Also known as lumbago, low back pain is one of the most common problems that everyone faces sometime in their life.  The pain can be mild or debilitating. It can occur in young patients as well as the elderly.  It can develop slowly or occur after an activity or accident.

Anatomy

The spine is composed of three segments:

Cervical

The upper spine is called the cervical.

Thoracic

The middle is the thoracic.

Lumbar

The lower portion is the lumbar spine. Most of the time when we are talking about low back pain it is the lumbar spine that is referenced.  The spine is composed of bones called vertebra which sit in a stack one on top of the other. Between each vertebra is a disc that functions as a shock absorber.  There are also muscles and ligaments running between the vertebra both in front and back.

Low Back Pain highlighted in diagram

Lower Back (Lumbar) Spinal Diagram

Causes

Lower back pain can occur after lifting or doing a strenuous activity.  As people age our joints become less mobile and degenerative changes can occur.  It is often the result of overuse along with Father Time. With aging of the spine, the disks become susceptible to injury. This can result in tearing and possibly herniation of the disk. More commonly the disk degenerates allowing the vertebra above to come in contact with the one below.  Other causes of back pain include scoliosis, which is an abnormal curve of the spine. It usually occurs in children, but there are cases that can happen in adults.

Whatever the cause, if your symptoms do not improve within a couple of weeks, it should be checked out by your physician.

Diagnosis

When I first see a patient with back pain, the history is extremely important. Does the pain occur all the time? Is it related to sitting or standing? Does pain radiate down the leg? Is there any associated weakness in the legs? These are all important questions a physician should be asking.

An x-ray is often done during the first visit. This allow us to look at vertebra and see if there are any changes or  deformities in the bones.  Disks do not show up on x-ray, but if there is narrowing between the vertebra an x-ray is helpful. In cases where there is concern about a herniated disk an MRI is the best imaging study.  Those patients with older pacemakers are not suitable for MRI and a CT scan may be necessary.

Low Back Pain Treatment

Conservative treatment is used in 99% of all back pain.  This may include activity restrictions, rest, physical therapy and anti-inflammatory medication.  The majority of patients respond to one or more forms of the above treatments for lower back pain. Surgery is reserved for those patients who have failed conservative treatment and there is a documented mechanical source for the pain.

Low Back Pain Prevention

Back pain cannot always be prevented, but the risk can be lessened.  The most important way to prevent back pain is to be in shape.  People who are overweight and unconditioned have a much higher incidence of back pain as well as a whole assortment of medical problems. Proper lifting is essential in preventing low back pain.  Lift with your legs, not your back.  Avoid sitting for long periods of time especially in a car or truck.  Walking is one of the best exercises to tone the lower back and it can be done anywhere.

3D Video Detailing Low Back Pain

If you’d like to learn more or gain a better understanding through visuals please see this quick video on low back pain. It does a great job of animating the lumbar and going into further detail.