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Low Back Pain : Causes, symptoms, and treatments

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Low Back Pain
Almost everyone will experience low back pain at some point in their lives. This pain can vary from mild to severe. It can be short-lived or long-lasting. However it happens, low back pain can make many everyday activities difficult to do.

Low Back Pain anatomy
Your spine is made up of small bones called vertebrae that are stacked on top of each other. Muscles, ligaments, nerves and discs are other parts of your spine.

The muscles and ligaments help stabilize the bones, while the discs "cushion" the spine to allow it to tolerate the various movements and loads you put on your spine. The nerves that allow communication between your brain and your body are located in the spine.

Understanding your spine and how it works can help you better understand back pain. Learn about the anatomy of the spine

Low Back Pain description
Back pain varies from person to person. The pain can come on slowly or come on suddenly. The pain can be intermittent or constant. In most cases, back pain goes away on its own within a few weeks.

Low Back Pain because
There are many causes of back pain. It sometimes occurs after a specific movement, such as lifting or bending. Aging also plays a role in many back problems.

As we age, our spines age with us. Aging causes degenerative changes in the spine. These changes can start in our 30s - or even younger - and make us vulnerable to back pain, especially when we overdo our activities.

These age-related changes don't stop most people from living productive and generally pain-free lives. We all know the 70-year-old marathon runner who undoubtedly has degenerative changes in her back.

Low Back Pain overactivity
One of the most common causes of back pain is sore muscles from overactivity. Muscles and ligament fibers can become overstretched or injured.

This is often caused by the first softball or golf game of the season, or by doing too much yard work or shoveling snow in one day. We all know that stiffness and pain in the lower back and other areas of the body that usually goes away within a few days.

Disk Violation
Some people develop back pain that doesn't go away within a few days. This can indicate an injury to an intervertebral disc.

hard drive crack. Small tears sometimes appear on the outer part of the disc (annulus) with age. Some people with herniated discs have no pain at all. Others may have pain that lasts for weeks, months, or even longer. A small number of people can develop constant pain that lasts for years and is quite disabling. Why some people are in pain and others are not is not well understood.

herniated disk

Disc prolapse. Another common type of disc injury is a herniated or herniated disc.

A herniated disc occurs when its gelatinous center (nucleus) presses against its annulus. If the disc is very worn or injured, the nucleus can be fully deflected. When the herniated disc bulges toward the spinal canal, it puts pressure on the sensitive spinal nerves and causes pain.

Because a herniated disc in the lower back often puts pressure on the nerve root that leads to the leg and foot, pain in the buttocks and down the leg is common. It's called sciatica.

A herniated disc often occurs during lifting, pulling, bending, or twisting movements.

disk degeneration
As we age, the spinal discs begin to wear out and shrink. In some cases, they can collapse completely, causing the facet joints — the small joints between each vertebra at the back of the spine — to rub against each other. The result is pain and stiffness. Smoking has also been found to accelerate disc degeneration.

This wear and tear on the facet joints is referred to as arthrosis, also known as spondylosis. It can lead to other back problems, including spinal stenosis.

Disk degeneration

Degenerative spondylolisthesis
(Spon-dee-low-lis-THEE-sis) Changes from aging and general wear and tear make it harder for your joints and ligaments to keep your spine in the right position. The vertebrae may move more than they should, and one vertebra may slip forward over the other. If too much slippage occurs, the bones can begin to press on the spinal nerves.

Spinal stenosis
Spinal stenosis occurs when the space around the spinal cord narrows, putting pressure on the spinal cord and spinal nerves.

Spondylolisthesis.

When discs collapse and osteoarthritis develops, your body can respond by forming new bone (arthritis) in your facet joints to support the vertebrae. Over time, these bony growths (called spurs) can narrow the spinal canal. Osteoarthritis can also cause the ligaments that connect the vertebrae to thicken, which can narrow the spinal canal.

scoliosis
Scoliosis is an abnormal curvature of the spine that can develop in children, most often during their teenage years. It can also develop in elderly patients with arthritis. This spinal deformity can cause back pain and possibly pain, weakness, or numbness in the legs when pressure is applied to the nerves.

compression fracture
Vertebral compression fractures are a common cause of back pain in the elderly. As we age, our bones weaken and are more likely to break, a condition known as osteoporosis. In people with osteoporosis, minor trauma—such as B. hard sitting on a hard chair or toilet, or falling at floor level - can cause bones in the spine to break, resulting in extreme back pain when moving.

Low Back Pain Additional Causes
There are other causes of back pain, some of which can be serious. If you have a vascular or arterial disease, a history of cancer, or pain that is always present regardless of your activity level or position, you should consult your GP.

symptoms
Back pain is different. It can be sharp or stabbing. It may be dull, painful, or feel like a "Charley Horse" type spasm. The nature of your pain will depend on the underlying cause of your back pain.

Most people find that leaning back or lying down relieves their back pain, regardless of the underlying cause.

People with back pain often find that their pain worsens when:

bending and lifting
meeting
standing and walking
You can also experience:

Back pain that comes and goes, often ebbs and flows, with good days and bad days.
Pain that extends from the back to the buttocks or outer hips, but not down the leg.
Sciatica. These include buttock and leg pain, and even numbness, tingling, or weakness that extends to the foot. Although sciatica is commonly associated with a herniated disc, it is possible to have sciatica without back pain.

Regardless of your age or symptoms, you should call your doctor if your back pain doesn't improve within a few weeks or is accompanied by a fever, chills, or unexpected weight loss. Other warning signs include weakness in the legs and loss of bladder and bowel control.

testing and diagnosis
History and physical examination
After discussing your symptoms and medical history, your doctor will examine your back. This includes looking at your back and pressing on different areas to see if it hurts. Your doctor may ask you to bend forward, backward, and side to side to check for restriction or pain.

