Everything you’ve ever wanted to know about lower back pain directly from the professionals
You’re not alone if you’ve ever had lower back discomfort prevent you from accomplishing what you want. Lower back pain is one of the most frequent health issues worldwide. It affects more than 80% of individuals at some time in their life, making it a common cause for people to consult a doctor. Lower back pain is also a key source of disability, according to the Global Burden of Disease research published in The Lancet medical journal.
Lower back discomfort is difficult to avoid, particularly as you get older and your back loses some of its power and resiliency. Fortunately, no matter what is causing your back discomfort, there are several options for treatment.
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What Is the Lower Back in the First Place?
The lumbar area of the spine refers to your lower back. It has several hefty responsibilities: The lumbar spine bears the weight of your whole upper body, as well as movement-related biomechanical stresses.
There are five vertebrae (backbones) in the lumbar spine. On the front side of each vertebra, a big disc – a cushiony gel covered in a strong membrane – works as a shock absorber. On the backside of each vertebra are two cartilage-lined facet joints. Discs and facet joints work together to enable the spine to flex and twist securely.
Ligaments, tendons, and muscles make up your lower back. Ligaments are strong bands of tissue that connect the vertebrae and discs. Tendons are the ligaments that connect muscles to the vertebrae. These structures limit an excessive movement that might injure the spinal cord.
When it comes to lower back pain, how long does it usually last?
Acute, subacute, and chronic lower back pain is the three types of lower back pain. Acute bouts of lower back pain last anywhere from a few days to four weeks, whereas subacute occurrences persist anywhere from four to twelve weeks. According to the National Institutes of Health, roughly 20% of persons who suffer from acute back pain acquire chronic back pain, which is defined as pain that lasts for more than 12 weeks. Even in these circumstances, there are various therapeutic options available to assist in alleviating the symptoms of lower back pain.
When your back is in excruciating pain, you may be concerned that something is badly wrong. The same may be said for back discomfort that never seems to go away. The good news is that, although back pain is inconvenient, it is seldom a life-threatening medical condition. You don’t
have to treat it very often. Unless you have a serious underlying disease, back discomfort normally goes away on its own.
What Are Some of the Most Common Causes of Lower Back Pain?
Mechanical, organic, and idiopathic causes of lower back pain have all been proposed. Spinal problems may be congenital (present at birth) or acquired (developing later in life).
Mechanical lower back pain is caused by spinal movement and affects the facet joints, intervertebral discs, vertebral bodies (vertebrae), ligaments, muscles, and soft tissues.
Organic lower back pain is caused by a disease, such as spinal cancer, while an unknown cause causes idiopathic lower back pain.
When you go to your doctor for back discomfort, these are some of the things he or she could check for – or rule out.
Strains and sprains are two different types of injuries. They’re often linked to excessive usage. Lower back discomfort is most often caused by ligament sprains and muscle or tendon strains.
Degenerative disc disease (DDD) is a kind of degenerative disc disease. While the term may be alarming, it just implies you have a damaged disc that is producing discomfort. Due to wear and tear, discs get thinner and flatter over time. As a result, they can less cushion the vertebrae and are more prone to tearing (see below).
Disc herniation. Intervertebral discs’ protective coating might wear away over time. The delicate inner disc tissue may push through the outer layer if this occurs. A herniated disc, bulging disc, or slipping disc is a disc that bulges or slides out of position. The herniation may put pressure on nerve roots, causing pain, tingling, numbness, or weakness in the region served by the nerve.
Sciatica. Sciatic nerve pain is caused by a pinched or inflamed nerve. This nerve passes through your lower back, hips, and buttocks, then down each leg. Although your doctor may use lumbar radiculopathy, sciatica is how laypeople refer to pain that runs down the leg from the lower back.
Spondylolisthesis. A vertebra moves forward out of place, altering the alignment of your spine and perhaps crushing nerve roots. The lumbar area is the most prevalent location. However, it may occur anywhere along the spine. Disc degeneration or a broken vertebra are the most common causes of slippage (spondylolysis).
Spinal stenosis is a condition that affects the spine. A narrowing of the internal spaces of your spine, usually due to a herniated disc, but sometimes due to bone spurs from spinal osteoarthritis. This may put a lot of strain on your spinal nerves, which can be quite uncomfortable. Both the
upper (cervical) and lower (lumbar) spines may have spinal stenosis; however lumbar spinal stenosis is more prevalent.
What Are Some Other Causes of Back Pain in the Lower Back?
Lower back discomfort may also be caused by the curvature of your spine, as well as spinal illnesses. Your doctor may search for the following things, depending on a variety of factors:
The curvature of the spine is abnormal. When seen from the side, a typical spine resembles a softly curved letter S. Lordosis is a condition in which the spine folds inward too much in the lower back.
