Almost everyone will have low back discomfort at some point in life. The intensity ranges from minor to severe and can be temporary or permanent.
To comprehend the causes and available treatments, one must be familiar with the anatomy of the spine. The spine comprises tiny bones, muscles, ligaments, nerves, and intervertebral discs. The muscles and ligaments support the bones, while the intervertebral discs cushion the spine, allowing for varied motions and stresses.
Lower back pain is the most common pain practically experienced by everyone, but not every lower back pain is severe. Many of them can be managed by simple corrections in diet and exercise, and proper posture maintained in daily routines.
This blog will discuss different aspects of lower back pain and its management
Anatomy
When we talk about back pain, it's essential to know the anatomy of the entire spine.
The spine is divided into four sections: cervical, thoracic, lumbar, and sacral. Small bones called vertebrae total 33, maintained by muscles and ligaments.
The first 7 spine bones are the cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral, and a coccyx at the end.
The inherent stability of the back comes from the bony column, also called the vertebral column. The muscles and ligaments make the bony column stronger.
Back pain varies from person to person. The discomfort may appear gradually or unexpectedly the pain might be intermittent or continuous.
Types of Back pain
Classified as per the anatomy or structural location into the following categories:
1. Upper back pain — comprises the neck and the shoulder
2. Mid-back pain — Thoracic region pain, which is relatively uncommon
3. Lumbar back pain/lower back pain — pain around the flank and the waist area.
Upper and lower back pain are the most common pains we encounter daily.
Lower back pain is further classified into two types
Organic
Inorganic
If we distribute the lower back pain — it's 20% organic and 80% inorganic. So essentially, it becomes imperative to understand and correct the inorganic lower back and stay fit, contributing to the healthcare system.
Organic pain arises from any structural change in the vertebral column, like vertebral fractures, ligaments, rise structures, or small joints called facetal joints of the vertebral column.
Inorganic back pain essentially means pain arising from faulty postures like popped shoulders, round backs, and slouching—poor ergonomics during daily activities at home or office.
When working from home, the posture that the majority of us assume is not appropriate. It's essential to keep your posture proper and work sitting on a chair and table where the height of the table is standard.
Lack of exercise leads to weak vertebral column muscles, putting strains on them, and a deficiency of specific vitamins contributes to lower back pain. The deficiencies have become rampant due to our lifestyles, like closed doors, working, no sunlight exposure, and dietary habits comprising processed and packaged food.
Deficiencies lead to muscle fatigue and affect posture poor posture causes back pain and further exhaustion. This vicious cycle needs to be broken through the corrective measures discussed above.
Structural or organic pain causes the following conditions.
1. Disk Damage
Intervertebral disc damage can cause chronic lower back pain that does not resolve after a few days. The reasons for wear and tear of the disk, age, and small tears to the outer region of the disc (annulus) can form.
It is unclear why some people experience discomfort while others do not. Some people who suffer from disc herniation have no discomfort, while others may feel the pain for weeks, months, or even years. A tiny proportion of people may experience chronic pain that lasts for years and is very debilitating.
Let's look at some of the conditions that cause discomfort in the lower back:
2. Disk herniation
When a disc's jelly-like core (nucleus)(central portion) presses against the annulus (peripheral portion), it herniates out and pushes the exiting nerves, causing pain in the back and lower limbs in the form of radiating and excruciating pain, along with tingling and numbness.
3. Sciatica
A herniated disc in the lumbar back frequently places pressure on the leg and foot nerve roots. Discomfort in the buttock and down the leg is also known as sciatica. Classically felt as excruciating pain in either of the legs with tingling and numbness with difficulty in movements. Lifting, tugging, bending, or twisting actions are common causes of disc herniation.
4. Disk deterioration
Intervertebral discs begin to wear away and decrease in height as we age. They may collapse entirely in some instances, causing the facet joints—the tiny joints placed between each vertebra on the back of the spine—to rub against each other, leading to pain and stiffness and causing arthritis of the facetal joints. It has also been discovered that smoking hastened disc deterioration.
5. Osteoarthritis
This deterioration of the facet joints is known as osteoarthritis, also called facet arthritis, which causes lower back pain.
6. Spondylolisthesis
Age and regular wear and tear make it difficult for your joints and ligaments to maintain proper spinal posture. The bones will slip, and they may begin to press against the spinal nerves.
