Lower Back Pain
Alternative Names:
Lower Back Ache, Lumbago
Definition:
Pain that affects the lumbar vertebrae (L1-L5), the sacrum, or coccyx can be described as lower back pain. According to the National Institute of Health, lower back pain is only trumped by colds and flus as reasons people see their doctor. Problems in other parts of the body may manifest through lower back pain, including problems in the upper or middle back, the testicles, ovaries, or groin. The lumbar region of the back is responsible for supporting the weight of the upper body.
Acute lower back pain is temporary pain that may last a few days to a few weeks. It is most often caused by a mechanical issue – either the result of trauma or a lower back condition like arthritis. Any lower back pain that continues longer than three months is considered chronic, which is often difficult to diagnose and treat.
Symptoms:
The following symptoms may be a sign of lower back pain:
- Muscle ache
- Shooting or stabbing pain
- Limited flexibility
- Inability to stand straight
- Weakness in your legs or feet
- Burning or tingling
Call your doctor if you experience any lower back pain symptoms and combination with the following:
- Fever
- Redness on the back or spine
- Pain radiating down legs to below the knee
- Weakness or numbness in your buttocks
- Burning or blood in your urine
- Loss of bowel control
- Pain that awakes you in the night
- Pain that does not allow you to become comfortable
- Weight loss
- Steroid or intravenous drug use
Exams/Testing:
Your doctor will take a thorough medical history and perform a physical exam to identify any immediate conditions or to determine any family history that would influence the pain. It is important to identify the location, onset, and intensity of the pain for your doctor. If deemed necessary, your doctor may order the following diagnostic tests:
- X-ray – this may help your doctor determine if your pain is radiating from your muscles, nerves, or skeletal structures.
- Discography – an injection of contrast dye into the spinal disc suspected of causing your lower back pain.
- Computerized tomography (CT) – a three dimensional x-ray procedure used to diagnose disc ruptures, spinal stenosis, or damaged vertebrae.
- Magnetic resonance imaging (MRI) – may be used to diagnose bone degeneration, injury, or disease in tissues, nerves, muscles, ligaments, and blood vessels.
- Electrodiagnostics – nerve conduction procedures used to determine the cause of muscle weakness.
- Bone scans – may diagnose and monitor infections, fractures, and disorders of the bone by injecting a small amount of radiation into the bloodstream. The radioactive material collects in the bones and displays any abnormalities.
- Thermography – an infrared measurement to detect the presence of nerve root compression.
- Ultrasound scanning – sound waves that may show tears in ligaments, muscles, tendons, and other soft mass tissues.
Outlook/Prognosis:
Lower back pain is often the result of muscle atrophy overtime. While symptoms may seem sudden, your pain took a longtime to develop, and it may take up to four to six weeks for you to feel better again. People who have back pain may benefit for the following steps after the presentation of their lower back pain:
- Stop physical activity for a few days until your symptoms begin to subside and the inflammation begins to decrease.
- Ice your back for the first 48 to 72 hours and then progress to heating the location of your pain.
- Take over-the-counter pain relievers like Advil and Tylenol.
- Sleep on your side, curled into the fetal position with a pillow between your legs.
It is important to reduce your activity for the first few days until your back begins to heal. However, bed rest is not recommended for treating lower back pain. It is important to do activities that will challenge, but not over exert your body. The following activities are great options for people who are recovering from lower back pain:
- Light cardiovascular training, like swimming, walking, or riding a stationary bicycle
- Stretching and strength exercises
- Avoiding jogging, football, golf, ballet, weight lifting, leg lifts or abdominal exercises
There are several treatments for lower back pain. Depending on if the cause of your pain can be diagnosed and identified, your doctor may prescribe the following:
- Medications – anticonvulsants, antidepressants, or opioids
- Spinal manipulation – exercises and leverage methods by chiropractors on the spine
- Acupuncture – small needles the width of a hair are inserted in the back to release painkilling hormones
- Biofeedback – patients are trained to become aware and conquer their pain
- Interventional therapy – easing of chronic pain by blocking nerve receptors to the brain through medications that affect the soft tissues, joints, or nerve roots
- Transcutaneous electrical nerve stimulation (TENS) – a battery-powered device sends electrical impulses through nerve fibers to block pain signals to the brain and produce endorphins
- Ultrasound – warms the body’s tissues, relaxing the muscles
- Surgery – usually reserved for serious cases only after pain is not relieved by other therapies
Causes:
Some common conditions or causes of lower back pain include the following:
- Muscle spasm
- Fibromyalgia
- Ruptured or herniated disk
- Cancer of the spine
- Spinal infection
- Muscle or ligament tears
- Spinal stenosis
- Spinal curvatures
- Spinal fractures
- Leaking abdominal aneurysm
- Arthritis
- Pregnancy
- Female reproductive problems
- Twisted testicle
- Hernia
- Kidney infection or kidney stones
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