Low Back Pain — Overview

Lower Back PainApproximately half a million people are afflicted with back pain in the United States. The causes of back pain are many and can therefore be difficult to diagnose. The most common cause of chronic back pain (pain that never quite goes away) is degenerative disc disease at the lumbar spine.

Although most back pain can be managed with non-surgical treatment, there are thousands of surgeries performed each year for the treatment of degenerative spinal disorders. While the vast majority of individuals suffering from back pain will fully recover within 1-3 months (90%), low back pain may also be chronic and lead to long-term disability.

Back problems are one of the most common ailments affecting adults in the United States. In any given year, 50% of the working population will experience back pain, with 80% reporting low back pain at some time during their lifetime.

Low Back Pain - Anatomy and Function

Understanding the fundamental anatomy and function of the spine is key to understanding injuries and diseases of the spine. The spine has several special roles in the human body:

  1. Protects the spinal cord
  2. Provides the support needed to walk upright
  3. Enables the torso to bend
  4. Supports the head

Sections of the Spine

SpineVertebrae - The spine has 33 doughnut-shaped bones called vertebrae. Each vertebra is assigned a letter and a number that identifies its location in the spine. When someone has osteoporosis, minor trauma can cause these bones to fracture.

Discs - Between each pair of vertebrae is a disc made of spongy cartilage. Intervertebral discs act as shock-absorbing cushions between the vertebrae. When the disc degenerates, it can be pushed posteriorly, causing disc herniation.

Cervical - commonly referred to as the neck. There are seven cervical vertebrae (doughnut-shaped bones) that connect the skull to the rest of the spine.

Thoracic - The spine's thoracic section begins at the shoulders and extends down to the end of the rib cage. There are 12 vertebrae in the upper back, with shock-absorbing discs between them. Scoliosis commonly affects the thoracic section of the spine.

Lumbar - The lumbar section, or low back, has five vertebrae. These vertebrae, separated by discs, are the largest in the spine. Degeneration most often occurs in the lumbar section, usually at the lower discs. In addition, the facet joints can become arthritic, causing pain.

Sacrum - Five vertebrae join together to form the sacrum, a wedge-shaped part of the spine that forms part of the pelvis. The sacrum joins the rest of the pelvic bone at the sacroiliac joint, which can become inflamed causing sacroiliitis.

Coccyx - often referred to as the tailbone, consists of four vertebrae.

Causes of Low Back Pain

Any part of the low back's complex system (vertebrae, discs, nerves, facet joints and muscles) can become a source of pain, as can nearby structures. The following are some causes of low back pain:

  • Muscle or ligament strain
  • Degenerative joint disease (facet joints)
  • Disk disease (herniation)
  • Spinal stenosis (spinal canal is too tight)
  • Spondylolisthesis (vertebral bodies are out of alignment)
  • Osteoporosis with compression fracture
  • Cancer
  • Infection
  • Organ-related pain

Self Preventive Measures to Reduce Low Back Pain

Lifting - With your feet shoulder-width apart, bend at the hips and knees. Grip the load firmly and hold it close to your body, tighten your stomach muscles and use the strong muscles of your legs to lift. Keep your back as straight as possible. Avoid twisting. Turn by using your feet, not your back.

Posture - Think tall: chest lifted, shoulders relaxed, chin tucked in and head level. Posture should be stable, balanced and relaxed when sitting, walking, or standing.

Sitting - Don't stay seated for too long. Stand up, stretch, and walk around. The right back support will also help.

Exercise - Stay in shape - healthy bodyweight is less strain on your back. Your physiotherapist can show you how to keep your back flexible and strong with correct back and abdominal exercises.

Driving - Good support from your car seat will prevent back pain. If you need more low back support, use a lumbar roll or a rolled-up towel.

Sleeping - Your mattress should be firm enough to support your natural shape.

Overweight - Your spine carries your bodyweight. the lower portion of the lumbar spine carries the abdominal weight. Losing weight will reduce back pain.