Low back pain is one of the most common causes of people missing work and effects most of us at some time in our life. It can vary from a mild ache to excruciating, debilitating pain that seriously limits what we can do and may last from a few minutes to many years. It may be limited to the low back or may be accompanied with leg pain that may go down to the feet in which case it is commonly referred to as sciatica. This article will discuss some of the causes of low back pain and what can be done about it.
Some of the more common possible causes of back pain are:
- Muscular strain: Overuse or injury to the muscles, tendons, and ligaments in the back can cause pain and stiffness.
- Bulging disc: A herniated disc occurs when the inner soft material of a spinal disc bulges out through a tear in the outer layer. This can put pressure on nearby nerves and cause pain.
- Degenerative disc disease: As people age, their spinal discs can begin to degenerate, leading to pain and stiffness.
- Spondylosis which is a term used to describe osteoarthritis in the spine. This is degenerative condition which is a part of the normal aging process that affects the joints in the back. It can cause pain and stiffness, as well as a loss of mobility.
- Sciatica: This condition occurs when a nerve in the lower back becomes compressed or irritated, leading to pain that radiates down the leg. Often caused by a bulging disc.
- Spinal stenosis: When the spinal canal becomes narrowed, putting pressure on the spinal cord and nerves.
- Scoliosis: When the spine curves to one side, and then possibly to the others side higher up, leading to pain and difficulty with movement.
- Fibromyalgia: A chronic pain condition that affects the muscles and soft tissues in the body.
- Spondylolisthesis: Where one vertebra lips forward of the vertebra below.
- Stress: Prolonged emotional stress, tension, anxiety and depression can all have physical effects including causing muscle tightness and pain in the back.
- Poor posture: Sitting or standing in an unnatural position or for long periods of time can lead to strain and pain in the back.
- Sedentary lifestyle: Lack of regular and varied movement through the normal range of movement of your joints throughout the day.
The last two causes are probably the most common causes chiropractors find as jobs, and our lifestyles generally, become more and more sedentary. Going to the gym regularly may help to some extent but still does not meet the requirement of “throughout the day”. People who have physical jobs are not immune because they tend to be doing the same movements throughout the day rather than varied movements we need.
It is important to note that back pain can also be a symptom of a more serious underlying conditions which need urgent medical referral such as:
- Kidney stones.
- Kidney infections (pyelonephritis)
- Bone infections (osteomyelitis)
- Spinal cord tumour or secondaries
- A large central disc bulge pressing on several nerves (cauda equina syndrome)
- Spinal stenosis (reduced gap in bone where nerves come out)
- Spinal fractures (which may occur without serious trauma)
The diversity of causes explains why chiropractors insist on a detailed consultation and examination before producing a care plan is produced and care commenced. The many questions and descriptions sought (e.g. the pain’s location, nature, duration, intensity and variation or, seemingly unrelated, questions about bladder and bowel function and night sweats) as well as the many seemingly strange tests performed during physical examination are necessary to try and distinguish between the many causes of back pain.
Only a very small percentage of people coming into a chiropractor have these more serious conditions which need medical referral so we are able to treat the vast majority of back pain sufferers.