Back pain is one of the most common health complaints. Especially lower back pain, which can go beyond discomfort to have a profoundly negative impact on your overall quality of life. In some cases, it can even lead to mobility problems and prevent you from working in your chosen profession.
The lumbar spine, of the lower back, is made up of a variety of bones, joints, connective tissues, nerves, and muscles that all work together in synergy to help support the upper body as well as transmit nerve signals from the brain to the lower body.
Causes of Lower Back Pain
There are several common causes of lower back pain, as well as some less common, though just as serious issues that can cause lumbar discomfort. This includes mechanical injuries as well as soft tissue injuries and inflammation issues. Damage and deterioration of the intervertebral discs, compression of nerves in the lower back, and dysfunction of the lumbar joints can also cause increasing problems with lower back pain.
Minor Mechanical Causes Of Lower Back Pain & Treatment
Muscle Strain and Ligament Sprains
They can cause damage or inflammation that affects the connective tissues and ligaments in the lower back. This might be the result of a strain from lifting a heavy object incorrectly or the result of a fall.
Often includes rest and practicing overall good posture to help damaged tissues knit. Over the counter anti-inflammatory medications, basic stretches and warm compresses might also help speed the recovery process. If you don’t see relative progress within a week to 10 days, you should consider scheduling an appointment with a physician who can help further diagnose and develop an effective treatment plan. This might include a chiropractic adjustment or physical therapy.
Slouching or other poor posture habits can apply chronic undue pressure on joints and connective tissues. Over time this can lead to inflammation issues and muscle discomfort. This often manifests as soreness below the rib cage that is relieved by moving or changing position.
Improving your overall posture is the first step in any effective treatment plan. A standing desk or setting aside time to take a walk and stretch might also help alleviate symptoms.
Sports injuries, especially in sports that involve twisting or large forces of impact. While sprains and strains do not sound serious and do not typically cause long-lasting pain, acute pain can be quite severe.
Common Causes Of Chronic Lower Back Pain
Chronic lower back pain can have a significant negative impact on your quality of life, affect your mobility, or prevent you from working.
A Lumbar Herniated Disc
Each of the vertebrae in your spinal column is buffered by a cartilage disc with a jelly-like center. If this disc is damaged or displaced it can easily irritate a nearby nerve root and cause severe inflammation as well as potential nerve compression. The herniated portion of the disc is full of proteins that cause inflammation when they reach a nerve root, and inflammation, as well as nerve compression, causes nerve root pain. The disc wall is also richly supplied by nerve fibers, and a tear through the wall can cause severe pain.
Symptoms Of A Lumbar Herniated Disk
- Continuous or intermittent back pain. …
- Back spasms
- Sciatica discomfort that starts near the back or buttocks before radiating down the leg.
- Muscle weakness in the legs
- Persistent numbness in lower extremities, calf or foot
- Decreased reflexes in lower body joints
Treatment For A Lumbar Herniated Disk
The severity of the symptoms and the associated effect on the surrounding nerves or soft tissues will factor into the treatment plan for a herniated lumbar disk. This is typically not the sort of lower back problem that takes well to exclusive self-care. The recovery process from a lumbar herniated disk will be faster under the supervised care of a licensed physician.
This might include the use of over-the-counter or prescription anti-inflammatory medications. In some cases, a chiropractic adjustment, traction therapy, or rehabilitative exercises may be needed to help realign a herniated disc and reduce symptoms. If inflammation is causing complications and discomfort during the rehabilitation process, steroidal injections may need to be administered.
In a severe case, spinal surgery may be needed to address one or more herniated lumbar disks.
Degenerative Disc Disease
This is a condition that typically occurs with age. As the years go by the discs buffering your vertebrae tend to lose a miniscule amount of hydration. With time they can grow stiffer and potentially start to wear down. This can lead to recurring problems with herniated discs, collapsed discs and may also exacerbate other conditions like spinal stenosis.
Symptoms & Treatment For The Stages Of Degenerative Disc Disease
Degenerative disc disease has four stages. Each comes with increased pain, as well as mobility issues. The treatment plan can vary depending on the stage of the degenerative disc disease.
