Low back pain affects millions of people each year. According to the National Institutes of Health, it is the leading cause of absenteeism from work and activity limitations. While low back pain affects all age groups, the prevalence increases as people age. Low back pain is a major cause of long-term disability.
Some people can pinpoint an incident that caused their low back pain. They may have twisted or bent a certain way, tried to lift a heavy object, or experienced an accident or fall. Other people cannot remember a specific event that precipitated their pain.
The following examples illustrate some of the common reasons for low back pain.
Muscle Strains and Sprains
Low back sprains and strains are often the result of heavy lifting, certain repetitive motions, or a fall. These soft tissue injuries may cause severe pain for a time and be temporarily disabling. Treatments generally involve anti-inflammatory medications, muscle relaxers for spasms, and rest. Physical therapy may be recommended. This may include therapeutic exercises, ultrasound, heat or ice therapy, and electrical stimulation. Most patients will recover without needing more invasive treatment.
Lumbar Disc Herniation
Disc herniation is common in the low back. Discs act as the shock absorbers for the spine. When the outer band of a disc cracks, the gel-like center leaks out and may irritate surrounding nerves. This becomes more common as people age, and the discs gradually dry out. The resulting pain may be dull or sharp. It may worsen with certain movements. A disc herniation may cause pain, tingling, or numbness in the buttocks, leg, or foot. The pain may diminish within 4-6 months with conservative treatments. However, some patients may need surgery.
Osteoarthritis can lead to lumbar stenosis, a narrowing of the space around the spinal cord or nerve roots. Patients may experience low back pain as well as weakness, pain, and numbness in the legs or buttocks. The pain often eases when sitting or bending forward. Many people are helped with non-surgical treatments including epidural steroid injections. Surgery is sometimes needed.
This is a degenerative condition in which one vertebrae slips forward over the vertebrae below it. Older women are most at risk due to osteoporosis. Pain may be felt in the low back, buttocks, thighs, and down the legs. Degenerative spondylolisthesis is a progressive disease, but many cases are treated without surgery.
When should I see a doctor for low back pain?
- Pain begins after a fall or other trauma
- Pain is constant and intense
- Pain spreads down one or both legs
- There is fever, swelling, or redness
- There are new bladder or bowel control problems