain is a tough job because pain could come in waves or disappear and reappear after a few months.
- Acute pain lasts less than six weeks
- Sub-acute lower back pain lasts 6 to 12 weeks
- Chronic back pain lasts longer than 12 weeks
If you suffer from acute lower back pain, and none of the available over-the-counter (OTC) medications are providing relief, your doctor may try to diagnose the reason for the pain via X-rays, CT scans, MRIs, myelograms, bone scans, discography and blood tests.
Causes of Lower Back Pain
The reason for your pain can be classified into the following categories:
- Mechanical: The source of the pain is present in the spine and supporting structures
- Sprains and strains
- Disc degeneration: the most common reason for pain caused by age-related loss of integrity of intervertebral discs
- Skeletal irregularities – abnormal curvature of the spine causing pain
- Neurogenic: The pain arises from the irritation of nerve roots
- Herniated/ruptured disc: The cushion discs between vertebrae get compressed, bulge out, or rupture, causing inflammation of nerves nearby, leading to severe pain.
- Spinal stenosis: Narrowing of the spinal column, which puts pressure on nerves, causing pain and numbness
- Sciatica: Compression of the sciatic nerve that runs from the buttocks, along the length of your leg, causing pain and numbness
- Radiculopathy: Compression, inflammation, or injury to the spinal nerve root, resulting in pain, numbness and tingling to parts of the body served by that nerve
- Non-mechanical spinal conditions, such as:
- Presence of a tumor (primary or metastatic). This rarely occurs and is usually metastatic due to breast cancer.
- Infections (e.g., abscess, discitis or osteomyelitis).
- Cauda equina syndrome, which is a rare complication of a ruptured disc that causes loss of bladder and bowel control.
- Kidney stones, which cause severe lower back pain but are present only on one side.
- A traumatic injury.
Lower Back Pain Treatments
Most episodes of lower back pain can be resolved without medical intervention. Non-medical options include:
- Hot/cold packs: These help numb pain and reduce inflammation
- Activity: Staying stationary when in pain can sometimes be a bad idea. Resuming normal daily activities and performing stretching exercises may return some flexibility to your back.
- Strengthening exercises to help maintain muscle strength and posture. These would include push-ups, squats, yoga, and the use of resistance bands. Please make sure that your physician is aware that you’re attempting these exercises.
Sub-acute and acute lower back pain may require medication. Some options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDS): OTC drugs such as ibuprofen and ketoprofen relieve pain and inflammation.
- Analgesics: OTC drugs such as aspirin (acetaminophen) were specifically developed to relieve pain. Narcotic drugs such as Codeine, Oxycodone, and Hydrocodone can be prescribed when OTC drugs don’t provide relief.
- Anticonvulsants are specifically prescribed for radiculopathy.
- If you suffer mental anguish because of the physical pain, you may be prescribed anti-depressants.
Newer options such as traction, chiropractic treatment and nerve-block therapies have gained momentum in the treatment of lower back pain. The newest is transcutaneous electrical nerve stimulation (TENS), which uses electrical impulses to block pain signals. It has been well received by chronic pain sufferers.
Pain is unpleasant and distressful, to say the least. If non-medication tactics don’t provide relief from lower back pain, it may be time to visit your doctor. Maintaining a healthy lifestyle will facilitate a full recovery.
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- Catherine Murari-Kanti