Low Back Pain - Causes And Management

Introduction: The lower part of the back helps to support the body, helps in movement and protects certain body parts. The lower back is an intricate structure with muscles, tendons, soft tissues as well as highly sensitive nerves and nerve roots that arise from the spinal cord. The lower spine is made up of small and complex joints and the bones of the spine are known as vertebra.

Causes Of Lower Back Pain: 
Symptom of main in the lower back is very common and about 8 in 10 people have suffered from a bout of lower back pain sometime in their life. In most cases it is not due to any serious disease. A few types and causes of the Lower back pain are described as follows:

1. Non-Specific Lower Back Pain: It is the most common type and the majority of people with back pain fall in this category. It is called non-specific because it is not clear what exactly causes the pain. The severity of pain may vary from mild to severe. It is thought that this type of pain may be caused by some strain or stretch of the muscle or the ligaments. It may sometimes develop suddenly following some awkward twisting movement or after lifting something heavy. Some people may sometimes just wake up with a lower back pain. It can also occur after standing for a long time or sitting in an abnormal posture.

2. Age Related Osteoarthritis: Older adults more than 60 years old may suffer from lower back pain secondary to age related degeneration of the joint and osteoarthritis.

3. Muscle Or Ligament Strain: Repeated heavy lifting, awkward movement during workouts may sometimes lead to a stretch or strain to the muscles and the ligaments causing pain.

4. Bulging or Ruptured Discs: Vertebral discs acts as cushions between the individual vertebra in the spine. Sometime the soft material inside the disc may bulge out or rupture and press on a nerve causing pain.

5. Ankylosing Spondylitis: It is a type of arthritis most commonly seen in young adult males and causes pain and stiffness in the lower back.

6. Skeletal Irregularities: Back pain may occur if the spine has an abnormal curvature. Scoliosis is one of such conditions in which the spine curves to the sides and can lead to back pain.

7. Radicular Pain (Sciatica): This pain is caused by irritation or compression of spinal nerve roots of the sciatic nerve. It is characterized by lower back pain, pain in the buttock, and pain along with numbness or weakness in one or both the legs and the foot.

8. Osteoporosis: A condition in which the bones become porous and brittle leading to minor fractures within the vertebra can cause lower back pain.

9. Pregnancy: Pregnancy can commonly cause lower back pain by mechanically stressing the lower back. The effects of hormones that loosen the ligaments as well as the anatomical change in curvature of the spine due to the growing fetus can cause pain.


10: Other Causes: Many other causes of lower back pain include:

• Pressure effect by tumors in the pelvis or near the spine. 
• Kidney stones and infections
• Rheumatoid arthritis affecting the spine
• Cauda equina syndrome, rare but an emergency condition cause by pressure at the bottom of the nerves in the spinal cord.
• People with poor physical health

Management: 

The treatment usually depends on the underlying cause of the back pain.It is important to first rule out the serious causes. 

• The minor strains and the non-specific pain can usually be managed by simple over the counter analgesics, rest, exercises and physiotherapy. 
• Most of the times no diagnostic testing is required but sometimes procedures like X-rays, MRI, bone scan and nerve studies may be done to confirm some underlying disease, 
• Common pain relievers like acetaminophen, ibuprofen etc are effective for non-specific lower back pain.
• There are only few patients who may need a surgery for the lower back pain depending on the underlying cause which may be serious and could not be manged by drugs alone.