Conditions

Lower back pain

What is lower back pain?

Lower back pain is one of the most frequent musculoskeletal complaints. Pain may arise from damage or irritation to structures of the lower back including the vertebrae (bony spine), facet joints, discs between the vertebrae, vertebral ligaments, muscles of the lower back, spinal cord, and peripheral nerves, as well as internal organs of the pelvis and abdomen (spleen, kidney, pancreas, and liver).

What causes lower back pain?

Common causes of low back pain are herniated discs, spinal stenosis, strained muscles, sciatica, arthritis (auto-immune vs. non autoimmune), fibromyalgia, vertebral body fractures, and osteoporosis. Less common causes include infections, Ankylosing spondylitis, psychological causes, and metastatic cancer. Approximately 10% of all low back pain is caused by disc disease.

Recognizing symptoms

  • Acute Low Back Pain: Acute low back pain typically comes on abruptly and occurs during a specific activity. Acute lower back injury is more commonly due to overuse by excessive exercise, lifting of heavy objects, motor vehicle accidents, or any trauma involving the lower back.
  • Chronic Low Back Pain: Chronic low back pain is defined as pain over three to six months in duration. Typically the symptoms are more gradual and occur over an extended period of time. With chronic low back pain, a person may experience pain in their back as well as down either leg.

Typical diagnosis

Your physician may perform a physical exam testing tenderness over certain areas of the spine, as well as assessing the various limitations in movement. The physician may also order radiological imaging such as X-ray, CT scan, MRI, or bone scan.

Treatments

Chiropractic manipulations
Targeted adjustments, especially combined with other modalities, may significantly reduce low back pain. Manipulations are undertaken in order to allow correct nerve transmission.

Physical therapy

Physical therapy (PT) techniques utilize modalities such as hot or cold therapy, stretching, positioning, massage, traction, ultrasound therapy, manipulation, and transcutaneous electrical nerve stimulation (TENS) in order to strengthen muscle groups and relieve pain.

See more treatments below.

Procedures / Surgeries

Surgical procedures are typically done when all conservative managements are unsuccessful in reducing pain, or when the spinal cord or exiting nerves are being severely compressed. Serious compressions are characterized by bladder or bowel incontinence, lower extremity weakness, spasticity, or loss of sensation.

Medications

NSAIDs (ibuprofen-like drugs), acetaminophen (such as Tylenol), muscle relaxants, and membrane-stabilizing medications are often effective in treating low back pain.

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