Lower Back Pain and Injury
The low back consists of 5 Lumbar vertebrae and a sacrum which are protected by various muscles ligaments and tendons. Whether you are a high level athlete or someone with an office job your low back is under constant strain. Over 80% of Americans experience some type of low back pain in their life and if left untreated it can progress to a chronic, debilitating condition
The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.
The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.
Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain.
There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.
Lower back pain is often caused by a torn or pulled muscle or ligament. This can occur after lifting a heavy object, a sudden movement, poor back posture, or a sports injury. A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements. While sprains and strains do not sound serious and do not typically cause long-lasting pain, the acute pain can be severe.
Most commonly, mechanical issues and soft-tissue injuries are the cause of low back pain. These injuries can include damage to the intervertebral discs, compression of nerve roots, and improper movement of the spinal joints.
The single most common cause of lower back pain is a torn or pulled muscle and/or ligament.
Pain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back often involves a disc problem, a joint problem, and/or an irritated nerve root.
Common causes include:
- Lumbar herniated disc
- Degenerative disc disease
- Facet joint dysfunction
- Sacroiliac joint dysfunction
- Spinal stenosis
- Compression fracture
Identifying the symptoms and getting a diagnosis that pinpoints the underlying cause of the pain is the first step in obtaining effective pain relief.
Specifically identifying and describing symptoms can help lead to a more accurate diagnosis and effective treatment plan.
Lower back pain is typically characterized by a combination of the following symptoms:
- Dull, aching pain
- Pain that travels to the buttocks, legs, and feet
- Pain that is worse after prolonged sitting
- Pain that feels better when changing positions.
- Pain that is worse after waking up and better after moving around
Obtaining an accurate diagnosis that identifies the underlying cause of the pain, and doesn’t just correlate to the symptoms, is important in guiding treatment. As a foundation of the diagnostic process, the patient provides a detailed description of symptoms and medical history. From this information, a doctor will usually have a general idea of the source of the patient’s pain.
The goal of medical treatments is to reduce pain, but these treatments do not change the underlying source of pain. Physical Medicine And Rehabilitation Doctor will typically prescribe medical treatments alongside a physical therapy program or other regimen.
Common medical treatments often include the combination of:
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Acute back pain
Chronic back pain
Sprains and strains