Low back pain can be either an acute or chronic disabling condition. It will affect most people at some stage in their life and accounts for more sick leave taken than any other single condition.

An acute lower back injury may be caused by a traumatic event, like a car accident or a fall. It occurs suddenly and its victims will usually be able to pinpoint exactly when it happened. In acute cases, the structures damaged will more than likely be soft tissue like muscles, ligaments and tendons. With a serious accident, vertebral fractures in the lumbar spine may also occur.

Chronic lower back pain usually has a more insidious onset, occurring over a long period of time. Causes include osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae or a lumbar disc herniation, or tumors (including cancer).

Causes

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Possible causes of low back pain:

• Mechanical:
  • Prolapsed intervertebal disc
  • Apophyseal osteoarthritis
  • Ankylosing hyperostosis
  • Spinal stenosis
  • Spondylolisthesis and other congenital abnormalities
  • Scheuerman's osteochondritis
  • Fractures
  • Non-specific

• Inflammatory:
  • Seronegative spondylarthritides (e.g. ankylosing spondylitis)
  • Rheumatoid arthritis
  • Infection

• Neoplastic:
  • Bone tumors (primary or metastatic)
  • Spinal tumors

• Metabolic:
  • Osteoporotic fractures
  • Osteomalacia
  • Ochronosis
  • Chondrocalcinosis

• Paget's disease

• Referred pain:
  • Pelvic/abdominal disease
  • Posture

• Depression

Diagnosis

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Often, getting a diagnosis of the underlying cause of low back pain and/or related symptoms, such as sciatica, is quite complex. A complete diagnosis is usually made through a combination of a patient's medical history, physical examination, and, when necessary, diagnostic testing, such as an MRI scan or x-ray ^*.

Treatments

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The course of treatment for low back pain will usually be dictated by the diagnosis of the underlying cause of the pain. Rarely, low back pain will require surgery. For the vast majority of patients, low back pain can be treated with non-surgical care. Typical non-surgical treatments for low back pain includes:

• Chiropractic manipulation
• Physical therapy and exercise
• Pain medications, such as NSAIDs or acetaminophen
• Ice and/or heat application (or moist heat)

If the pain is severe and does not respond to non-surgical treatments, patients may elect to have surgery to correct the problem causing the pain (e.g. a lumbar disc pressing on a nerve).

See also

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• Back pain
• Upper back pain
• Lumbar disc herniation
• Degenerative disc disease

References

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• Spine-health.com website's article

External links

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• Acupuncture
• Back Pain Medical Journal for Patients
• Low Back Pain - American Academy of Orthopedic Surgeons

Disability | Symptoms