Health Bulletin - July 2024
Lower Back Pain: Understanding, Managing, and Preventing a Common Health Challenge
Dr. Praveen Reddy MD, M.ch, MBA Center for Minimally Invasive Neurosurgery
The Woodlands, TX
What is lower back pain?
Lower back pain refers to discomfort or ache in the lumbar region of the spine, which is the area below the ribcage and above the hips. It can range from a dull, constant ache to a sudden, sharp sensation that can significantly impact daily activities.
There is both acute and chronic lower back pain. Acute lower back pain typically lasts from a few days to a few weeks and often resolves on its own with self-care. Chronic lower back pain persists for 12 weeks or longer, even after an initial injury or underlying cause has been treated.
What are the causes of lower back pain?
- Muscle or ligament strains: Often caused by sudden movements or lifting heavy objects improperly.
- Bulging or ruptured discs: The soft material between discs can bulge or rupture, pressing on a nerve.
- Arthritis: Osteoarthritis can affect the lower back, causing pain and stiffness.
- Skeletal irregularities: Conditions like scoliosis can lead to back pain.
- Osteoporosis: Vertebrae can develop compression fractures if bones become porous and brittle.
- Spinal stenosis: Narrowing of the spinal column that puts pressure on nerves and the spinal cord.
How common is lower back pain?
- Approximately 80% of adults experience lower back pain at some point in their lives.
- It's the leading cause of disability worldwide, affecting over 600 million people.
- In the United States alone, about 31 million people suffer from lower back pain at any given time.
- Lower back pain is more prevalent in developed countries and is increasing due to sedentary lifestyles and aging populations.
What are the symptoms?
Symptoms of lower back pain can vary and may include:
- Muscle ache
- Shooting or stabbing pain
- Pain that radiates down your leg
- Limited flexibility or range of motion of the back
- Inability to stand up straight
In more severe cases, additional symptoms may include:
- Weight loss
- Inflammation or swelling on the back
- Persistent back pain that doesn't improve with rest
- Pain that spreads down one or both legs, especially if it extends below the knee
- Weakness, numbness or tingling in one or both legs
How is lower back pain diagnosed?
Diagnosis of lower back pain typically involves:
- Medical history: : Your doctor will ask about your symptoms, recent injuries, and medical conditions.
- Physical examination: This includes assessing your ability to sit, stand, walk and lift your legs, as well as testing for nerve involvement.
- Imaging tests: X-rays, CT scans, or MRIs may be ordered to visualize bones and soft tissues.
- Blood tests: These can check for underlying conditions like infections or arthritis.
- Nerve studies: Electromyography (EMG) can measure electrical impulses produced by nerves in response to muscle
How can I prevent lower back pain?
- Exercise regularly to keep back muscles strong and flexible
- Maintain a healthy weight to reduce stress on your back
- Practice good posture when sitting, standing, and lifting
- Use proper lifting techniques: bend at the knees and lift with your legs
- Quit smoking, as it impairs blood flow and can lead to osteoporosis
- Manage stress through relaxation techniques like meditation or yoga
- Ensure your workplace is ergonomically optimized
- Get enough quality sleep on a supportive mattress
How is lower back pain treated?
Treatment for lower back pain depends on the cause and may include:
Medications:
- Over-the-counter pain relievers (NSAIDs, acetaminophen)
- Muscle relaxants for severe muscle spasms
- Topical pain relievers (creams, ointments)
- In some cases, prescription opioids for short-term use
Physical therapy:
- Exercises to strengthen core and back muscles
- Stretching techniques to improve flexibility
- Posture correction and body mechanics training
Alternative therapies:
- Chiropractic care
- Chiropractic care
- Massage therapy
Interventional procedures:
- Epidural steroid injections for nerve-related pain
- Radio frequency ablation for chronic pain from specific nerves
Surgery (rarely needed):
- Discectomy for herniated discs
- Laminectomy for spinal stenosis
- Spinal fusion for vertebrae problems
Works Cited:
- https://www.webmd.com/back-pain/ss/slideshow-surprising-reasons-back-pain
- https://my.clevelandclinic.org/health/diseases/7936-lower-back-pain
- https://www.healthline.com/health/lower-back-pain-causes-female#bottom-line
- https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/lower-back-pain-what-could-it-be
- https://www.who.int/news-room/fact-sheets/detail/low-back-pain
Sujeeth R. Punnam, MD, FACC, Interventional Cardiologist, Stockton, CA