Lower back pain can be due to many reasons and the causes may be quite a lot. The location, severity, pattern, and the type of pain, in addition to the history of pain, the time when the patient started to feel pain, any activities or positions that are making the pain better or worse are all important aspect to ascertain the causes of the pain and thus help in proper diagnosis and planning the treatment.
Causes of lower back pain?
The causes of back pain include irritation of the large nerve roots, smaller nerves, large paired lower back muscles, damage to the bones, ligaments or joints, degeneration of intervertebral disc. The pain may radiate to other parts of the body. Sometimes, back problems also cause muscle spasms, which may cause pain. Sometimes, severe lower back pain starts after sudden movement, activity, lifting heavy object or after exercise (Back Muscle Strain is one of the most common causes of severe lower back pain).
Many older adults experience back pain mostly due to degeneration of the joints in the spine (spinal stenosis), degenerative osteoarthritis, and osteoarthritis of the spine and due to spinal compression fractures.
- Lumbar Herniated Disc (common in adults)
- Degenerative Disc Disease (common in adults)
- Isthmic Spondylolisthesis
- Sacroiliac Joint Disease
- Facet Joint Osteoarthritis (common in older adults)
- Spinal Compression Fracture (common in older adults)
What are the symptoms?
In young adults slipped disc or lumber disc hernia or degenerative disc disease, in addition to soft tissue and back muscle strain may cause lower back pain. Though back pain is quite common, the symptoms and severity of the pain may vary greatly to the extent that sometimes lower back muscle strain may be extremely painful enough to necessitate an emergency room visit, while a degenerating disc may cause only mild, intermittent discomfort. Lower back pain may travel to the buttock, leg and foot (sciatica). The pain due to lumbar herniated disc can range from nagging to severe pain sometimes worsened by sitting/ standing. The pain due to Lumbar degenerative Disc Disease is deep and worsens when standing or walking. Knowing the symptoms, visiting a specialist is the first step in obtaining effective pain relief.
When to seek immediate medical help?
Though most cases of back pain do not require urgent care, but if you experience pain due to trauma along with leg weakness, severe abdominal pain, loss of control of urination, and sudden bowel or bladder incontinence, you must seek immediate medical help or treatment. Your physician will investigate the possible causes of the pain including spinal fracture, infection or tumor and may recommend the appropriate treatment.
How to diagnose lower back pain?
A better diagnosis helps classify the patient condition as one of the following types of pain: Axial low back pain – this is confined to lower back; Lumbar radiculopathy – the pain is more severe in the legs, buttocks or foot, and it is associated with numbness or weakness; low back pain with referred pain – the pain radiates to groin, buttock and upper thigh, but rarely below the knee. Classification of pain is important in guiding the right treatment plan. If the pain is severe and is not relieved within 6 to 12 weeks, a specific diagnosis becomes more important. X-rays, CT scan, Myelogram and MRI scans, will be recommended by the spine specialist based on the patient history, underlying cause and severity of the pain.
What is the treatment?
Treatment for lower back pain depends on the patient history, the type and severity of the pain. For some types of pain, medication and lower back pain exercises, rest, traction, application of heat and ice packs and physiotherapy serve the purpose; however, for more severe and persistent pain surgical procedures including the newer modalities of treatment like endoscopic surgeries may be recommended. Therefore, owing to many reasons and health conditions that are associated with back pain, it is always better to approach a neurophysician or neurosurgeon to rule out any severe health condition.