Low back pain is an ache or discomfort in the area of the lower part of the back and spinal column. The lower spinal column consists of many small bones that surround and protect the spinal cord and nerves. Low back pain is very common, affecting most adults at some point in their lives.
There are many possible causes for low back pain, including:
These factors increase your chance of developing low back pain. Tell your doctor if you have any of these risk factors:
Pain is usually localized in the low back. It gets worse with back motion, sitting, standing, bending, and twisting. If a nerve is irritated, the pain may extend into the buttock or leg on the affected side, and muscle weakness or numbness may be present. It usually gets better with rest, and there is good bowel and bladder control.
More serious symptoms associated with back pain that may require immediate medical attention include:
Pain that doesn't improve or worsens with rest (even at night) may be an indication of a more serious disease.
The doctor will ask about your symptoms and medical history, and perform a physical exam. In particular, the doctor will examine your back, hips, and legs and usually will test for strength, flexibility, sensation, and reflexes.
Other tests include:
It's important to keep in mind that imaging tests, like CT or MRI scan, may not be helpful immediately after a back injury.
Treatment options include:
Short-term bed rest is not generally recommended in normal individuals. It is only recommended in those with severe debilitating back pain, and for not more that 1-2 days. Movement helps in cases of muscle spasm and to maintain muscle strength.
Your doctor may recommend that you restrict activities for 3-6 weeks, then resume activities as soon as possible.
Only a small number of patients need surgery. It may be needed if nerve problems develop or other treatments fail to provide relief. Common procedures are diskectomy , laminectomy , and spinal fusion .
If you have low back pain, follow your doctor's instructions .
The following steps may help you avoid low back pain:
While some people think that using shoe inserts will prevent back pain, so far there is not a lot of evidence to support this.
RESOURCES:
American Academy of Orthopaedic Surgeons
http://www.aaos.org/
Family Doctor.org
http://www.familydoctor.org/
CANADIAN RESOURCES
Canadian Orthopaedic Association
http://www.coa-aco.org/
Canadian Orthopaedic Foundation
http://www.canorth.org/default.asp/
References:
American Academy of Family Physicians. Management of chronic musculoskeletal pain: focus on low back pain. CME videotape monograph; 1999.
American Association of Neurological Surgeons website. Available at: http://www.aans.org/ . Accessed July 1, 2009.
Back pain. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/back-pain/DS00171/DSECTION=3 . Published February 8, 2008. Accessed July 1, 2009.
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Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am. 2006;88 Suppl 2:21.
Low back pain. The Merck Manual. 17th ed. Whitehouse Station, NJ: Merck; 1999.
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Press release. American Academy of Orthopedic Surgeons. 2006.
9/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Kalus SM, Kornman LH, Quinlivan JA. Managing back pain in pregnancy using a support garment: a randomised trial. BJOG. 2008;115:68-75. Epub 2007 Nov 12.
12/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain. Cochrane Database Syst Rev. 2008;CD001929.
1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Yuan J, Purepong N, Kerr DP, Park J, Bradbury I, McDonough S. Effectiveness of acupuncture for low back pain: a systematic review. Spine. 2008;33:E887-900.
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Last reviewed September 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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