Over 70% of people will experience low back pain at some point in their life. It presents as anything from mild pain and tightness to completely thrown out and its causes can be simple or serious. The low back is an exceptionally complicated region of the body and despite containing the 5 largest vertebrae of the spine, the low back is still quite susceptible to injury. Similar to injuries in other areas, back pain can develop rapidly after a fall, quick twist or strenuous lift or develop slowly after many years.
Causes of low back pain
The main generators of pain in the low back are the joints of the spine, its inter-vertebral discs, ligaments and surrounding muscles. These can all be injured quickly or slowly over time. The following list will highlight some of the more common injuries.
- Muscle strain: this has a very simple cause effect relationship, your muscles were asked to do more work than they were capable of doing. As a result the muscle develops small tears which decrease its strength, activate pain receptors and leave the muscle susceptible to further injury. Most of those suffering muscle strains will feel increased tension and fatigue in the affected muscle, pain when contracting or stretching that muscle or its surrounding muscles.
- Joint sprain: this has a similar cause effect relationship in that the joint has either been compressed or taken beyond its normal movement range. As a result the surface of the joint can become damaged and the ligament like capsule around the joint can become stretched. Both structures send strong pain signals, especially with further compression or stretch. Those suffering joint sprains often feel sharp pains near the end of the normal movement ranges.
- Disc injury: The intervertbral disc exists between every vertebrae in your spine and act to facilitate and also limit many of the motions of your back. It is made up of two key parts; a jelly like center that acts to distribute forces which is surrounded by a ring of elastic fibres that control the motion of its vertebrae. With prolonged poor posture, especially during strenuous activity the inner jelly begins breaking outwards through the ring of fibres. These fibres are very strong pain generators and can render a person quite disabled when injured. As tearing continues the outer ring can then deform creating a disc bulge, and then finally break through the ring resulting in a disc herniation. Those with disc injuries often experience severe low back or buttock pain and often have pain shooting down their leg like an electric current.
- Dynamic lumbar spine instability: this is a relatively new concept in low back pain where the normal biomechanics of the low back are altered, often at just one vertebrae, during normal motion. This results in a vertebrae being just a couple millimetres out of sync with its neighbours but causing significant joint and muscle stresses. Those with instability often experience a catching sensation with particular movements.
The above recommendation of self-care for low back pain should not replace recommendations from your health care provider or your own judgement regarding your low back pain. If you feel your back pain warrants immediate care you should seek immediate care. The above information is meant to provide general information and not a specific directions to treat your low back pain.
1. Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK, Clinical Efficacy Assessment Subcommittee of the American College of Physicians, American College of Physicians, American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007 Oct 2;147(7):478-91.View this paper