Low Back Pain

In most cases, mechanical issues and soft-tissue injuries are the main cause of low back pain. Injuries like this can result in damage to the intervertebral discs, compression of nerve roots and improper movement of the spinal joints.

The most common cause of low back pain is a torn or pulled muscle or ligament. This can occur at any time when a muscle is stretched too far and tears, therefore ending up damaging the muscle itself in the process. When overstretching and tearing occurs, this affects the ligaments as well. Ligaments are what keep the bones connected together.

Common occurrences of sprain and strain to your lower back can be from:

• Lifting heavy objects or twisting the spine while lifting
• Too much stress on the lower back after sudden movements (such as a fall)
• Frequent poor posture
• Injuries during sports, especially those involving twisting or great impact

Often, chronic pain located in the lower back can be from problems with your disc, joints or an irritated nerve root.

Causes include:

• Lumbar herniated disc. A nearby nerve root can be irritated when the center of a lumbar disc’s outer layer is broken through. These herniated portions of the disc can cause inflammation when they reach a nerve root due to the proteins inside it. The inflammation and nerve compression can, thus, cause nerve root pain. Severe pain can also occur.

• Degenerative disc disease. When the disc loses hydration this can cause tears that create pain or weakening. This then can lead to a herniation or the disc can collapse and contribute to stenosis.

• Facet joint dysfunction. Behind each disc at each motion segment are two facet joints in the lumbar spine. Within these joints are cartilage between the bones that are then surrounded by a capsular ligament, which is richly innervated by nerves. In conjunction with disc pain or alone these joints can be painful.

• Sacroiliac joint dysfunction. If the sacroiliac joint becomes painful then t can become inflamed or even when there is too much or too little motion from that joint.

• Spinal stenosis. Through narrowing of the spinal canal where the nerve roots are located, this condition can cause pain. The narrowing can occur in any area or can be: central, forminal, both or at a single or multiple levels in the lower back.

• Spondylolisthesis. When the vertebra slips over the adjacent one this can occur. The most common are: secondary to a defect or fracture of the pars or mechanical instability of the facet joints. Pain can be a result of instability in the back or compression of nerves.

• Osteoarthritis. This is when wear and tear of the disc and facet joints occur. Common results from this are pain, inflammation, instability and stenosis (to a degree) and can occur in singular or multiple levels within the lower back and spine area. It is also associated with aging.

• Deformity. This relates to the curvature of the spine, which can include scoliosis or kyphosis. It involves the breakdown of the discs, facet joints, sacroiliac joints or stenosis.

• Trauma. After any accident, trauma should always be medically evaluated immediately, any can result in acute fractures or dislocations of the spine that can cause low back pain.

• Compression fracture. Within the cylindrical vertebra, a fracture can occur when the bone caves in on itself. It causes sudden pain that is most common within individuals that have weak bones. It is also most common in older individuals.

Not always are these conditions the root source of pain. A patient can have one of these but experience little to no pain at all.

Less common causes of low back pain can also be from:

• Infection
• Tumor
• Autoimmune disease

Recommended treatment for low back pain depends upon the type of pain that you are experiencing. Some treatment options can be as follows:

• Over-the-counter pain relievers
• Muscle relaxants
• Topical pain relievers
• Narcotics
• Antidepressants
• Injections

Along with this physical therapy and exercise can also help. A physical therapist can recommend heat, ultrasound, electrical stimulation and muscle-release techniques that can help reduce pain in your back muscles and soft tissues.

Not many, but few people may need surgery for back pain. If the pain is unrelenting, then the individual may benefit from surgery. However, low back pain associated with narrowing of the spine or a herniated disk that hasn’t improved with therapy is usually when surgery may be recommended.

*The effectiveness of diagnosis and treatment will vary by patient and condition. New York Spine Institute does not guarantee certain results.