How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
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Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
Treating Chronic Arthritis Pain In The Spine
Facet joint arthritis is a degenerative condition. In its early stages, occasional mild back pain may respond to one or more of the above tips. However, spinal arthritis can affect the facet joints between each backbone in the lumbar spine, eventually leading to constant bone and/or nerve pain. Only a doctor can determine if arthritis of the facet joints is the source of chronic lumbar pain.
Sperling Medical Group offers a new noninvasive MRI-guided treatment called Focused Ultrasound, a one-time noninvasive outpatient procedure that gives lasting relief without the use of drugs, injections or surgery. To learn more, visit the Sperling Medical Group or contact us to set up a consultation.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you have health concerns or questions of a personal medical nature.
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What Is The Function Of The Low Back
The low back, or lumbar area, serves a number of important functions for the human body. These functions include structural support, movement, and protection of certain body tissues.
When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.
Protecting the soft tissues of the nervous system and spinal cord as well as nearby organs of the pelvis and abdomen is a critical function the lumbar spine and adjacent muscles of the low back.
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What Causes Lower Back Pain
Many injuries, conditions and diseases can cause lower back pain. They include:
- Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.
- Fractures: The bones in the spine can break during an accident, like a car crash or a fall. Certain conditions increase the risk of fractures.
- Disk problems: Disks cushion the vertebrae . Disks can bulge from their position in the spine and press on a nerve. They can also tear . With age, disks can get flatter and offer less protection .
- Structural problems: A condition called spinal stenosis happens when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord can cause severe sciatic nerve pain and lower back pain. Scoliosis can lead to pain, stiffness and difficulty moving.
- Arthritis: Osteoarthritis is the most common type of arthritis to cause lower back pain. Ankylosing spondylitis causes lower back pain, inflammation and stiffness in the spine.
- Disease:Spine tumors, infections and several types of cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysm.
- Spondylolisthesis: This condition causes the vertebrae in the spine to slip out of place. Spondylolisthesis leads to low back pain and often leg pain as well.
Spinal Manipulation By Chiropractors Works About As Well As Exercise Or Over
Passive therapies can also play a role in helping people manage back pain, though theres no silver bullet among them, and their effects also tend to be modest and short-lived. The research base for these alternative therapies is also generally weak: Theres a lot of variability among the practice styles and programs on offer, even within one category of treatment like massage. It can be difficult to blind the patients to the treatment they are receiving, and the people who seek out particular therapies acupuncture, massage are probably more amenable to them, which may bias the results. With that said, heres what we know.
Spinal manipulation, the cranking and tweaking on offer when you visit a traditional chiropractor, is among the most popular approaches to back pain. Practitioners lay their hands on the patient and move their joints to or beyond their range of motion a technique thats often accompanied by a pop or crack.
There is some evidence the approach can help people with chronic back pain but not any more than over-the-counter painkillers or exercise, and you need to take precautions when seeking out a chiropractor.
The Cochrane review on acute pain found that spinal manipulation worked no better than placebo. So people with a short episode of back pain should probably not bother seeing a chiropractor.
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What Can Cause Lower Back Pain
Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:
Congenital
- Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
Injuries
- Sprains , strains , and spasms
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
Degenerative problems
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
Nerve and spinal cord problems
Non-spine sources
Simple Steps To Healing Back Pain
On any given day, 5 percent of Americans 15 million people have back pain. Eighteen percent have suffered back aches in the past month. And over a lifetime, significant back pain bedevils two-thirds of the population. Not surprisingly, back pain is a leading reason why Americans consult physicians, accounting for 14 percent of primary-care doctor visits.
According to the American Academy of Family Physicians, the most frequent cause of back pain is muscle strain. The injury might result from overuse or twisting , or lifting incorrectly . But quite often, there is no trauma. You rise from a chair or bend over while dressing, and wham, you feel sharp pain in your back.
The No. 2 cause of back pain is a herniated disk. Disks are the cartilage rings between the 33 small bones that comprise the spine. The alternating bone-cartilage arrangement provides flexibility. But disk injury which typically appears on X-rays and MRIs as bulging or a rupture can press on nearby nerves and cause severe pain.
Rarely, back pain is caused by other conditions: infections, cancer or other diseases.
But no matter what the cause, according to back pain researcher Richard Deyo, M.D., a professor of medicine at the Oregon Health Sciences University, Nearly everyone gets better.
Heres how to deal with back pain:
Michael Castleman is one of the nations top health writers .
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Low Back Pain Treatment
Epidural Steroid Injection
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck , referred to as cervical radiculopathy, which causes pain.
When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
References
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Is It Possible To Prevent Low Back Pain
Avoiding injury to the low back is a method of preventing low back pain. Additionally, conditioning exercise programs designed to strengthen the lumbar area and adjacent tissues can help to minimize risk of injury to the low back. Specific programs to relieve and prevent back pain can be designed with the help of physical therapists and other treating health care professionals.
Tips For Dealing With Lower Back Pain
By Robert Greenleaf, MD, Spine Surgeon
Lower back pain is extremely common and one of the top reasons for missed workdays. Thats because the lower back supports the weight of the upper body and is subject to a lot of stress and strainespecially during everyday movements like lifting and twisting.
