Low back pain (sometimes referred to generally aslumbago) is a common symptom of musculoskeletal disorders or of disordersinvolving the lumbar vertebrae and related soft tissue structures such asmuscles, ligaments, nerves and intervertebral discs. It can be either acute,sub-acute or chronic in its clinical presentation. Most often, the symptoms oflow back pain show significant improvement within a few days to a a few weeksfrom onset. In a significant number of individuals, low back pain can berecurrent in nature with a waxing and waning quality to it. In a smallproportion of individuals this condition can become chronic. Population studiesshow that back pain affects most adults at some stage in their life andaccounts for more sick leave and disability than any other single medicalcondition.
Back pain affects 90% of Americans at some time in theirlives and is the leading cause of visits to the doctor. Low back pain is themost prevalent cause of disability in people under age 45. An estimated $100billion is spent annually in the management of low back pain, with more thanhalf spent on surgical treatment.
Spinal vertebrae are held together by muscles, tendonsand ligaments. Between the vertebrae are discs, which act as "shockabsorbers" and prevent the vertebrae from hitting one another when youwalk, run or jump. They also allow your spine to twist, bend and extend. Sincethe lower back is the hinge between the upper and lower body and carries mostof your weight, it is especially vulnerable to injury and is the site of mostreported back pain. When lower back pain strikes, we become acutely aware ofjust how much we rely on a flexible, strong back.
Back pain can be:
•Acute: lastingless than 3 months. Most people gain
relief after 4 to 6 weeks of home treatment.
•Recurrent: arepeat episode of acute symptoms. Most
people have at least one episode of recurrentlower back pain.
•Chronic:lasting longer than 3 months.
The term "lower back pain" is used to describea spectrum of symptoms. Depending on the cause, lower back pain may be dull,burning, or sharp, covering a broad area or confined to a single point. It canworsen gradually or suddenly and may or may not be accompanied by muscle spasmsor stiffness.
Leg symptoms can be caused by lower spine problemsplacing pressure on a nerve to the leg. The symptoms can occur on their own oralong with lower back pain. Leg symptoms can include pain, numbness, ortingling, usually below the knee.
Weakness in both legs, along with loss of bladder and/orbowel control, are symptoms of cauda equine syndrome, which requires immediatemedical attention.
Most cases of lower back pain are due to skeletaldegeneration or musculo-ligamentous injury and are referred to as non specificlow back pain. The full differential diagnosis however includes may other lesscommon conditions.
·Misaligned pelvis -pelvic obliquity, anteversion or retroversion
Inflammatory:
·Seronegativespondylarthritides (e.g. ankylosing
spondylitis)
·Rheumatoid arthritis
·Infection - epiduralabscess or osteomyelitis
Neoplastic:
·Bone tumors (primary ormetastatic)
·Intradural Spinaltumors
Metabolic:
·Osteoporotic fractures
·Osteomalacia
·Ochronosis
·Chondrocalcinosis
Psychosomatic:
·Tension myositissyndrome
Paget's disease
Referred pain:
·Pelvic/abdominaldisease
·Prostate Cancer
·Posture
Depression
oxygen deprivation
Tips forpreventing back strain
•Don't lift bybending over. Lift an object by bending your knees and squatting to pick up theobject. Keep your back straight and hold the object close to your body. Avoidtwisting your body while lifting.
•Push ratherthan pull when you must move heavy objects.
•If you mustsit at your desk or at the wheel of a car or truck for long hours, break up thetime with stops to stretch.
•Wear flatshoes or shoes with low heels (1 inch or lower).
•Exerciseregularly. An inactive lifestyle contributes to lower back pain.
Sit in chairs with straight backs or low-back support.Keep your knees a little higher than your hips. Adjust the seat or use a lowstool to prop your feet on. Turn by moving your whole body rather than bytwisting at your waist.
When driving, sit straight and move the seat forward.This helps you not lean forward to reach the controls. You may want to put asmall pillow or rolled towel behind your lower back if you must drive or sitfor a long time.
The best way to sleep is on your side with your kneesbent. You may put a pillow under your head to support your neck. You may alsoput a pillow between your knees.
If you sleep on your back, put pillows under your kneesand a small pillow under your lower back. Don't sleep on your stomach unlessyou put a pillow under your hips.
Use a firm mattress. If your mattress is too soft, use aboard of 1/2-inch plywood under the mattress to add support.
