|
|
|
|
|
|
|
Low Back Pain - Overview
Approximately half a million people are afflicted with back pain in the
United States. The causes of back pain are many and thus they can be
difficult to diagnose. The most
common cause of chronic back pain (pain that never quite goes away) is
degenerative disc disease at the lumbar spine.
Although most back pain can be managed with non-surgical treatment, there
are more than 1 million spinal surgeries performed for the treatment of
degenerative spinal disorders. Although the vast majority of individuals
suffering from back pain will fully recover within 1 month (90%), low back
pain may also be chronic and leads to long-term disability.
Back problems are one of the most common ailments affecting adults in the
United States. In any given year, 50% of the working population will
experience back pain, with 80% reporting low back pain at some time during
their lifetime.
Low Back Pain - Anatomy and Function
Understanding the fundamental anatomy and function of the spine is key to
understanding injuries and diseases of the spine. The spine has several
special roles in the human body:
1. Protects the spinal cord
2. Provides the support needed to walk upright
3. Enables the torso to bend
4. Supports the head
Sections of the Spine
 Cervical
- commonly referred to as the neck. There are seven cervical vertebrae
(doughnut-shaped bones) that connect the skull to the rest of the spine.
Thoracic - The spine's thoracic section begins at the shoulders and
extends down to the end of the rib cage. There are 12 vertebrae in the upper
back, with shock-absorbing discs between them. Scoliosis commonly affects
the thoracic section of the spine.
Lumbar - The lumbar section, or low back, has five vertebrae. These
vertebrae, separated by discs, are the largest in the spine. Degeneration
most often occurs in the lumbar section, usually at the lower discs. In
addition, the facet joints can become arthritic, causing pain.
Sacrum - Five vertebrae join together to form the sacrum, a
wedge-shaped part of the spine that forms part of the pelvis. The sacrum
joins the rest of the pelvic bone at the sacroiliac joint, which can become
inflamed causing sacroiliitis.
Coccyx - often referred to as the tailbone, consists of four
vertebrae.
Vertebrae - The spine has 33 doughnut-shaped bones called vertebrae.
Each vertebra is assigned a letter and a number that identifies its location
in the spine. When someone has osteoporosis, minor trauma can cause these
bones to fracture.
Discs - Between each pair of vertebrae is a disc made of spongy
cartilage. Intervertebral discs act as shock-absorbing cushions between the
vertebrae. When the disc degenerates, it can be pushed posteriorly, causing
disc herniation.
Causes of Low Back Pain
Any part of the low back's
complex system (vertebrae, discs, nerves, facet joints and muscles) can
become a source of pain, as can nearby structures. The following are some
causes of low back pain:
-
Muscle or ligament strain
-
Degenerative joint disease
(facet joints)
-
Disk disease (herniation)
-
Spinal stenosis (spinal canal
is too tight)
-
Spondylolisthesis (vertebral
bodies are out of alignment)
-
Osteoporosis with compression
fracture
-
Cancer
-
Infection
-
Organ-related pain
Back Pain and Herniated Discs
A herniated disc occurs when a fragment of the inner gel-like substance,
called the nucleus, is pushed out of the outer disc margin, into the spinal
canal through a tear or rupture. In the herniated disc's new position, the
disc presses on a spinal nerve, producing pain going down the corresponding
leg.
Disc herniations are a common cause of low back pain and leg pain
(sciatica). Symptoms may include dull or sharp pain, muscle spasm or
cramping, sciatica, and leg weakness or loss of leg function. Sneezing,
coughing, or bending over usually intensifies the pain. A herniation may
develop suddenly or gradually over weeks or months.
Disc herniation, rupture, protrusion, and extrusion are all terms that
describe this injury. There are subtle differences between these terms, but
they all refer to a tear in the outer ring, which allows some of the inner
core to escape.
Why does a disc get herniated? As you grow older, your discs become flatter
and less cushiony. If a disc becomes too weak, the outer part may tear. The
inside part of the disc pushes through the tear and presses on the nerves
beside it. Herniated discs are most common in people in their 40s and 50s.
What are the signs of a herniated disc? When part of a disc presses on a
nerve, it can cause pain in both the back and the legs. The location of the
pain depends on which disc is herniated and which nerve is affected. In most
people with a herniated disc, the pain spreads over the buttocks and goes
down the back of one thigh and into the calf. Some people have pain in both
legs. Sometimes legs or feet feel numb or tingly..
Self Preventive Measures to Reduce Low Back Pain
Lifting - With your feet shoulder-width apart, bend at the hips and
knees. Grip the load firmly and hold it close to your body, tighten your
stomach muscles and use the strong muscles of your legs to lift. Keep your
back as straight as possible. Avoid twisting - turn by using your feet, not
your back.
Posture - Think tall: chest lifted, shoulders relaxed, chin tucked in
and head level. Posture should be stable, balanced and relaxed when sitting,
walking or standing.
Sitting - Don't stay seated for too long - stand up, stretch and walk
around. The right back support will also help
Exercise - Stay in shape - healthy body-weight is less strain on your
back. Your physiotherapist can show you how to keep your back flexible and
strong with correct back and abdominal exercises.
Driving - Good support from your car seat will prevent back pain. If
you need more low back support, use a lumbar roll or a rolled-up towel.
Sleeping - Your mattress should be firm enough to support your
natural shape.
Overweight - Your spine carries your bodyweight. the lower portion of
the lumbar spine carries the abdominal weight.. Losing weight will reduce
back pain.
|
|
|
