People have asked a lot of questions about low back pain such as:
How do I deal with lower back pain?
What are the reasons for lower back pain?
What should i know about low back pain?
How big problem is lower back pain?
Lets take some time to talk about this problem. We will look at some
stretches for lower back pain, lower back pain causes, lower back pain relief,
exercises for lower back pain treatment, diagnosis and so on
Why It Hurts
In low back pain, every structure in the spine and around the spine can hurt.
Low back pain is very is common. 80% of the general population will experience low back pain, but only two to 3% will have Sciatica
means the pain is shooting down the leg and the foot.
Cause Of low Back Pain
No specific cause of low back pain is identified. In the majority of cases, up to 80% of the time, you will not find a cause for acute low back pain.
Low back pain is the primary cause of disability in people younger than 50 years old.
So what are the factors that contribute to low back pain?
Factors Contributing To Low Back Pain
Why is one person hurting more than the other person?
What makes you experience low back pain?
So what are these factors that contribute to low back pain?
Certain occupations that involve lifting heavy objects and continuous vibrations, Operating certain motor vehicles, Prolonged setting
lifestyle and social factors like sedentary lifestyle can cause low back pain.
- Lack of fitness
some people live day in and day out and do not do exercise. regular exercise is very important to preventing or even eradicating low back pain.
Smoking interfere with the blood supply to the Intervertebral disc, which is important in the stability and motion of the spine. Nicotine, a major composition of smoking causes disk degeneration,
In most cases, there are some persons who are suffering for depression can experience low back pain since they are often insensitive to there body system.
Another cause of back pain is obesity. Due to the weight gain by obese persons, this can result to low back pain.
Types Of Back Pain
There are two types of low back pain. they are acute and chronic back pain. The natural history, the treatment and the prognosis is different for each of them.
Acute And Chronic Low Back Pain
Acute low back pain lasts up to twelve weeks. Chronic back pain on the other hand lasts longer than twelve weeks and can recur.
Most of the patients with acute low back pain recover quickly without any residual loss of function. 90% of patients with acute low back pain return to work within twelve weeks. But after twelve weeks of symptoms, the return to work is very slow.
Sources Of Low Back Pain
The potential painful sources of low back pain will include the intervertebral discs, the facet joints, the vertebrae, the nerves, the muscles, the ligaments and these are the causes of low back pain. You can have spinal causes and you can have non spinal causes.
What are the primary causes of low back pain? It can be muscle or ligament strain. It can be disconnected from an annular tear.
Low back pain is known to be caused by disorders of the intervertebral disc. So what is an annual tear?
What Is An Annual Tear
The spine has intervertebral discs between the vertebrae and the disc is made of an inner gelatinous soft part called the nucleus bulbous, which distributes the load that comes across the spine. And there is a strong outer fibrous layer called the annulus fibrosis. The Nucleus pulposus have high water content and high protein. It is like a sponge that absorb the water.
In the third decade of life, the Nucleus pulposus gradually will have less water and the concentration
of the protubly will decline. When there is a decrease in the water content, for example, by age or decrease of the protubly
content that absorbs this water, there will be degeneration of the disk, distortion of its fibers, tears in its lemony and loss of the disc height.
Why does it occur? Because the nucleus pulposus which usually works as a cushion to distribute the load is now
unable to distribute the load, so this will lead to more load outside at the periphery, causing tears at the endless fibrosis.
Why Obesity Leads To Low Back Pain
For people suffering for obesity, all the body weight is transmitted over the gelatinous soft nucleus pulposus and that definitely will affect the mechanical behavior, the deformation, the iron transport and the hydraulic changes inside the nucleus pulposus. It seems like the hydraulic pressure inside the nucleus pulposus has to shift when it can bear the weight and the load to the peripheral fibrosis, the strong structure will increase and that can tear the annulus fibrosis and the condition will become painful.
The annual tear may cause low back pain even without sciatica or Radiculopathy, which is pain shooting down the leg because the pain receptors are found on the outer aneurysm and the posterior logitechinal ligament, which is next to it. The poster lateral corner of the annuals is the most susceptible to tear, usually due to flexion and rotation or torsional stresses, so that annular tear may be the beginning of discharging it or degeneration. When there is a tear in the annulus, the disc can herniate through the tears. There are the types of herniation.
Types of herniation.
It can be a bows or protrusion, or it can be extrusion that the hernated disk is through the endless fibroses, or it can be sequestered complete displacement with free disc fragments. Most of the time the patient will have Radiculopathy or sciatica with leg pain, which is greater
than the back pain, and that leg pain can resolve with time. The pain is worse with sitting, sneezing, coughing, leaning forward, and the pain is less by resting and by lying.
The herniated disc may affect the nerve roots. For example, if it is a postulateral discharniation between L four and L five, that will affect
the L five nerve root and this will cause decreased sensation on the top of the foot. Most common location of disc herniation at Elf La Graze will be positive.
Other causes of low back pain
Another cause of low back pain is discognic pain. There will be disc changes, but not disc herniation. The patient will have more back pain than leg pain. The low back pain can also be due to arthritis of defacet joints, spinal stenosis due to narrowing of the spinal canal framing or both spondylothesis, which is slipped vertebrae.
In general, for most patient with short term history of activity related back pain, to the manage this pain will usually require reassurance, nonsteroidal, anti-inflammatory physiotherapy. There’s no need to get an X ray or an MRI in the early stages of acute low back pain.
There are other causes of low back pain that arises from the spine, such as segmental instability, infection, dyscotis and osteomyelitis, primary or secondary tumor, multiple myeloma or for a patient with osteoporosis and osteoporotic fracture.
There might be also inflammatory diseases of the spine such as enclosing spondylitis rituals syndrome rheumatoid arthritis. There are causes from lower back pain that arises from the muscular skeletal system, such as hep arthritis, or have diseases sickly, ilia, joint and pyriformis syndrome. All these conditions can cause symptoms that mimic low back pain. There are also extra spinal causes of back pain such as renal stones, urinary tract infection and paleonthritis judinal ulcer, abdominal or thoracic aneurysm pelvic inflammatory disease.
Understanding the cause of low back pain at the molecular and genetic level is not that easy. Cytokines such as matrix metalloproteinases and phospholipases, a two nitric oxide and tumor necrosis factor alpha, can contribute to the development of low back pain. There are chemical mediators drugs and therapy being developed to modulate the effect of these mediators. There is an evidence that there is increased activity and production of the cytokines, so anti inflammatory medication may be helpful. Recent research on growth factors and gene therapy appear to be promising.
Thank you very much.
I hope that was helpful.
Dr Terry here.