Lower Back Pain (Lumbago)

Author: admin
April 3, 2010

Lower back pain, also known as lumbago, is a common ailment which has been experienced by approximately 60% of adults. Lower back pain causes more lost work days than any other health issue.

Lower Back Pain Overview

Lower back pain, or lumbago, occurs as an ache or a pain anywhere below the lower ribs and above the legs, and is common in both genders and all age groups, though it’s most common in adults between the ages of 35 and 55. Over the course of a lifetime, almost 70 out of every 100 people will experience low back pain, resulting in lost work days, and limiting normal activities, exercise and recreation.

Lumbago can vary in its intensity, resulting in restricted movement, and may spread into the buttocks and upper thigh regions. Lower back pain may be either chronic or acute, sharp and sudden or dull and continuous, can be localized to the lower back itself, below the waist, or extend down through the buttocks and on down through the backs of the legs and right down to the feet. Though for many folks who experience lumbago it will only last for a period of days, it can recur. If it does, then a change in lifestyle may be necessary to lessen strain on the lower back and lessen the chance of a recurrence. In a small percentage of people who suffer lower back pain, it can be continuous and persistent and lead to a chronic disability.

Definition of lower back pain
The definition of lower back pain, or lumbago, is any back pain or ache located between the bottom of the ribcage and above the legs.Lower back pain that flares up suddenly is called acute lower back pain. If the lower back pain continues persistently, then it’s called chronic lower back pain.

Usual causes of lower back pain
Lower back pain is often caused by a physical injury, such as a car accident, a slip-and-fall, or a sports-related injury. Lower back pain can also be a consequence of strained muscles. It can also result from a more specific cause, ie a spinal injury such as a herniated disc.

Most Common Lower Back Pain Symptoms
Pain that occurs anywhere from the bottom of your rib cage to the tops of your thighs on your back, which can be local to one region or can be a broader, more widespread pain are the most common symptoms. Sometimes the pain will intensify with certain movements, sometimes it will vary over time, and sometimes it can spread outward from one region to another.

Lower Back Pain Treatment
For most instances of lower back pain, painkillers, ice and heat applications to the affected area, rest and some careful and low impact exercise are recommended. For most people this is a self-limiting ailment and if treated correctly will eventually fade away.

However, chronic back pain will require medications such as non-steroidal anti-inflammatory drugs, along with physical therapy, and possibly acupuncture or spinal stimulation. In certain unusual cases surgery may be indicated, but usually only as a last resort.

Prevention of Lower Back Pain
Correcting your posture and learning proper habits and limits when lifting any substantial weight will help you to maintain a healthy back.

Lower Back Pain Symptoms

There are two general categories that cover most lower back pain; acute, or sudden onset, and chronic, or persistent. Many of the symptoms are shared between these two categories.

Acute Lower Back Pain Symptoms
The bangs and jolts from car accidents, sports-related activities, or other physical trauma can result in stress and strain on spinal bones, ligaments and the musculature of the back, often the cause of acute lower back pain. When an injury occurs varied symptoms will manifest, from a dull generalized ache to more severe and localized pain, which will often restrict range of movement.

Acute lower back pain symptoms usually last for a few days to a few weeks. Most incidences of acute lower back pain result from physical trauma, or physical damage caused by a medical condition, ie arthritis.

Chronic Lower Back Pain Symptoms
Any lower back pain lasting more than three months, and often worsening over time, is chronic lower back pain. Sometimes it’s hard to pinpoint the cause of lumbago, and many times it’s linked to a long-term health issue. The range of symptoms, though similar to those of acute lower back pain, can also be more far-reaching, often radiating into the buttocks area, down the back of the thighs, or even into the groin area, and can worsen over time. Movement will often cause mild to severe pain, and may result in back muscle spasms which can alter your posture.

Often, with chronic back pain, flexibility is lost as the pain becomes more severe, and movement will become restricted. Sometimes a tingling, numbness or pain will move down the leg, even below the knee, which are usually the result of a nerve compression.

Should You Seek Medical Attention?

You should see your doctor immediately if any of the following occurs:

Sudden leg weakness
New numbness or tingling sensation in the buttocks, groin area, or legs
Sudden loss of bladder or bowel control
Moderate to severe pain following an injury to the back

If you experience any of these symptoms, even if you’ve not had an obvious back injury, they may indicate that you have spinal cord compression, which requires immediate medical treatment. If you have back pain that routinely interferes with your lifestyle and your everyday activities, you should seek medical advice. If you’ve experienced lower back pain that has lasted more than two weeks in spite of home treatment, you should seek medical treatment.

Causes of Lower Back Pain

Lower back pain can come on suddenly (acute) or can develop gradually over a period of weeks. If the pain persists it’s described as chronic.

