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Low Back Pain Guide
Low back pain can range from minor muscle aches to shooting or stabbing pains, and can even cause limited range of motion or the ability to stand up straight. Back pain is one of the most common neurological conditions in the United States and is the most common case of missed work and disability. Most pain is caused by trauma, sports injury or car accident. Once pain lasts more than three months, it is considered chronic.
There are many components in the lower back, including the spine, muscles and ligaments. Injury to any of these areas can cause strains, spasms and sprains, or ruptured or bulging discs. Straining the back by lifting heavy objects, sports injuries, car accidents or other trauma are some of the causes of injury. Pain can also be caused by conditions like arthritis, osteoporosis, fibromyalgia or spinal abnormalities. Poor posture while standing or sitting and poor sleeping positions can also result in pain. More serious conditions include pinched nerves, which can also cause problems with the bladder or bowels. Neuropathy resulting from diabetes is another serious condition that can cause back pain. Low back pain may also be caused by disorders in internal organs, including the kidneys, pelvis, bladder, ovaries or appendix.
Diagnosis of the cause of lower back pain usually begins with a primary physician. During an initial diagnosis , a physician will conduct a thorough medical history, test reflexes, watch a patient walk and examine the painful area. If further examination is needed, a patient may be sent for various diagnostic imaging studies, including X-rays, ultrasound, CT scan or MRI. Other spinal diagnostic tools include discography, where contrast dye is injected into a disc in the spine to enhance X-rays. To test nerves and muscles, physicians may use nerve conduction studies, like evoked potential (EP) and electromyography (EMG.) Bone scansThermography can be used to check for nerve compression. may be used to measure joint disease or look for breaks or disorders of the bones.
Low back pain is usually treated with rest, exercise and analgesics or anti-inflammatory drugs. Many patients find relief with regular visits to a chiropractor. Chiropractors work on the theory that nerve impulses are blocked when the spinal column is not properly aligned, called subluxation theory. A chiropractor works to align the spine with adjustments that put the spine into proper alignment. Chiropractors may also use heat therapy and recommend exercises for spine health. Clinical trials have shown that care from a chiropractor is as safe and effective as conventional treatments.
In some cases, patients may elect to have surgery for low back pain. This is usually recommended only for those who have progressive spinal disease or damage, since spinal surgery carries some risk and is not always effective. Several surgical techniques can be used to block nerve pain. Other spinal surgery involves fusing the spine to strengthen it and prevent movement that causes pain, or spinal decompression to relieve pressure on the spinal cord.
People with chronic back pain, especially those who suffer from arthritis or other degenerative spinal conditions should practice good posture and avoid injury. Tips include proper lifting techniques, avoiding heavy lifting, practicing ergonomics, and wearing back belts for support.