7. Stenosis of the Spine
The space around the spinal cord reduces and puts pressure on the line and nerves. When the intervertebral discs collapse and osteoarthritis develops, your body may respond by forming new bone (arthritis) in the facet joints to help maintain the vertebrae.
This bone overgrowth (called spurs) can cause spinal canal narrowing over time. Osteoarthritis can also cause the ligaments that link the vertebrae to thicken, causing the spinal canal to shrink.
8. Scoliosis
Scoliosis is a spine abnormality that affects children. It can also occur in elderly people with arthritis. This spinal malformation may cause back discomfort, pain, paralysis, or numbness in the legs if nerves are compressed.
9. Fracture of Compression
Back discomfort in the elderly is frequently caused by vertebral compression fractures. Our bones get weaker and more prone to breaking as we age, a disease known as osteoporosis. For those with osteoporosis, minor trauma, such as sitting firmly on a hard chair or toilet, or a ground-level fall, can cause bones in the spine to shatter, resulting in acute back discomfort when moving.
Treatment of Lower Back Pain
There are three treatment options for low back pain medications, physical therapy, and surgery.
1. Medications
Expert doctors may prescribe a variety of drugs to alleviate your discomfort. Acetaminophen is a pain reliever with few adverse effects. Steroids are anti-inflammatory medications that can be taken either orally or injected into your spine. They can, however, cause drowsiness. So, if you're using muscle relaxants, don't drive or do anything else that requires you to be awake.
2. Physical therapy
Low back discomfort can be incapacitating. Exercising to restore mobility and strength to the lower back can be beneficial for pain relief. Combining medications and therapies can give you enough pain relief. Non-surgical invasions like heat, cold, massage, ultrasound, and electrical stimulation can all be used in physical therapy. Stretching, weight lifting, and cardiovascular workouts are part of active therapy. Chiropractic or manipulation therapy also comes in many cases.
3. Surgical Intervention
All non-surgical therapy alternatives have been exhausted. Before considering surgery, it is advised to attempt non-surgical treatments for six months to a year. Even though they are in severe pain and other therapies have failed, some people are not surgical candidates. Surgery cannot be used to treat chronic low back pain—a spine fusion. Spinal fusion is fundamentally a welding procedure. The central concept is to fuse the sore vertebrae so that they recover into a single, solid bone.
Few essential pointers that may help prevent lower back pain
1. Use proper posture
Good posture is essential for avoiding future problems. A therapist can teach you how to safely stand, sit, and lift.
2. Lower back pain: best sleep position
You can relieve back pain by making minor modifications to your sleeping posture. Draw your legs closer to your chest and place a cushion between your legs if you sleep on your side. If you like, use a full-length body pillow.
3. Lower back pain from pregnancy
Pain on one side of the lower and mid-back, either right or left. These symptoms may manifest as a dull ache or a severe, scorching pain in the lower back. Lower back pain symptoms might appear at any stage of pregnancy.
4. Yoga lowers back pain.
Pose with a Bow (Floor) When done correctly, the bow pose is a beautiful way to train your glutes, stretch your shoulders, chest, and thighs, and expand your heart. However, this position is too strenuous for people with sensitive backs or back problems.
5. Lower back pain exercises
Stretching concentrated back and abdominal strengthening are two of the most effective methods for relieving lower back pain. Powerful abdominal and hip flexor muscles aid in posture improvement, and vital glutes aid back support during walking, standing, and sitting. Muscles that are adequately stretched assist with movement.
Final Takeway
Fixing lower back pain is not as difficult as it feels lower back discomfort usually improves with all the treatments elaborated in the paragraphs above. You are most welcome to get in touch with me for any questions related to orthopaedic concerns. info@polarishealthcare.com
About The Author: Dr. Surendra Patil
Dr. Surendra Patil, MBBS, Diploma in Orthopaedics, DNB - Orthopedics Surgery, is a dynamic surgeon with skilled hands well versed in various surgical procedures in orthopedics and exceptionally well-read in his chosen expertise. He is proficient in Arthroscopic Surgeries, Adult Joint Reconstruction Surgery, Accidents & Emergencies, Joint Replacement, Healthcare Management, and Healthcare in general. He is an experienced Medical Professional with a demonstrated history of working in the hospital & healthcare industry.