The spine is an extremely complicated structure of bones, muscles, ligaments, and nerves that come together to provide the upper body with support, strength, and flexibility. The lumbar spine, commonly known as the low back, supports the weight of the upper body while also providing mobility for bending, twisting, and flexing. The nerves in the low back allow us to have feeling in our feet, legs, and pelvis.
What causes low back pain?
Lower back pain is known in the medical community as a multifactorial condition, which means that there are several different things that could contribute to the pain. Some factors result in temporary cases of lower back pain, while others lead to chronic pain.
The most common causes of lower back pain are muscle strains and ligament sprains. Muscle strains are a result of a muscle being stretched too far, causing it to tear. Ligament sprains occur when the ligament is overstretched and can become torn. Common causes of sprains and strains include:
- Heavy lifting, or twisting while lifting
- Trauma such as car accident or fall
- Poor posture over a period of time
- Sports injuries that result from large, impactful forces
While sprains and strains do not typically cause long-term pain, the short-term pain can often be quite severe.
Chronic (Long-Term) Causes
Chronic pain is categorized as pain that lasts for more than three months and exceeds the body’s natural healing process. In cases related to the spine, chronic pain is often a result of problems with a disc, joint, or nerve root.
Some common causes of chronic lower back pain include:
- Trauma – Fractures and dislocations of the spine can lead to long-term pain if not medically evaluated.
- Lumbar herniated disc – Occurs when the center of a lumbar disc breaks through the outer layer of the disc and irritates the surrounding nerve root.
- Degenerative disc disease – Causes the intervertebral discs to lose hydration and wear down. As a result, the disc is not able to resist forces as well, making it more likely to tear. The disc may also collapse, which can cause stenosis.
- Facet joint dysfunction – Behind each disc, there are two facet joints. Between these bones, there is cartilage and the bones are also surrounded by ligaments that have lots of nerves.
- Spinal stenosis – Causes the narrowing of the spinal canal where the root nerves are located. This can occur at a single level or multiple levels.
- Osteoarthritis – Results from the wearing down of the disc and facet joints, causing inflammation, pain, instability. This often happens with age and can occur slowly over long periods of time.
- Compression fracture – A fracture of the cylindrical vertebra, where the bone collapses and causes severe pain. This most commonly is due to weak bone structure.
- Scoliosis – while there may not be a cure for scoliosis, chiropractic care can greatly reduce the amount of pain experienced by the afflicted person, while also reducing the curvature of the spine.
Low Back Pain Symptoms
Lower back pain often begins after an injury to the back, causing the pain to go from acute (short-term) to chronic (long-term). Proper diagnosis and treatment early on can reduce pain and time of the symptoms. Lower back pain often includes one or more of the following symptoms:
- Dull, aching pain
- Pain that travels through the buttock, legs, and feet
- Pain after periods of sitting
- Pain that reduces after walking
- Sciatic Pain
Diagnosing Low Back Pain
Identifying the cause of the pain is crucial to getting the treatment needed to reduce pain. In order to get an accurate diagnosis, the doctor will need to get the patient’s information regarding symptoms, activity levels, injuries, posture, and even sleeping habits. After gathering this information, the doctor will then perform a physical examination testing several factors including but not limited to:
- Range of motion
- Leg raise test
- Reflex test
- Neurological exam
In some cases, imaging scans such as x-rays, CT scans, or an MRI may be needed to get a better idea of what may be causing the pain. These can also help the doctor locate exactly where the root cause of the pain is originating.
Treatment for Lower Back Pain
In treating low back pain, one of the first things that we tell our patients is that we do not treat pain. This usually catches the patient off-guard because they are here to get rid of their pain. Of course we will help them with their pain but at the end of the day, we are looking at movement patterns, joint restrictions, nerve interference in the spine and different conditions that are creating a functional deficit which is creating pain in muscles and joints.
Patients respond quite positively to what we do. This is the primary reason why chiropractors are very successful in treating lower back pain conditions. In addition to treating mechanical difficulties and correcting the functional deficits, chiropractors will always talk about other healthy lifestyle changes and other healthy lifestyle habits that can form as a result of their treatment here.
These lifestyle changes such as diet, proper exercise and getting manipulative therapy every now and then will help assure a relatively pain-free life and the ability to maintain your ability to do the things you enjoy doing because in the end, it is not about how long we live but how well we live.