One of two things typically causes lower back pain: a sudden injury or the wear and tear of aging, arthritis and physical activity. No matter the cause of your lower back pain, here are 10 recommendations that can help you relieve it and prevent future problems.
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
As a primary supporter of research on pain and pain mechanisms, NINDS is a member of the NIH Pain Consortium, which was established to promote collaboration among the many NIH Institutes and Centers with research programs and activities addressing pain. On an even broader scale, NIH participates in the Interagency Pain Research Coordinating Committee, a federal advisory committee that coordinates research across other U.S. Department of Health and Human Services agencies as well as the Departments of Defense and Veterans Affairs.
Addendum: Americas Most Famous Back Guru
No back pain article would be complete without a mention of the late John Sarno, an NYU professor of rehabilitation medicine and probably Americas best-known back guru. He believed there is an emotional basis for all chronic back pain.
More specifically, he thought that the brain distracts us from experiencing negative emotions by creating pain. We may not want to accept the uncomfortable truths that we are angry with our children, or that we hate our job, so instead of thinking those thoughts, we focus on the pain.
Back pain researchers and doctors generally still dont find Sarnos theories entirely convincing particularly his one-size-fits-all diagnosis and Ive written about why at length here. But Sarno got some things right. As Ive mentioned, its now mainstream to view chronic back pain as a biopsychosocial condition, and central sensitization is also gaining traction. Both ideas suggest its not just whats going on in your body and back that matters for your pain.
That means he was also ahead of his time when it came to treatment. What recommended as treatment was essentially cognitive behavioral therapy elimination of fear avoidant behavior and catastrophizing before anyone had ever heard of it, Ramin said, and its exactly what is being used now to treat patients with central sensitization.
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What Structures Make Up The Back
The lower backwhere most back pain occursincludes the five vertebrae in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
Other regions of vertebrate are cervical , thoracic , and sacral and coccygeal segments.
Facts And Figures About Lower Back Pain
- Both men and women commonly develop back pain, however some research shows women tend to have more recurrent symptoms.
- Overweight adults who dont exercise and have other health issues are at the highest risk for back pains.
- The incidence of low back pain is highest in someones 30s, and overall prevalence increases with age until the 6065 age group, at which point it seems to decline.
- Globally, back pain is one of the most common reasons for missed work days and the second most common reason for doctor office visits. Its estimated that around 13 million people go to the doctor for chronic back pain every year.
- Approximately 2.4 million Americans are chronically disabled due to back problems. At any given time, around 2.4 million adults are temporarily disabled.
- Studies show that back pain symptoms tend to come back. The rate of recurrence at one year ranges from 24 percent to 80 percent depending on the group.
- Americans spend at least $50 billion each year to help diagnose and treat various lower back pain symptoms.
- Back pain can be both acute and chronic . About 20 percent of people affected by acute low back pain develop chronic low back pain that winds up lasting more than one year.
- The majority of lower back pain cases are caused by irritation/inflammation of five spinal vertebrae in the lumbar region, which supports much of the weight of the upper body. Thirty-one pairs of nerves are also rooted to the spinal cord, which can cause radiating pain downward or outward.
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Ways To Relieve Back Pain Naturally
There are a wide variety of natural remedies to soothe your back, which can help reduce the intake of medications or provide an added benefit to your existing medical treatment.
Take a look at these natural pain-relieving strategies and find out what works best for you:
Read on to learn more about effective pain-relieving strategies for chronic back pain from natural methods.
Bonus Tip: Consider Taking A Vitamin D3 Supplement
If your doctor agrees, consider taking a vitamin D3 supplement. Vitamin D is essential for bone, neuromuscular, and immune system function. Taking a vitamin D3 supplement can help reduce back pain by increasing the absorption of calcium in your body and improving bone strength.15
See Calcium and Vitamin D Requirements
Finding the perfect pain relief technique is usually a process of trial and error, making it worth exploring various approaches. Try these natural pain-relieving strategies for your back pain and see what works best for you. Severe pain that is not relieved by self-care must be evaluated by a health professional for an accurate diagnosis and treatment plan.
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Home Remedies For Lower Back Pain
Do you suffer from lower back pain? Regardless of how often and how much it hurts, youre in the company of millions of others affected by an aching lower back.
The lower back is called the lumbar region or lumbar spine. At some time or another, four out of five adults report they have had lumbar pain. At any given time, about 25% report that theyve had pain within the previous three months. Thats a LOT of pain in the population!
S To Heal Your Low Back Injury
So youve done it, you pulled too hard with a rounded back on that last deadlift, or waited one second too long before tapping. Youre a CrossFitter or BJJ with a hurt low back. Now what?
In last weeks article the brilliant and arm-barringly gifted Sam Kressin wrote about the best means he knows for healing one of the two most common injuries to CrossFitters and BJJers injuries to the neck. This week its my turn to talk about the lumbar area or low back.
So youve done it, you pulled too hard with a rounded back on that last deadlift, waited one second too long before tapping, and/or generally had something unpleasant happen right above your sitting apparatus. Unfortunately, low back injuries are very common to beginning CrossFitters and BJJ players.
Herere are some easy steps to get you back in the gym or back on the mat, without pain:
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