Your doctor may also measure nerve function in your legs. This includes checking your reflexes in your knees and ankles, as well as strength and sensitivity tests. This could tell your doctor if the nerves are seriously affected.

Imaging tests
Other tests that can help your doctor confirm your diagnosis include:

X-rays. Although they only show bones, plain X-rays can help determine if you have the most obvious causes of back pain. They show broken bones, age-related changes, curves or deformities. X-rays show no discs, muscles or nerves.

Magnetic resonance imaging (MRI). MRI scans can create better images of soft tissues, such as muscles, nerves, and discs, than X-rays. Conditions such as a herniated disc or infection are more visible on an MRI scan.

Computed axial tomography (CAT) scans. If your doctor suspects a bone problem, he or she may suggest a CT scan. This examination is similar to a three-dimensional X-ray and focuses on the bones.

bone scan Your doctor may suggest a bone scan if they need more information to evaluate your pain and make sure the pain isn't from an uncommon problem like cancer or an infection. A bone scan can also help detect a fracture.

bone density test. If osteoporosis is a problem, your doctor may order a bone density test. Osteoporosis weakens the bone and makes it more likely to break. Osteoporosis alone shouldn't cause back pain, but spinal fractures due to osteoporosis can.

treatment
In general, treatment for back pain falls into one of three categories: drugs, physical medicine, and surgery.

Non-surgical treatment
medication. Several medications can be used to relieve your pain.

Paracetamol can relieve pain with few side effects
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen reduce pain and swelling
Steroids, either taken orally or injected into your spine, deliver a high dose of anti-inflammatory drugs
Muscle relaxants like methocarbamol, carisoprodol, and cyclobenzaprine are another type of oral medication that may help. However, they can make you drowsy. So if you're taking muscle relaxants, don't drive or perform tasks that require you to be alert.
physical medicine. Lower back pain can be disabling. Drugs and therapeutic treatments combined often provide enough pain relief to allow you to do all the things you want to do.

Physical therapy can include passive modalities such as heat, ice, massage, ultrasound, and electrical stimulation. Active therapy consists of stretching, weight lifting and cardiovascular exercises. Exercises to restore movement and strength to the lower back can be very helpful in relieving pain.
Braces are often used. The most common is a corset-like brace that can be wrapped around the back and abdomen. Braces aren't always helpful, but some people report feeling more comfortable and stable while wearing them.
Chiropractic, or manipulative therapy, comes in many different forms. Some patients are able to relieve their back pain with these treatments.
Traction is often used, but without scientific evidence of its effectiveness.
Other exercise-based programs, such as Pilates or yoga, are helpful for some patients.
surgical treatment
Surgery for low back pain should only be considered when nonsurgical treatment options have been tried and unsuccessful. It's best to try non-surgical options for 6 months to a year before considering surgery.

Additionally, surgery should only be considered if your doctor can pinpoint the cause of your pain.

Surgery is not a last treatment option. Some patients are not candidates for surgery even though they have significant pain and other treatments have not worked. Some types of chronic back pain just can't be treated with surgery.

spinal fusion. Spinal fusion is essentially a welding process. The basic idea is to fuse the painful vertebrae together so that they heal into a single, solid bone.

Spinal fusion eliminates movement between vertebral segments. It's an option when movement is the source of the pain. For example, your doctor may recommend a spinal fusion if you have spinal instability, a curvature (scoliosis), or severe degeneration of one or more of your spinal discs. The theory is that if the painful spinal segments aren't moving, they shouldn't be hurting.

Fusion of the vertebrae in the lower back has been performed for decades. A variety of surgical techniques have evolved. In most cases, a bone graft is used to fuse the vertebrae. Screws, rods, or a cage are used to keep your spine stable while the bone graft heals.

The surgery can be performed through your abdomen, your side, your back, or a combination of these approaches. There's even a procedure that's performed through a small opening next to your tailbone. No method has proven to be better than another.

The results of spinal fusion for back pain vary. It can be very effective at eliminating pain, not working at all, and everything in between. Full recovery can take more than a year.

hard drive replacement. In this procedure, the hard drive is removed and replaced with an artificial hard drive. It is performed through the abdomen, usually at the bottom two discs of the spine.

The goal of disc replacement is to allow the spinal segment some flexibility and more normal movement.

Although no longer considered a new technology, the results of artificial disc replacement compared to fusion are controversial.

discectomy. A discectomy removes the damaged portion of a herniated disc. This relieves pressure on the nerve and allows the sciatica to resolve.

laminectomy. Laminectomy removes the thickened ligaments and bone spurs that are compressing the nerves. This relieves the spinal canal, which leads to less nerve pain.

Kyphoplasty/Vertebroplasty. In this procedure, cement is injected into the broken bone to stabilize an osteoporotic compression fracture. This will help eliminate the sharp pain associated with the fracture.

prevention
Lower back pain may not be preventable. We cannot avoid the normal wear and tear on the spine that comes with aging. But there are things we can do to lessen the impact of lower back problems. A healthy lifestyle is a good start.

Do sports regularly
Combine aerobic exercise like walking or swimming with specific exercises to keep the muscles in your back and abdomen strong and flexible.

Use proper lifting technique
Make sure you lift heavy objects with your legs, not your back. Don't bend down to pick something up. Keep your back straight and bend your knees.

Maintain a healthy weight
Excess weight puts additional strain on the lower back.

Avoid smoking
Both the smoke and the nicotine age your spine faster than normal. if you smoke

Use correct posture
Good posture is important to avoid future problems. A therapist can teach you how to stand, sit, and lift safely.