LOW BACK PAIN

What’s Low Back Pain?

The lumbar spine, also known as the low back, involves a complex system made up of interconnected bones, joints, nerves, ligaments, and muscles that all work together to provide stability, strength, and flexibility (Suzuki et al., 2016). This complicated anatomy, however, makes the low back vulnerable to damage and discomfort. Low back pain (LBP), also known as lumbago, refers to a common condition that affects the muscles, nerves, and bones of the back, between the bottom border of the ribcage and the lower fold of the buttocks. Pain can range from a faint aching to a strong stabbing sensation. Based on the duration, the classification of low back pain includes acute (lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (lasting more than 12 weeks) (Yan et al., 2021). The underlying cause of the condition includes mechanical cause, non-mechanical cause, or referred pain. Low back pain symptoms normally improve within a few weeks after onset, with 40–90 percent of patients fully healed by six weeks. This low back pain refers to the most prevalent cause of job-related impairment. Low back pain will affect a minimum of 80% of Americans at some point during their lives.

What’s the Common Signs and Symptoms of Low Back Pain?

The most prevalent symptom of acute low back pain includes discomfort that comes after lifting, twisting, or forward-bending. The symptoms may develop shortly after the motions or when people wake up the next morning. The symptoms might range from localized soreness to widespread pain. Certain actions, such as elevating a leg, or postures, such as sitting or standing, may or may not make it worse. Sciatica (pain radiating down the legs) may occur. Depending on the underlying cause, the symptoms of low back pain may range from muscle spasms, severe back pain, burning sensations in lower back, difficulty standing, etc.

A large number of underlying problems can cause low back pain in people. The majority of low back pain occurs due to muscle sprains or strains, vertebral disc injury, herniated discs, spinal fracture, sciatica, abnormal spine curvature, spinal stenosis, arthritis, fibromyalgia, spondylitis, spondylosis, etc. Several risk factors of this condition include obesity, stress, poor posture, poor sleeping position, etc. Most people will first suffer severe low back pain between the ages of 20 and 40, (Zaina, Balagué, Battié, Karppinen, & Negrini, 2020). More than half of patients experience recurrent episodes, which causes more pain than the first. Lower back pain usually occurs alongside other issues, such as sleep problems. Patients with low back pain may experience sleep disruption, take a longer time to fall asleep, feel less rested, shorter sleep times, etc. Furthermore, the majority of people suffering from chronic low back pain develop depression or anxiety symptoms.

How Do Spinal Specialists Diagnose Low Back Pain?

Initial diagnosis of low back pain includes a brief medical history and complete physical examination of patients by a neurosurgeon in the clinic. Physical examination includes identifying the degree, severity, and location of pain. Neurosurgeons will also check the reflexes and nervous sensation of the patient. Neurosurgeons will monitor the patient for at least 2 weeks to observe the symptoms. Usually, self treatment can resolve most of the lower back pain cases. To diagnose the further causes of low back pain, neurosurgeons will perform imaging tests such as X-rays, CT scan, MRIs, etc. to see the condition of bone, disc, or ligaments. For special cases, neurosurgeons also recommend a bone scan or bone density test. Sometimes, neurosurgeons conduct electromyography (EMG) or nerve conduction tests to identify any problems with the nerves (Vujcic et al., 2018).

How Do Spinal Specialists Treat Low Back Pain?

Treatment procedure of low back pain include both surgical and non-surgical options. The primary goal of treating this condition includes reducing the pain and correcting the underlying cause of it. Most people with mild pain require no treatment and gradually improve over time. However, the treatment options may include (Loney & Stratford, 1999):

• Physical management: Increasing general physical activity can improve the patient’s condition. Exercise helps to improve a patient’s physical function, strengthens trunk muscles and mental health for patients with chronic low back pain.
• Medications: Certain medications such as muscle relaxants, nonsteroidal anti-inflammatory drugs (NSAIDs), narcotic drugs such as codeine, etc. help to relieve pain and improve patient condition. Antidepressants also help to treat chronic pain associated with symptoms of depression.
• Injections: Corticosteroid injections help to alleviate the inflammation and relief of pain.

If the above options fail, neurosurgeons recommend surgery for chronic low back pain. Neurosurgeons can offer different surgical options, such as spinal fusion, discectomy, foraminotomy, spinal decompression surgery, etc., based on the underlying cause of the patient’s condition. For more information, please contact us.

References

Loney, P. L., & Stratford, P. W. (1999). The prevalence of low back pain in adults: A methodological review of the literature. Physical Therapy, 79(4), 384–396. https://doi.org/10.1093/ptj/79.4.384

Suzuki, H., Kanchiku, T., Imajo, Y., Yoshida, Y., Nishida, N., & Taguchi, T. (2016). Diagnosis and characters of non-specific low back pain in Japan: The Yamaguchi low back pain study. PLoS ONE, 11(8), 1–13. https://doi.org/10.1371/journal.pone.0160454

Vujcic, I., Stojilovic, N., Dubljanin, E., Ladjevic, N., Ladjevic, I., & Sipetic-Grujicic, S. (2018). Low Back Pain among Medical Students in Belgrade (Serbia): A Cross-Sectional Study. Pain Research and Management, 2018. https://doi.org/10.1155/2018/8317906

Yan, W., Yu, Y., Wang, Y., Jiang, X., Wan, R., Ji, C., … Wang, Y. (2021). Research relating to low back pain and physical activity reported over the period of 2000–2020. Journal of Pain Research, 14(July), 2513–2528. https://doi.org/10.2147/JPR.S312614

Zaina, F., Balagué, F., Battié, M., Karppinen, J., & Negrini, S. (2020). Low back pain rehabilitation in 2020: New frontiers and old limits of our understanding. European Journal of Physical and Rehabilitation Medicine, 56(2), 212–219. https://doi.org/10.23736/S1973-9087.20.06257-7