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Low Back Pain

Low Back Pain

Definition

Low back pain is an ache or discomfort in the area of the lower part of the back and spinal column. The lower spinal column has many small bones and muscles that surround and protect the spinal cord and nerves. Low back pain is common and affects most adults at some point in their lives.

Bones of the Lower Back
lumbar disc herniation back
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Causes

There are many possible causes for low back pain, but in most cases it is unknown. Some causes of back pain may include:

  • Muscle strains or ligament sprains
  • Disc degeneration
  • Spinal deformities
  • Injury
  • Health conditions

Risk Factors

Low back pain in more common in older adults.

Factors that increase your chance of low back pain include:

General factors, such as:

  • Certain activities, such as lifting, bending, or twisting
  • Inactivity
  • Obesity
  • Pregnancy
  • Smoking
  • Prior back injury
  • Prior back surgery

Health conditions, such as:

  • Herniated disc —the cushions between the bones of the spine develop a bulge
  • Degenerative diseases, such as arthritis
  • Fractures due to trauma and/or osteoporosis
  • Spinal stenosis —narrowing of the spinal canal
  • Spondylolisthesis —slippage of a bone in the lower back
  • Ankylosing spondylitis —an autoimmune disease involving the spine
  • Cauda equina syndrome —nerve roots at the base of the spinal cord are compressed
  • Tumors
  • Infections

Occupational factors, such as:

  • Bending, twisting, or reaching
  • Exposure to vibrations
  • Heavy manual labor
  • Heavy lifting

Psychosocial factors, such as:

  • Anxiety and depression
  • Stress
  • Low job satisfaction
  • Repetitive, monotonous tasks

Symptoms

Pain is usually restricted to the low back. It can get worse with back motion, sitting, standing, bending, and twisting. If a nerve is irritated, the pain may spread into the buttock or leg on the affected side. Muscle weakness or numbness may occur.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. The exam will focus on your back, hips, and legs. The doctor may test for strength, flexibility, sensation, and reflexes.

Imaging tests are rarely needed. They may be done for pain that is severe or does not respond to treatment. If needed, imaging tests options include:

  • X-rays
  • MRI scan
  • CT scan
  • Ultrasound

Your doctor may recommend other tests to help diagnose or eliminate any causes of your back pain.

Treatment

Treatment options include:

Prevention

To help reduce your chance of low back pain:

  • Begin a safe exercise program with the advice of your doctor.
  • Practice good posture to reduce pressure on your spine.
  • Avoid sitting or standing in one position for long periods of time.
  • Use proper body movement when playing sports, exercising, or lifting heavy objects.
  • Consider job retraining if your work requires a lot of heavy lifting or sitting.
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