At any given time, forty percent of the world’s population experiences lower back pain. Strangely enough, the majority of back pain sufferers live in developed countries.
What Causes Lower Back Pain?
Most lower back pain doesn’t have a definite cause, rather it’s due to non-serious skeletal and muscle issues such as strains or sprains. There are many reasons one why you may feel your back is betraying you with aches and pains. Here are a few of the reasons your back may hurt.
— Because lower back pain is a musculoskeletal problem, being overweight or suddenly gaining weight, can bring pain. So can poor posture and poor sleeping positions.
— Playing “rough and tumble” sports, falling, and injury, are all reasons why you might develop lower back pain. Lifting a heavy object the wrong way is often the beginning of a back ache,
— Pregnancy. Nearly half of all pregnant women report lower back pain. The pain is mostly due to the changes in the body’s center of gravity, leading to ligament and muscle strain.
— When a woman is experiencing medical problems affecting the reproductive organs, such as ovarian cysts, uterine fibroids and endometriosis, she will most likely feel pain in the back.
— Strange as it may seem, smokers, especially adolescent smokers, are more likely to have back pain than non-smokers.
— Another big contributor to lower back aches and pain, is simply getting older. As we age, the “cushions” between our vertebrae lose moisture and begin to shrink causing musculoskeletal problems. Older adults are the group most affected.
— Prolonged sitting. Today many of us sit for long hours at a time. Too much sitting softens and weakens our back muscles, bringing on back problems.
Lower back pain falls into four distinct categories:
- Musculoskeletal—includes muscle strain, spasm, herniated disk and compression fracture, spinal stenosis;
- Inflammatory—which is linked to different types of arthritis such as: ankylosing spondylitis, psoriatic, reactive arthritis;
- Malignancy—different forms of cancer from your prostate, lung, thyroid, etc
- Infection—which includes osteomyelitis.
What’s the Difference Between Acute and Chronic Lower Back Pain?
Lower back pain can be a constant ache or a sudden sharp feeling. Pain lasting for a period of less than six weeks is classified as acute; between six and twelve weeks, it is sub-chronic; more than twelve weeks is chronic.
Pain symptoms usually improve within a period of few weeks from the time of onset. The majority of patients report feeling completely better within a period of six weeks.
Getting the Right Diagnosis For Lower Back Pain
When you work with a knowledgeable therapist, a thorough hands-on examination will provide an accurate analysis.
If for some reason more information is required, one of the following tests may be suggested:
- X-rays to give details of your body; taking pictures of the bones in the area suspected to be source of pain. Although they give limited detail, they are often helpful when in deciding the next course of treatment.
- CT Scans are recommended when suspecting infections or complications brought about by cancer. Scans show more details than an X-ray.
- MRIs are recommended when there is a suspicion of cancer or low back infections. An MRI gives greater detail than either an X-ray or CT scan.
- It’s useful for identifying disc disease and diagnosing spinal stenosis.
- The Straight leg raise is the test most used to determine disc herniation.
- Lumbar Discography helps in identifying specific disc pain in patients suffering from chronic lower back pain.
Although few cases of lower back pain require tests and imaging, they can be important tools for making a proper diagnosis—especially when neurological symptoms, worsening pain, or suspicion of conditions such as cancer and infections are present.
Your Treatment Options
Medications that Ease Lower Back Pain
Doctors will often recommend medications to ease lower back pain. Though helpful in easing pain, care must be taken in their use.
- First in line are NSAIDs (aspirin, ibuprofen etc.) or the skeletal muscle relaxants. Although they are effective in treating pain, these medications can promote kidney problems, stomach ulcers and even heart issues when used long-term.
- If pain escalates, opioids such as morphine are usually prescribed. Opioids need to be used with extreme caution because of the risks of addiction and drug interactions.
- Antidepressants can be effective in treating chronic lower back pain, but like most of the pain management drugs, there is a risk of side effects.
- Facet joint and steroid injections are not effective in treating persistent pain; however, they can be useful for sciatic pain.
- Epidural injections provide the patient with short term improvement, especially for people with sciatica. Long term benefits, however, are doubtful.
See A Doctor of Physical Therapy
Seeing a Doctor of Physical Therapy is increasingly being recommended as a way to manage lower back pain. The reason? It’s natural and been proven to work for many. It addresses the cause of your back pain rather than just your symptoms. When you see a physical therapist that specializes in the spine they’ll be able to provide the following treatments:
Treatment #1- Patient Education
Physical therapy shows you how to move, sit, and lift to prevent further injury and pain. It’s an important aspect of decreasing pain, and preventing your from hurting your back more.
Treatment #2- Myofascial Release
Are your muscles tight and sore? A physical therapist can loosen up your muscles and take the pressure off your back. This form of treatment can be good for you especially if you have pain with prolonged standing.
Treatment #3- Exercise Therapy
Whether you’ve just hurt your back or have suffered from some time, exercises to strengthen and stretch your back has been one of the best interventions anyone can perform. A physical therapist can help select the right exercises you should our shouldn’t be performing depending on your back. Exercise will give you increased confidence that your back is healed.
Treatment #4- Spinal Mobilization or Manipulation
Spinal mobilization has been around for hundreds of years. This is because it works! A specialty trained physical therapist in the spine can provide spinal mobilization and manipulation when needed. What’s great about a physical therapist’s mobilization is that it doesn’t need to be aggressive. It is usually more gentle and soothing for the patient. Spinal mobilization and manipulation help reduce pain but also improve your mobility to turn or bend more efficiently.
Treatment #5- Spinal Decompression or Traction
Do you have pain when standing or walking for prolonged periods of times? A physical therapist can provide spinal traction and decompression to your spine to unweight your vertebrae, joints, and discs.
Surgery—Always a Last Resort For Lower Back Pain
- Surgery may prove necessary for someone with a herniated disc that’s causing significant pain. It could also be beneficial to those with spinal stenosis.
- Discectomy, which is the partial removal of the disc causing pain, may provide relief.
- Micro-discectomy is less invasive, but there is no evidence that it will give different outcomes than regular discectomy,
- Spinal fusion can benefit those with localized pain. It is an intensive procedure, and is better than the low intensity, non-surgical treatment options. For those with low back pain displaced vertebra, this may be the needed treatment.