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Low Back Pain

Woman with back painLow back pain, also commonly referred to as lumbago, is a common disorder that involves bones and muscles of the back. About 40% of people have low back pain at some point of their lives. Also abbreviated as LBP, low back pain can be classified according to duration. Acute low back pain is pain that last for less than 6 weeks, sub-chronic back pain is pain lasting between 6 and 12 weeks and chronic back pain is pain lasting for over 12 weeks. Classification can also be done based on the cause of the condition and this can be – referred pain, mechanical or non-mechanical back pain.

Most low back pains are believed to be caused by mechanical issues such as joint or muscle strain and thus there is no identification or search for an underlying cause. If after conservative treatment, the pain does not fade away, or the pain is experienced along ‘red flags’ like fever, loss of weight and problems associated with movement and feeling, then further tests will be carried out to identify a serious underlying problem. Treatment is through conservative methods though some cases might require other advanced treatments depending on the situation.

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Signs and Symptoms of Low Back Pain

In common low back pain, the pain will be experienced after movement that involves, twisting, bending forward, or lifting. The symptom can start after the movement or in some cases; they are experienced the following day in the morning. The pain described ranges from tenderness of some areas to diffuse pain. This pain might or might not worsen when the individual makes certain movements such as raising their legs, and certain sitting or standing positions. Sometimes the individual might experience sciatica, which is pain that radiates down their legs.

Most people experience their first acute low back pain when they are between the age of 20 and 40 years old. This is the first reason why most people see a medical professional in adulthood. In most case there are recurrent pain episodes and in more than 50% of the people, the following episodes are more painful than the first one. There are other problems that might emanate from low back pain. People suffering from chronic low back pain might experience sleep problems such as disturbances during sleep, less sleep satisfaction, short sleep durations and a great amount of time required to fall asleep. A large number of people suffering from chronic LBP will also show anxiety or depression symptoms.

Causes of Low back Pain

Low back pain cannot be classified as a specific disease because it is a complaint which can result from a wide range of underlying causes and will vary in seriousness level. Most of the low back pains experienced by most patients will not have a clear underlying cause but are believed to result from non-serious skeletal or muscle problems such as strains or sprains. Some of the conditions that might contribute to low back pain include obesity, gained weight during pregnancy, poor posture, poor physical condition, poor sleeping position, stress and smoking.

There is a list that shows the possible cause of low back pain including less common conditions. Some of the physical causes behind low back pain include spinal disc herniation, broken vertebrae, osteoarthritis, degeneration of discs located between the vertebrae, and in rare cases, a spine tumor or an infection.

Women are known to have low back pain which is associated with conditions that affect their reproductive systems such as ovarian cysts, endometriosis, uterine fibroids or ovarian cancer. About 50% of pregnant women experience low back pain which is as a result of change in posture, and muscle and ligament strain cause by the position of the center of gravity. There are four main categories of low back pain. These are:

  • Infectious
  • Inflammatory
  • Musculoskeletal
  • Malignancy

Types of Low back pain

Low back pain is a general term and there are different types which are classified under this term. It is important to know the type a patient is experiencing for proper treatment and management. The most common types of low back pain are:

Low back Pain Diagnosis

The structure of the back is a complex one and pain reports are affected and subjected to social factors. For these reasons, the diagnosis of low back pain has not become a straightforward process. Most of low back pain cases are caused by joint and muscle issues but these causes should be distinguished from spinal tumors, neurological problems, infections and fractures in the spine among other problems. It is important for a proper diagnosis to be carried out for proper treatment directions to be taken.

Prevention

There are no effective methods developed for purposes of preventing low back pain. For patients with pain that lasted for a period exceeding 6 weeks, exercise is the best option in preventing recurrences. A medium firm mattress is effective in dealing with chronic pain as opposed to firm mattresses. Little or no evidence is available about the effectiveness of back belts in preventing low back pain. It is important to note that shoe insoles will not assist in the prevention of this pain.

Management

The management of low back pain relies greatly on which of the 3 main categories the pain belongs to. Is it referred pain, mechanical or non-mechanical? When the pain is acute and causes mild to moderate problems, the management goals are restoring normal functions, minimizing pain and returning the patient to work. This condition will not cause any serious harm and will be resolve without much effort. For patients suffering from sub-chronic pain or chronic low back pain, the management is through multidisciplinary treatment methods.

There are other methods used in the management of low back pan such as,

Physical management – This mostly involves physical exercise and therapy.

Medication – In most cases, medication may be used in the management of low back pain but most are somewhat effective and the use might lead to reduced satisfaction since the benefits may differ from the reality. The first medication recommended is acetaminophen or paracetamol, or NSAIDs but not aspirin, and they are enough for most patients. There are other medications used but incase they are not effective, opioids like morphine are prescribed but on a short term use.

Surgery – Surgery is an option incases that involved a herniated disc. Surgical procedures are recommended when the pain is caused by a mechanical problem especially one involving the spine.

Alternative Medicine – A number of alternative treatment methods such as chiropractic and spinal manipulation, acupuncture, behavioral therapy and prolotherapy may be used to manage low back pain.

For people who have experienced low back pain, it is important that they seek medical attention to have the problem solved through trusted medical management programs and also because it might be a sign of a serious medical condition.


 
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