Kyphosis, a condition in which the upper back spine is unnaturally rounded.
Scoliosis is a condition in which the spine bends from side to side, forming a C shape.
Arthritis. There are over 100 different forms of arthritis, with many of them causing lower back discomfort. The most frequent forms are osteoarthritis (by far the most common; it’s called spondylosis in the back), rheumatoid arthritis, and ankylosing spondylitis.
Cauda equina syndrome is a condition that affects horses (CES). The bundle of nerves that originates below the spinal cord in the lumbar spine is compressed. It’s an uncommon but life- threatening condition that needs quick medical care and, in some cases, emergency surgery. The fanned-out bundle of nerves that makes up the CES resembles the base of a horse’s tail.
Osteomyelitis or discitis.
Both disc infections (discitis) and bone infections (osteomyelitis) may cause excruciating pain and need immediate medical intervention.
Osteoporosis. Bones become brittle when they lose mass quicker than they can be replenished. They may even shatter suddenly and without notice. These fractures, known as vertebral compression fractures, are particularly prevalent in the spine. Men and women both lose bone mass as they become older, but postmenopausal women lose it quicker, putting them at a higher risk for osteoporosis.
Tumors of the spine. Tumors form when cells divide and proliferate uncontrollably. Lower back discomfort may be caused by both benign and malignant tumors. They may either start in the spine or spread there from someplace else in the body.
What Lower Back Pain Home Remedies Work?
You usually don’t need to see a doctor for back discomfort unless you’ve suffered a significant injury, such as a fall or a vehicle accident. You may wish to start with these easy self-care techniques.
Stay away from the bed. When lower back pain arises, many individuals believe that full rest would alleviate the problem. Patients who went to bed, on the other hand, suffered greater pain – and healed more slowly – than patients who remained moderately active, according to a study of several clinical research.
Use ice and/or heat as needed. Many individuals find that using ice or cold packs for up to 20 minutes at a time helps to decrease swelling and discomfort. To avoid injuring your skin, wrap ice or a cold pack in a small towel before applying it to your body. Heat, such as a heating pad or a warm bath, may also help to relieve pain. Ice is indicated for the first 48 hours following an accident; beyond that, a combination of ice and heat may be used.
Over-the-counter (OTC) medicines are a good place to start. Short-term usage of over-the- counter pain medicines like ibuprofen and naproxen, which are nonsteroidal anti-inflammatory drugs (NSAIDs), may help alleviate your lower back discomfort. Consider applying OTC creams, gels, patches, or sprays to the skin. To lessen the sense of pain, they activate the nerves in the skin to give sensations of warmth or cold.
What Are Some Treatments for Back Pain That Aren’t Invasive or Invasive?
Your doctor may prescribe a variety of therapies to alleviate your lower back discomfort. Expect your doctor to use a stepped-care strategy in general. Starting with easy, low-cost therapies and progressing to more aggressive ones later is the best way to go. It’s important to remember that many therapies take time to fully take effect.
Medications. Your doctor may prescribe a prescription medicine if over-the-counter tablets and topicals aren’t adequate to ease back discomfort. Anti-seizure medicine, such as gabapentin or pregabalin, for nerve-related discomfort, are examples.
Opioids, such as oxycodone or hydrocodone, on a short-term basis
Muscle relaxants, such as baclofen or carisoprodol
Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen (Opioids aren’t suitable long-term solutions for lower back pain for several reasons.)
Physical therapy is a kind of treatment that is used (PT). Passive and active treatments are used in PT for lower back pain to assist the patient in strengthening core muscles, increasing spinal
flexibility and range of motion, and correct posture, among other things. Exercise, ice/heat, massage, transcutaneous electrical nerve stimulation (TENS), and ultrasound injections may all be part of your physical therapy sessions. When lower back discomfort creates sciatica symptoms like leg pain, an epidural steroid injection or a selective nerve block may give temporary pain relief.
What Are Some Alternative, Complementary, and Emerging Lower Back Pain Treatments?
Doctors may recommend therapy that isn’t deemed “standard of care” in certain instances. They’re unlikely to be covered by insurance, but they’re worth thinking about. Here are several examples:
Plasma with a high concentration of platelets (PRP). PRP treatments employ a tiny sample of your own blood containing concentrated concentrations of platelets, which are the blood’s building components. The PRP is then injected directly into a damaged disc by your doctor. PRP injections, according to theory, utilize your healing mechanism to help damaged tendons, ligaments, muscles, and joints repair faster. Although PRP therapy has a long track record in treating knee osteoarthritis, a new review paper published in the Journal of Spine Surgery shows it may also be effective in the treatment of back pain. Before PRP may be called a proven method, additional study is required.
