Causes of Low Back Pain

unknownLow back pain is common in the community, up to 80% of Australians experiencing it during their lifetime.

What is the number #1 cause of low back pain?

Mechanical low back pain!  What does this mean?

This describes low back pain due to a musculoskeletal cause, often triggered by wear and tear of daily living of the joints, ligaments, muscles, intervertebral discs or bone as people get older.

Examples of mechanical low back pain include:

Sprains and Strains
This is the most common cause of acute low back pain.  Sprains involve an over-stretching of a ligament, which strains involve muscular or tendon tears.  These often occur due to twisting, heavy lifting or over-stretching beyond the bodies current ability.  These injuries can trigger muscular spasm, a very painful protective response of the surrounding tissues.

Disc injury
There are numerous disc injuries or complaints that occur, including bulging (herniation), degeneration or rupture.  These can be sudden injuries often accompanying a combined bend and twist movement, or can be a slowly developing complaint.  A loss of cushioning of the spine can occur and lead to low back pain that can be mild to severe in nature.

This involves squashing (compression) or irritation of a spinal nerve root as the nerve exits the spinal column to the surrounding tissues that it supplies.  This can result in severe, often described as toothache like, spasming and referred pain.  There may be accompanying nerve symptoms such as numbness, tingling, pins and needles or just a sense of altered awareness of an area.  It may result from inflammation, disc injury or arthritis, or another cause.

Many patients come in and say they have “sciatica”, but often they are using it as a term for undiagnosed low back pain.  Sciatica is a lay term describing a specific type of low back pain involving compression of the sciatic nerve, a large nerve in the lower back region that supplies part of the pelvis and lower limb.  It is accompanied by shock like, electrical or burning pain down the buttocks, the back of the leg and may travel as far as the foot.  It is a type of radiculopathy and may have associated nerve symptoms.  Rarely it may be due to infection or tumour.

The most concerning types of scoliosis develop during growth spurts in children and adolescents, however may not cause pain.  There can be mild to significant sideways curvature of the spine, which when severe can lead to pressure on the chest cavity and may require surgery in these instances.  In older people, it is rarely serious, however can cause pain during middle age and beyond.

Increased “sway back” or curvature of the spine, this may or may not be associated with pain and is often related to posture.

Spinal Stenosis
Is a condition whereby the spinal column is partially or significantly blocked leading to increased spinal cord pressure.  There are numerous causes and when suspected requires investigation.  There may be accompanying muscular weakness and other nerve symptoms.

This term is derived from two terms, spondylo meaning spine and listhesis meaning slippage.  It involves one vertebrae sliding forward (or backward in retrolisthesis) over another, which may lead to spinal stenosis or nerve compression.  It may be related to previous sport history or traumatic injury.  It may be mild to severe and requires different management approaches according to grade, clinical signs and current symptoms.

Other irregularities
People can be born with small to significant irregularities of the spine.  This may make you more vulnerable to developing low back pain during the course of your life.

While we hope you are in the 20% of the population who will never experience back pain, you can feel assured that your Osteopath is experienced and familiar with all of these and other causes of low back pain.  Please get in touch if you need any further assistance.

Want to know more about diagnosing low back pain, click here for more.

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