LOW BACK PAIN

Why is low back pain common?

Nearly 12 million visits are made to the doctor each year because of back problems. Four out of five adults will experience significant low back pain sometime during their life. After the common cold, problems caused by the lower back are the most frequent cause of lost work days in adults under the age of 45.

The lower or lumbar spine is a complex structure that connects your upper body (including your chest and arms) to your lower body (including your pelvis and legs). This important part of your spine provides you with both mobility and strength. The mobility allows movements such as turning, twisting or bending; and the strength allows you to stand, walk and lift. Proper functioning of your lower back is needed for almost all activities of daily living. Pain in the lower back can restrict your activity and reduce your work capacity and quality of enjoyment of everyday living.

How is low back pain diagnosed?

Most cases of low back pain are not serious and respond to simple treatments. Your Doctor of Chiropractic can accurately diagnose and effectively treat most types of low back pain in the office. You will be asked about the nature of your symptoms and whether you sustained an injury. You also will have an examination of your spine and legs. For many episodes of low back pain no expensive tests are needed for initial assessment and treatment.

If your pain is severe and not responding to treatment or if you have significant leg pain, some imaging tests may be required. Plain X-rays will show arthritis and bone diseases, but will not show soft tissues such as the lumbar disks or nerves. For conditions or injuries that involve these soft tissues, CT scan (computerized tomography) or MRI (magnetic resonance imaging) may be needed. Occasionally, a bone scan will be needed to assess bone activity and electrical tests, EMG (electromyography) may be needed to determine if the spine condition has caused nerve or muscle damage.

What are the common causes?

Low back pain can be caused by a number of factors from injuries to the effects of aging.

Low Back Sprain and Strain - The muscles of the low back provide power and strength for activities such as standing, walking and lifting. A strain of the muscle can occur when the muscle is poorly conditioned or overworked. The ligaments of the low back act to interconnect the five vertebral bones and provide support or stability for the low back. A sprain of the low back can occur when a sudden, forceful movement injures a ligament which has become stiff or weak through poor conditioning or overuse.

These injuries, or sprain and strain, are the most common causes of low back pain. Frequently, a combination of other factors may increase the likelihood of injury or disease:

• poor conditioning
  
• prolonged sitting
  
• obesity
  
• smoking
  
• incomplete healing of past injuries
  
• poor posture
  
• improper ergonomics
  
• excessive repetitive torsal motions
  
• auto or work accidents
  
• congenital weaknesses

The natural effects of normal aging on the body, in general, and low back, in particular, are osteoporosis or decreased amount of bone; decrease in strength and elasticity of muscles; and decrease in elasticity and strength of ligaments. Although you cannot totally halt the progress of these effects, they can be slowed by regular exercise, knowing the proper way to lift and move objects, proper nutrition, and avoidance of smoking.

Age - "Wear and tear" and inherited factors will cause degenerative changes in the disks, called degenerative disk disease, and arthritic changes in the small joints. These changes occur to some degree in everyone. When severe, they can cause low back stiffness and pain. Arthritic bone spurs and inflamed joints can cause nerve irritation and leg pain. Almost everyone develops "wear and tear" changes in their low back as they age, although for most people it causes little pain or loss of function.