Low back pain

Low back pain is a common symptom that has been experienced by almost every adult at some point in his/her life. In order to understand low back pain, it is important to understand the anatomy of the back.

Our lower back is primarily composed of bones, muscles, nerves, and other connective tissues.

• The vertebrae or backbones make up the framework of our back. The vertebrae sit on top of each other forming a long column from the hip area to the neck. This spinal column provides stability to our back.
• In between the vertebrae are cartilage bodies called intervertebral discs that serve as cushion, or shock-absorbers, against the pressure that is carried by the spinal column. The discs provide a certain degree of mobility to the spine.
• Within the spinal column is a long canal that serves as a passageway for the spinal cord. The spinal canal houses and protects the spinal cord and the spinal nerves that sprung from it.
• Around the spinal column are ligaments that hold the column in place and make it even sturdier.
• A large part of our back is composed of broad muscles that serve to support the spinal column and permit the movement of our back. The muscles are responsible for keeping the back erect or for permitting the twisting and bending motion of the back.

Any abnormality in the structures mentioned above can cause back pain. Injury to the vertebra, spinal cord, spinal nerves, discs, ligaments, muscles, or other tissues in the back can lead to lower back pain. In addition, other structures that are not part of the back, but which are located close to the back, can cause referred pain to the lower back. For example, abnormalities in the abdominal organs can cause referred pain to the back as in cases of kidney injury or ureteral stones. Some examples of the common causes of low back pain are the following:

• Muscle Fatigue usually from over-activity
• Disc problems like herniation, tear or disc desiccation
• Osteoarthritis or degeneration
• Spinal stenosis or narrowing of the passage of spinal nerves

When to seek consult

Most cases of lower back pain are mild and are usually self-resolving. However, the following sets of low back pain warrants immediate consult to your doctor:

• Chronic or long-standing low back pain, particularly those lasting for more than 3 days
• Severe low back pain
• Low back pain that is associated with any of the following symptoms:
• Fever or chills
• Leg numbness
• Shooting pain radiating down the legs
• Weight loss
• Painful urination
• Incontinence

Diagnosis

The treatment of low back pain is largely dependent on the cause. Therefore, it is important to first identify what is causing the pain. Your doctor will perform a thorough history taking and physical examination to get an idea of the possible cause of your back pain. After that, several tests may be requested to confirm the diagnosis. These tests can include imaging studies like X-rays, CT scan, or MRI.

Blood tests and urinalysis may also be requested as the need indicates.

Treatment

Again, the treatment for low back pain depends on the cause. In general, low back pain is treated with pain medications and non-steroidal anti-inflammatory drugs. Injected steroids might also be used to decrease the inflammation. For most patients, physical therapy in the form of exercise, manipulation, traction or massage is usually very helpful. Alternative medicine can also be helpful like acupuncture and chiropractic medicine. In severe instances, surgical intervention might be warranted as in cases needing spinal surgery or disc replacement.

Prevention

While it is impossible to prevent the natural wear and tear of our body as we age, it is possible to slow down its rate and prevent the early occurrence of low back pain.  Some suggestions that could minimize or prevent low back pain are the following:

• Exercise regularly. It has been proven that exercise can strengthens our muscles. If your back muscles are strong, they can provide better support for your back and they will be less likely to tire easily.
• Be careful when you’re lifting. Bend your knees, not your back, when you lift heavy objects. This way, the pressure is shifted to your legs instead of your back.
• Avoid carrying heavy bags. If you have to bring a heavy luggage, consider using trolley bags.
• Keep a good posture because this is the stance that gives the least pressure to your spine.
• Watch your weight. The heavier you are, the heavier the weight that has to be carried by your spine and back muscles.