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Low Back Pain


 

DESCRIPTION

Over 80% of the population will suffer from lower back pain during their lives.

Most cases of lower back pain can be linked to a general cause—such as muscle strain, injury, or overuse—or can be attributed to a specific condition of the spine.


SYMPTOMS

Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowly—possibly coming and going—and gradually get worse over time.

Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example:

  • Pain that is dull or achy, contained to the low back
  • Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica)
  • Muscle spasms and tightness in the low back, pelvis, and hips
  • Pain that worsens after prolonged sitting or standing
  • Difficulty standing up straight, walking, or going from standing to sitting


CAUSES

Most commonly, mechanical issues and soft-tissue injuries are the cause of low back pain. These injuries can include damage to the intervertebral discs, compression of nerve roots, and improper movement of the spinal joints.The single most common cause of lower back pain is a torn or pulled muscle and/or ligament.

  • Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.
  • Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.

Common causes of sprain and strain include:

  • Lifting a heavy object, or twisting the spine while lifting
  • Sudden movements that place too much stress on the low back, such as a fall
  • Poor posture over time
  • Sports injuries, especially in sports that involve twisting or large forces of impact


POSSIBLE TREATMENT OPTIONS

The goal of medical treatments is to reduce pain, but these treatments do not change the underlying source of pain. A doctor will typically prescribe medical treatments alongside a physical therapy program or other regimen.

Common medical treatments include:

Muscle relaxants. This medication acts as a depressant of the central nervous system and increases mobility of tense muscles, relieving pain from muscle tightness or spasms. Muscle relaxants have no role in chronic pain management.

Narcotic pain medications. Narcotic medications, also called opioids or painkillers, alter one’s perception of pain by weakening signals sent to the brain. Narcotic medications are most often used for treating intense, short-term pain, such as acute pain after an operation. Narcotics are rarely used to treat long-term pain, as they have many side effects and can easily become addictive.

Back braces. Some patients find that a back brace can be used to provide comfort and possibly reduce pain. There is some evidence that use of an inelastic corset-style brace, worn daily, in combination with a physical therapy exercise program, can speed healing and reduce pain.2 A back brace may also be helpful after back surgery

Epidural steroid injections. This injection involves a steroid administered directly into the outer part of the dural sac, which surrounds the spinal cord. A live x-ray, called fluoroscopy, is used to guide the needle to the correct area. The goal of the injection is to temporarily relieve pain by reducing inflammation around a compressed nerve root.

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