LOWER BACK PAIN

OVERVIEW

Low back pain is a very common occurrence, and can be very hampering and uncomfortable. It is also one of the commonest reasons for patients to visit a doctor. 80% of people will experience one or more episodes of back pain at least once in their lifetimes.

Current life styles of less physical activity and prolonged periods of sitting down are all contributing towards an increase in patients coming in with back pain. While it can be painful and uncomfortable to live with, the good news is that lower back pain is rarely due to a serious cause. It is classified as acute if it comes on suddenly and resolves within 6 weeks (usually due to trauma), or chronic if the pain lasts longer than 3 months (usually is due to underlying medical condition). Often times, by adjusting your posture and doing simple back exercises, you can manage your pain effectively at home.

 Common causes of lower back pain include:

heavy manual labor, handling tasks and pulling loads that require excessive force

poor posture, especially involving bending over repeatedly or crouching

maintaining the same position for long periods of time, especially in people with sedentary jobs

working outdoors in cold environments

arthiritis (joint pain)

bulging or ruptured discs in the spine

abnormal curvature of the spine, for example in scoliosis

Osteoporosis – common in elderly females due to low calcium levels in the body

 

Risk factors for developing lower back pain may include one or more of the following factors:

Previous back injury – which is the best predictor of back pain

Age : It is more common in adults approaching the age of 40 years

Low physical strength and endurance.

Obesity

Underlying medical conditions such as arthritis or cancer (spine is a common site for some cancers to spread to)

Contact sports

Increased psychological or social stress. People with depression or anxiety are more prone to developing back pain.

 

SYMPTOMS

Apart from the back pain, other symptoms that may be present alongside the pain can be :

decreased range of motion in the back

pain shooting down one or both legs

decreased sensation in lower extremities (rare)

muscle aches

In rare cases, back pain can signal a serious medical problem, in which case the following may be present with the pain:

  •  new bowel or bladder problems
  • fever
  • decreased sensation on the inside of the legs

 

MANAGEMENT

If there is reason to suspect a specific condition may be causing your back pain, you may have one or more of the following tests done:

 

X-ray is a commonly performed test to look for causes of back especially injuries, osteoporosis, arthritis and metastasis

 

MRI or CT scans may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.

 

Blood tests can help determine whether the underlying cause of the back pain is an infection.

 

Bone scan may be done in rare cases to look for bone tumors or compression fractures caused by osteoporosis.

MEDICATION

Most acute back pain gets better with a few weeks of home treatment. Over-the-counter pain relievers and the use of heat or ice might be all you need. Bed rest isn’t recommended.

Continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain, but don’t avoid activity out of fear of pain. If home treatments aren’t working after several weeks, your doctor might suggest medicines to control the pain, such as paracetamol, or NSAIDS such as naproxen, brufen and voltral. Pain relief gels are also available which can be applied locally, for a lower side effect profile.

Back pain exercises have been shown to be very efficient in controling pain and preventing further episodes, especially if done properly and continued over a period of time. Some effective back pain exercises are shown below.

 

 

 

 

Dr. Annie

Physician, mom and wife

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