Four out of five adults experience low back pain at some time in their lives. It is one of the top reasons people visit their doctors. Besides the discomfort and impact on quality of life, low back pain causes thousands of hours of missed work each year, interferes with hobbies, and steals time from your family. In addition, it also has the potential to create dependency on prescription pain medications.
If you have ever dealt with low back pain, you know the condition can include a variety of signs and symptoms, including burning, numbness, stabbing/shooting pain, tingling, dull aching—all of which can change over time.
The goal of this article is to help you learn what to do if you experience low back pain, how can it be prevented, and when you should seek medical attention immediately.
Understanding Low Back Pain
Many parts of the back can cause pain, including bone (vertebrae), discs (the cushions between the vertebrae), muscles, ligaments, nerves, and facets (the joints between each of the spinal bones).
Injuries including muscle and ligament strains are often the cause of short-lived low back pain. These can be very painful and often result in temporary limitations in activity. These injuries are also usually improved with rest and by using over-the-counter medications. In most cases, this may be all you need to help your body recover.
Pain that lasts more than 4-6 weeks—even with rest, use of anti-inflammatory medications (e.g., ibuprofen or naproxen), and appropriate physical therapy—generally merits further evaluation by your physician. If your pain lasts more than three months, it is often considered to be chronic low back pain. This is a more complicated situation.
Sciatica and Other Common Causes of Back and Leg Pain
The wide range of low back pain symptoms results from an equally wide variety of causes. Perhaps you suffered a fall or lifted something too heavy. Maybe the chair you sit in at home or work isn’t the best. Perhaps you have a spinal condition or are recovering from surgery. Some of the more common causes of low back pain include:
- Muscular strain or spasm
- Herniated (“slipped”) disc
- Disc degeneration
- Lumbar stenosis, a narrowing of the open spaces in the lower (lumbar) spine
- Vertebral compression fractures
Treatment for Low Back Pain
Just as the causes of low back pain are unique, so are the appropriate treatment strategies to successfully manage it. In other words, treatment should be anything but “cookie-cutter.”
A medical exam and several tests can help your doctor identify the source of your pain, confirm a problem, rule out certain serious conditions, and then determine the best treatment. This might include physical therapy, over-the-counter and possibly prescription medications, massage therapy, chiropractic treatments, relaxation techniques, or acupuncture.
If these treatments are not working, you may be referred to a pain management specialist to consider the possibility of injections. If your condition is serious enough to consider surgery, a spine surgeon would be consulted.
When to Consider Spine Surgery
Surgery is usually reserved for problems in which a nerve is severely pinched, the spinal cord is compressed, or the spine is unstable. Surgery may be recommended (sometimes immediately) if you have back pain accompanied by symptoms of nerve damage. These symptoms may include:
- Pain that radiates down your legs (sciatica) or arms
- Pain, numbness, weakness or tingling in your arms or legs
- Loss of bladder or bowel control
Prevent Low Back Pain Before It Starts
What is the best advice is to avoid low back pain altogether? Here are a few tips:
- Stay physically active: Exercise can help delay or prevent back pain by strengthening the supporting structure of the spine. Walking, stretching and low-impact exercise helps keep muscles strong and flexible. Too much rest leads to stiffness and weakness.
- Lift properly: Lift with your legs, keeping the weight close to your body and avoid bending at the waist to put less strain on your back.
- Practice good posture: Sit up straight and keep your shoulders back when standing.
- Don’t smoke...and if you do, stop. People who smoke are much more likely to develop chronic back pain than those who don’t smoke. Smoking negatively affects the small blood vessels that send nutrients to the discs and joints of the spine.
If you are experiencing back pain that is not getting better, Penn Medicine Lancaster General Health has a comprehensive spine program. You can request an appointment at www.LGHealth.org/Spine.