Degenerative Disc Disease Stage One
This is usually associated with everyday wear and tear on the lower spine and lumbar joints. It sometimes manifests as an acute backpack and spinal discs can sometimes herniate, tear, lose fluid, and gradually become less flexible. Many of the treatment plans for stage one degenerative disc disease are similar to treating a herniated disc.
Degenerative Disc Disease Stage Two
Is characterized by increased periods of relative instability in the affected segment of the lumbar spine. It often includes intermittent periods of back pain. Many people with stage two degenerative disc disease lose a little height due to thinning and compression of the vertebral discs. Though at stage two there is no appreciable bone loss, damage, or spinal changes.
Treatment of stage two degenerative disc disease often includes physical therapy and the use of prescription pain medication. Targeted steroid injections may be needed to reduce localized inflammation and help improve flexibility.
Degenerative Disc Disease Stage Three
This is the point where changes begin to develop in the vertebral bones of the lumbar spine. This includes painful bone spurs, as well as pressure on the spinal cord, which can result in muscle weakness and numbness.
During stage three, you will begin to have bony changes in your spine. Bony spurs may develop at the edge of your vertebrae, which can put painful pressure on the spinal cord. Stage three also brings further disc thinning.
Treatment of stage three degenerative disc disease includes physical therapy, weight loss, and prescription medications to help ease discomfort or inflammation issues. Stage three treatment strategies might also include injecting the joints next to the damaged disc with steroids or local anesthetic.
Stage Four Degenerative Disc Disease
This is the most severe form of degenerative disc disease. At this point, the individual has minimal disc material remaining. There are typically significant bony changes of the vertebrae and the vertebrae may be almost bone on bone due to the reduced thickness of the spinal discs.
Treatment of stage four degenerative disc disease might include disc replacement surgery or vertebral fusion surgery to essentially lock the joints in place.
Facet Joint Dysfunction
Each lumbar vertebral joint has two facets behind the disc at each motion segment. Each of these joints has a small amount of cartilage between the bones and they are enveloped by a capsular ligament, that is densely innervated by nerves. When there is a problem with a disc, these joints can also experience discomfort and exacerbate the pain. This is even more likely to be a complication of degenerative disc disease.
Sacroiliac joint dysfunction. The sacroiliac joint connects the sacrum at the bottom of the spine to each side of the pelvis. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The sacroiliac joint can become painful if it becomes inflamed (sacroiliitis) or if there is too much or too little motion of the joint.
Spinal stenosis is a condition where the spinal canal continues to narrow near the nerve roots. It can occur in the central, formal, or both areas of the spinal canal at a single level or multiple levels in the lumbar region of the spine. Symptoms often include pain in the lower back, a burning pain that radiates to the buttocks and down into the legs similar to sciatica. As spinal stenosis progresses the individual might experience numbness, tingling, cramping, or weakness in the legs as well as a loss of sensation in the feet. In its most severe stages, a spinal stenosis sufferer might experience “Foot Drop” that causes their foot to slap down when walking.
Treating spinal stenosis in the early stages often involves prescription pain medications and physical therapy. Severe cases of spinal stenosis might need laminectomy surgery. This is a significant surgical procedure that removes more bone, and may also be performed in conjunction with spinal fusion to limit the movement of the spine.
Spondylolisthesis occurs when one vertebra essentially slips over the adjacent one and may defect or fracture of the pars of the facet joints. This can also cause mechanical instability of the facet joints. With Spondylolisthesis the pain is typically intense, and instability can affect mobility. In some severe cases, compression of the nerves can lead to numbness and weakness in the legs.
Treating a minor to moderate case of spondylolisthesis might call for wearing a back brace, doing physical therapy exercises, and over-the-counter or prescription medications to manage pain and inflammation. In a severe case, surgical intervention might be required. A facetectomy to remove the Gill fragments causing nerve compression.
Lumbar osteoarthritis results from wear and tear of the disc and facet joints. As it progresses, the individual will often experience complications from inflammation, instability, and stenosis. Spinal osteoarthritis is associated with aging and is generally progressive. As time goes on it can lead to a deformity in the spine, pain, and loss of mobility.
Treating lumbar osteoarthritis starts with physical therapy and prescription medications. In a more progressive case of lumbar osteoarthritis, spinal fusion surgery might be needed to stabilize the spine and reduce discomfort.