Stem cells are a kind of cell that may be used to make. Your doctor injects stem cells taken from your hip into the intervertebral disc or discs, causing your discomfort in this new therapy. While this might help with pain and the degenerative consequences of aging, more study is required before stem cells for lower back pain become the standard of therapy, similar to PRP.
Acupuncture. Although your doctor is unlikely to practice acupuncture (although some do), he or she may encourage you to try it as a supplemental treatment. Acupuncture is the insertion of small, sterile needles into precise places on the body with great care. This may cause the release of pain-killing molecules in your body.
Chiropractic treatment involves the manipulation of A chiropractor, a healthcare specialist who specializes in spinal manipulation, is seen by more than half of persons with acute lower back pain. Look for one that employs research-based methods.
What are the most common procedures for lower back surgery?
Most persons with lower back discomfort do not need spinal surgery. If you do need it, your doctor will advise you on the best course of action based on your symptoms and medical condition. The following are examples of common spine surgeries:
Fusion of the spine. To minimize excessive spinal mobility, two or more vertebrae are permanently fused together. To keep the vertebrae together so they can recover into a single unit,
your surgeon will use a mix of bone, bonelike material, screws, plates, and rods. In severe instances of spinal osteoarthritis or herniated discs, spinal fusion may be used to rectify deformities or enhance spine stability.
Laminectomy and laminotomy are two terms for the same thing. A laminectomy is a procedure in which the rear section of one or more vertebrae is removed to provide room for the spinal cord or other nerves. Bone spurs inside the spinal canal may develop big enough to push on the spinal cord in persons with severe arthritis, causing discomfort and restricting movement. Your surgeon will remove a little piece of bone called the lamina from the rear of the vertebra in a laminotomy procedure.
Discectomy and microdiscectomy are two procedures that are used to remove discs. Your surgeon may operate to remove a part of a herniated disc in the lower back if it is producing significant symptoms such as pain or loss of feeling. A discectomy is a procedure in which the physician performs via regular incisions in your back. A microdiscectomy is a procedure in which the surgeon utilizes a minimally invasive approach with tiny incisions. Discectomies are no longer often done owing to microdiscectomy’s safety, efficacy, the convenience of use, and low risk of complications. When Is Lower Back Pain an Emergency?
Although most bouts of lower back pain heal on their own, there are situations when you should seek medical help right away. Here are a few examples of these scenarios:
The patient is a youngster
There has been an accident, injury, or another traumatic event
Fever or nausea
Weakness, numbness, and/or tingling feelings occur in the legs and/or feet
Loss of bladder or bowel control
Severe, persistent pain that develops abruptly or gradually and/or does not go away
While certain circumstances may need immediate action, most instances are not urgent and may be arranged at the patient’s convenience.
How Can Lower Back Pain Be Prevented?
While you can’t stop time or alter your genetic makeup, you can manage and avoid lower back discomfort with lifestyle adjustments. A healthy lifestyle may also make you less likely to get an injury due to an accident.
Increase your physical stamina. Because strong core muscles support the lower back, those who are not physically active are more prone to suffer lower back discomfort.
Continue to be active. People who maintain sedentary lifestyles are more prone to sustain injuries when they do exercise. When it comes to back health, it’s preferable to conduct less physical activity most days of the week than to sit all week and over-exert yourself on weekends.
If necessary, lose weight. The more weight you have, the more pressure your lumbar vertebrae are under. Obesity or being overweight may put a strain on the spine and cause lower back discomfort.
Lifting large stuff correctly is essential. Squat when lifting to allow your hips and knees to accomplish the majority of the effort. While lifting, keep the burden close to your chest.
Make your work environment as comfortable as possible. If you work at a desk, ensure sure your chair provides enough low-back support and that your hips are aligned with the floor.
Take control of your mental health. People with anxiety and depression and those who are under a lot of stress are more prone to develop back discomfort over time. Living with lower back discomfort, let’s face it, may be challenging. Making mental health a top priority might help you avoid lower back discomfort.
Tobacco products should not be used. In addition to all of the other health issues it brings, tobacco smoking may impede blood flow and oxygen to the discs, leading them to deteriorate more quickly.
To avoid damage, make sensible decisions. While in a moving vehicle, always wear your seatbelt. Heavy backpacks should not be carried (or allowed to be carried) by you or your kid. And, although it should go without saying, if you’ve been inactive for a few months, don’t spend your weekend doing heavy gardening or competing in a tennis match.