Acute lower back pain is often due to a strained muscle or tendon caused by lifting or moving heavy objects. The pain and the strain may be aggravated by further activity. In most cases, if care is taken, the pain will fade within 7-14 days.

Chronic Lower Back Pain that is more persistent is often caused by poor posture while sitting, or by excessive muscle tension due to emotional stress.

Pregnancy often brings about chronic lower back pain. There are two issues at work. Pregnancy causes posture to change because of the weight and weight distribution of the baby, and ligaments supporting the spine will soften due to high levels of hormones caused by pregnancy.

When people get older, past the age of 45, chronic lower back pain is often caused by spinal osteoarthritis, while in people who are younger, the pain may be due to ankylosing spondylosis, an inflammation between the spinal bones or the joints of the spine and pelvis.

Sometimes, if the nerve root becomes compressed because of a prolapsed spinal disc or because of spondylosis causing pressure on the spinal nerve, the result is chronic pain, and can have either a sudden onset or a more gradual onset. Sciatica, pain shooting down the back of one or both legs, can also occur with this type of physical trauma.

It is possible, in very rare instances, that the pain may come from the bone itself, for instance where cancer has metastasized from a tumor elsewhere in the body.

There are other medical conditions which can cause lower back pain, conditions such as kidney infections or kidney stones, pelvic inflammatory disease, peptic ulcers, and gallbladder disease, to name a few. This is why it’s important, if pain persists, to seek medical attention.

Lower Back Pain Diagnosis

A complete physical exam, including a detailed history of your past health, present symptoms and regular and recent physical activity will allow the doctor to determine the most likely cause. In most cases further tests or imaging are not requred, though the doctor may request further testing and imaging if the pain has been chronic for over six weeks, or if there’s a history of back injury, or if the doctor suspects a medical reason for the lower back pain.

If the doctor suspects that spinal disc problems are the cause of the pain, then an x-ray or CT scan may provide the doctor with a more complete picture of what’s going on. MRIs are performed if the doctor needs more information about the soft tissue in your lower back.

Treatment and Relief for Lower Back Pain

In many cases time is all that is needed for lower back pain to resolve. Staying active, while being careful not to strain, will help relieve symptoms, even when the pain is severe.

The treatment for acute lower back pain, which will help alleviate pain within a few days to a few weeks:

Limit bed rest, since it doesn’t help recovery. Movement helps recovery.
Over-the-counter (OTC) painkillers and anti-inflammatory medications in consultation with your doctor, which will alleviate mild to moderate pain levels.
Continuing with your day-to-day activities, wherever possible.
Short-term treatment with a muscle relaxant medication.
Exercises designed to strengthen muscle and improve posture through stretching. Swimming, walking and yoga are all good for this. There will be some discomfort at first, but the discomfort fades as the muscles gain in strength and flexibility.
Applying cold compresses, ie. an ice pack, to reduce inflammation. Follow up with a local heat application after a few days to help ease muscular pain and provide relief, ie. a heat pad, or a hot bath.

The treatment for chronic lower back pain should be determined in consultation with your doctor. This treatment program, involving multiple types of treatment, may extend over weeks or months, and may include:

Medical Treatment for an underlying cause.
Prescription medications: nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants and anticonvulsants, and opioids in some cases.
Physical Therapy: Activities such as walking, swimming, or cycling on a stationary bike place minimum stress on the spine, while improving muscle tone and strength, which will help alleviate pain. Therapy must be individually tailored based on the physical or medical trauma causing the pain, and must be stepped up gradually.
Interventional Therapy: Blocking or numbing the pain pathways in one of several ways to achieve pain relief. Epidural steroids, nerve blocks, and analgesic pump devices are a few ways used to achieve pain intervention.
Complementary Treatments: These encourage the release of natural pain-relieving substances in the body. Spinal manipulation, chiropractics, massage, and acupuncture have all been found to be helpful when used with analgesics.
Psychological Therapy: Many who suffer from chronic back pain also suffer from depression. Treating the depression along with the pain will ensure a quicker and more thorough recovery.
Surgery: Only indicated in rare instances for herniated discs and spinal stenosis.

Tips and Advices for a Pain-free Lower Back

Use chairs with low-back support.
Maintain good posture.
Sleep on a firm mattress.
Use a lumbar support when sitting or driving. One can be created using a small pillow or rolled towel.
Take frequent breaks on long car trips, standing and stretching.
Avoid high heels, wear flat shoes.
Avoid standing for long periods of time.
If you must lift something heavy, squat and use your legs to do the lifting, rather than bending from the waist.
A regular exercise program to strengthen lower back muscles will help to avoid future injuries.

Lower Back Pain – Lumbago