Low back pain
The National Institutes of Health (NIH) reports that back pain affects eight out of 10 people at one time or another. You may have acute back pain that comes on suddenly and is gone in a few days or a few weeks. Chronic low back pain is the term for back pain that lasts more than three months. Low back pain symptoms can range from a dull, constant ache to a sudden, sharp pain.
Low back pain usually goes away on its own in two to three weeks with a little help from over-the-counter pain medications and rest, but chronic low back pain needs the help of a spine specialist to diagnose it accurately and give you the relief you need.
When you ask, "Why do I have low back pain?" the answer isn't always obvious, due to your spine's complex anatomy. The spine is made up of small bones called vertebrae stacked on top of one another. Between them, inter-vertebral discs act as shock absorbers, cushioning the vertebrae and preventing them from rubbing against each other. The spinal column is made up of three areas that create three natural curves in your back:
- Neck area (cervical)
- Chest area (thoracic)
- Low back (lumbar)
The spinal column protects your spinal cord, a complex center of "electrical cables" that carry messages between your brain and muscles. Nerves branch out from your spinal cord through openings in the vertebrae and carry specific messages to different parts of your body.
Muscles and ligaments (tough, fibrous, rope-like bands of tissue) support and stabilize your spine and upper body. The ligaments connect your vertebrae to help keep your spinal column in position. Between the vertebrae, there are small joints (facet joints) that help your spine move.
The leading causes of most acute low back pain are trauma to the lower back or a disorder such as arthritis. Pain may be caused by a sports injury, working around the house or in the garden, or a sudden jolt such as a car accident or fall. In most cases, low back pain may be a result of many different causes, including one of more of the following:
- Overuse, strenuous activity, or improper use (repetitive or heavy lifting or prolonged exposure to vibration)
- Degeneration of vertebrae (often caused by the effects of aging or stress on the muscles and ligaments that support the spine)
- Abnormal growth (tumor)
- Obesity (resulting in increased weight on the spine and pressure on the discs)
- Poor muscle tone in the back
- Muscle tension or spasm
- Ligament sprain
- Muscle strain
- Ligament or muscle tears
Diseases of the spine that cause low back pain
- Osteoarthritis – known as "wear and tear" arthritis.
- Osteoporosis – causes bones to thin and weaken, making them more vulnerable to fractures.
- Lumbar herniated disc – the shock-absorbing cushion between discs becomes compressed and bulges out from its normal position. This can then irritate nerves and cause pain.
- Lumbar spinal stenosis – the spinal canal narrows and causes compression of the nerves.
- Lumbar strain – the condition consists of damaged tendons and muscles that spasm and feel sore.
- Vertebral compression fracture – a fracture of the small bones (vertebrae) of your spine.
- Degenerative spondylolisthesis – degenerative changes in the spinal joints (little joints between the vertebrae) cause adjacent vertebrae to "slip," resulting in loss of the normal stabilizing structures of the spinal column.
- Spondylitis – inflammation of spinal joints (little joints between the vertebrae) that makes them painful and stiff.
Depending on the source of your low back pain, you may experience any of these symptoms:
- Muscle ache
- Shooting or stabbing pain
- Limited flexibility
- Limited range of motion
- Inability to stand straight
- Occasionally, pain felt in one part of your body may radiate from a disorder or injury elsewhere in your body
The National Institute of Neurological Disorders and Stroke (National Institutes of Health) reports that most low back pain can be treated without surgery by using a combination of rest, exercise and pain relievers to reduce discomfort and anti-inflammatory drugs to reduce inflammation. However, you should contact your doctor if you don't feel a noticeable reduction in pain and inflammation after 72 hours of self-care. Consult a spine specialist to ensure that you receive an accurate diagnosis and the proper treatment plan. When nonsurgical treatment is unsuccessful, your doctor may recommend spine surgery.
The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute treats low back pain as well as a broad range of spine conditions that can occur at any stage of life.