Lower back pain can be excruciating and is one of the leading causes of disability that we see at our Raleigh primary care offices. Studies show that 80% of the population will have lower back pain at one time or another. While serious diseases are rarely associated with lower back pain, the pain itself is often worse than the actual issue causing the pain.
The low back is also referred to as the lumbar spine, the L1-L5 vertebrae that sit above the hips. This area is a complex machine of muscle, bone, nerves, discs, joints, and ligaments responsible for supporting the upper back and allowing you to bend and twist. There are many kinds of low back pain from mild, short-term pain to severe, chronic pain which can come on slowly or all of a sudden. If your lower back pain lasts more than a week, is constant or intense, radiates down your legs, or causes weakness, numbing, or tingling, see your primary care physician as soon as possible.
What is Lower Back Pain?
Lower back pain can be caused by several factors, but mostly from physical injury or your lifestyle. It is characterized by pain in or stemming from your lower back above your hips, sometimes known as the lumbar region. Low back pain can be acute, chronic, or somewhere in between.
Acute lower back pain tends to come on quickly and last a short time, from a few days to weeks. This is normally in response to an injury to the lower back. Subacute low back pain can last anywhere from six weeks to three months and is normally caused by strain. Chronic back pain lasts more than 3 months and is usually severe. Both subacute and chronic back pain will likely need to be brought up to your primary care doctor.
Lower back pain is commonly associated with pain that travels to your extremities, pain that is worse after sitting for long periods of time, pain that gets better when changing standing or sitting positions, and pain that is worse when you first wake up, but better when you move around.
Causes of Low Back Pain
There are two major types of causes of low back pain, mechanical pain and radicular pain. Mechanical pain is pain caused from bone, muscles, joints, and ligaments around the spine. Radicular pain radiates from the nerve being either inflamed or pinched. The most common causes of low back pain are:
Just like your ankles, wrists, or any other joint, the spine is susceptible to strains and sprains. These normally occur when lifting heavy objects or suddenly twisting and can also trigger muscle spasms.
Disc Degeneration, Herniated Discs, and Ruptured Discs
The discs in your back help cushion the spine and allow your body to bend and twist. Disc degeneration happens as you age, and the discs’ ability to cushion movement lessens. Herniated and ruptured discs are when the discs become compressed causing bulges or rupturing.
Radiculopathy and Sciatica
A lot of back pain can be traced to compression of nerves in the lower back. Radiculopathy is when the root of the spinal nerve is compressed and radiates pain throughout the lower back. Sciatica is when the sciatic nerve is compressed, causing radiating pain down the buttocks and thighs.
Falling, car accidents, and even playing sports can have bad effects on the lower back, either from strain, sprains, compression, or blunt force trauma.
Diagnosing Your Lower Back Pain
In order for your lower back pain to be properly diagnosed, you’ll need to see your Raleigh primary care physician. Your appointment will have several different parts to it. Your history will be taken first, so you’ll need to be prepared to discuss the history of the pain, your activity level, sleep habits, posture, and any physical activities or injuries that might have led to your back pain.
There will be a physical exam that could involve palipation or feeling by hand your lower back to locate any injury or tightness, a range of motion test to see where and when the pain occurs, motors exams where your limbs will be manually moved, a reflex test, or a leg raise test to see if it causes pain.
In addition to your history and physical exam, you will likely go through some diagnostic imaging tests such as xrays, a CT scan, or possibly an MRI. This diagnostic test will help show what could possibly be going wrong with your spine, muscles, or ligaments.
Treatment for Lower Back Pain
If the cause for your lower back pain is serious, your primary care doctor might recommend surgery. For most lower back pain cases, the cause is not serious and the pain can be treated through a combination of at-home self-care, medication, and physical activities.
Depending on the specific cause of your lower back pain, your primary care provider might recommend or not-recommend one of the following: heat and ice therapy, activity modification (avoiding sitting for long periods of time, stretching), and over-the-counter pain medications like ibuprofen to ease the pain and reduce inflammation.
Muscle Relaxants and Other Painkillers
Different medications might be recommended for your lower back pain to help the tightness loosen up and to give some relief from the pain.
Some braces can help with long-term pain by providing support and comfort during the day and can help promote healing in your back.
Physical Therapy, Massage Therapy, Chiropractic, and Acupuncture
There are several other alternative therapies to surgery, pain medications, and back braces. Depending on the nature of your injury or problem, physical therapy or massage therapy can help soothe and train your muscles to properly sit and support your back. Small adjustments made by a chiropractor have been shown to help readjust the spine over time, and acupuncture has been shown to provide pain relief in some patients.