Low Back Pain
What is the back?
The back is made up of the rear, or posterior, part of the body from the neck to the buttocks. The main component of the back is the spine, a complex structure that has been compared to modern skyscrapers. Like a skyscraper, the spine is a marvel of engineering that defies gravity, allowing humans to walk upright. It is strong and flexible, supporting the head and trunk of the body and enabling us to twist, turn, bend, and lift.
The spine is composed of two main parts, the spinal, or vertebral, column and the spinal cord.
The spinal column contains 33 hollow, ring-shaped bones, called vertebrae, which are separated and cushioned by 23 discs made of spongy cartilage. These vertebrae are divided into 3 sections: the 7 vertebrae of the cervical spine in the neck; the 12 vertebrae of the thoracic spine in the chest; and the 5 vertebrae of the lumbar spine in the lower back. The fourth, bottom section of the spinal column includes the sacrum and coccyx (commonly called the tailbone), both of which are made up of several fused vertebrae. The spinal column is supported and held together by a network of muscles, tendons, and ligaments.
The spinal column forms a protective tunnel or canal for the spinal cord, the bundle of nerve fibers that transmit the impulses, or “signals,” to and from the brain that give us the ability to feel and enable us to move.
Low Back Pain
Back pain is extremely common in the United States and will afflict most adults at least once in their lives. It is one of the main reasons why people go to the doctor, and accounts for more than $50 billion in lost work time and worker’s compensation claims.
Most episodes of back pain go away within days or a few weeks. This is called acute back pain. Other pain takes longer to resolve, and if it lasts for more than 3 months, it is classified as chronic.
Back pain can occur anywhere in the spine. However, most people experience pain in the lumbar spine, or lower back.
What causes low back pain?
Several factors can cause low back pain, including:
- Muscle or ligament strain or spasm. Trauma, repeated heavy lifting, a sudden awkward move, overstretching, and overuse can all place undue stress on back muscles and ligaments.
- Bulging or ruptured discs. Discs that protrude or rupture—herniate—out of normal alignment can place pressure on one of the more than 50 nerve roots attached to the spinal cord, causing neuropathy and potentially leading to permanent nerve damage.
- Trauma. Accidents and other trauma are common causes of back pain.
- Arthritis. Osteoarthritis can cause the spine to deform and deteriorate and in some cases, it can result in a narrowing, or stenosis, of the canal containing the spinal cord. Severe spinal stenosis can put pressure on the nerves.
- Congenital abnormalities of the spine. Abnormal curvature of the spine, such as scoliosis, and other irregularities.
- Osteoporosis and other bone diseases. Painful fractures of the vertebrae can occur if they are weakened and made brittle and porous by osteoporosis or other diseases that affect the bone.
- Aging. Bone strength and muscle tone and elasticity generally decrease with age. In addition, the discs stiffen, which reduces their ability to cushion the vertebrae. These factors can all contribute to lower back pain.
- Obesity. Extra weight places a constant strain on the back, which can eventually lead to pain.
Other conditions such as fibromyalgia and diabetes can trigger low back pain as well, but in many cases, doctors cannot pinpoint any specific cause of lower back pain, even with the use of x-rays and other imaging tests.
What are the symptoms of low back pain?
Symptoms can vary from muscle aches to throbbing, shooting, or stabbing pain that can be mild or debilitating, intermittent or constant. Pain can sometimes “radiate” to the back from a disorder or injury in another location in the body. Lower back pain is often accompanied by decreased flexibility or range of motion, or both, as well as an inability to stand straight.
Low back pain may be a symptom of a more serious medical condition, especially if it is accompanied by other symptoms such as fever, loss of bowel or bladder control, or both, and weakness in the legs.
Who is at risk for low back pain?
Low back pain is most common in middle age. This is probably the result of a combination of factors, including changes caused by the aging process and poor overall physical conditioning due to too little exercise, obesity, smoking, and other habits of modern life. Women are more likely than men to experience back pain.
Low back pain is widespread in professions that involve repeated heaving lifting, including manufacturing, construction, trucking, and healthcare, but it is also common in professions that require a lot of sitting.
What is the treatment for low back pain?
Advances in anesthesia and surgery have given doctors several options for treating low back pain, depending on the cause and severity of the pain. Your doctor will discuss these options with you and will develop a plan targeted to your specific problem and needs. In general, we have found that a holistic, team approach provides the best results.
What research are you conducting for low back pain?
You can see our Current Studies page for more information.