Back Pain

The Spine

More than 30 million visits were made to physician offices in 2002 because of back problems. Eight out of 10 people will experience back pain at some point in their lives. Low back pain is one of the most frequent problems treated by orthopaedic surgeons.

What is the lower back?

Your lower back is a complex structure of vertebrae, disks, spinal cord, and nerves, including:

* five bones called lumbar vertebrae - stacked one upon the other, connecting the upper spine to the pelvis

* six shock absorbers called disks - acting both as cushion and stabilizer to protect the lumbar vertebrae

Low Back Pain

The lower back is an elegant construction of bone, muscle, and ligament. Because the lower back is the hinge between the upper and lower body, it is especially vulnerable to injury when you are lifting, reaching, or twisting. When low back pain strikes, we become acutely aware of just how much we rely on a flexible, strong back. Ironically, most of us don't think of the importance of keeping our back and stomach muscles strong until we have back trouble.

See an illustration of the lower back (lumbosacral region of the spine)

Click here to see larger image.

Up to 85% of all people have low back pain at one time or another. Each year, about 2% of American workers are compensated for disability caused by back pain.1 Low back pain is often triggered by some combination of overuse, muscle strain, or injury to the muscles and ligaments that support the spine. Less commonly, low back pain is caused by illness or spinal deformity.

Exercise, Return to Activity Helps Back Pain

By Salynn Boyles
WebMD Medical News
Reviewed By Michael Smith, MD

Got Back Pain? Assess Your Options

Low Back Pain Shouldn't Sideline You

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June 9, 2005 -- Low back pain is one of the most common and difficult-to-treat medical complaints among adults. Treatment often includes physical therapy, but new research shows that a hands-off educational and behavioral approach to pain management works just as well.

Researchers say people in the study who suffered from short-duration low back pain responded well to counseling programs that explored their attitudes toward pain and urged them to exercise and resume routine activities despite their discomfort.

Relieving Low-Back Pain With Exercise

Brian Shiple, DO; Series Editor: Nicholas A. DiNubile, MD

THE PHYSICIAN AND SPORTSMEDICINE

If you suffer from low-back pain, the most important part of your treatment is something only you can give yourself: exercise. Regular workouts make pain go away faster. By strengthening the muscles that support your back and improving your back's flexibility, exercise reduces the chances of another acute attack.

A full program has two parts. The first component is aerobic exercise to get your whole body in good condition (aerobic exercise like walking or biking uses large muscles and gets your heart and breathing rates up). The second component is specific exercises designed to strengthen your back muscles and increase or maintain flexibility. Your doctor will tell you when to begin each type of exercise.

How to Save Your Back

Always try to maintain the natural curves in your back.

These curves provide strength and support for your back. This is especially important when lifting or when sitting for long periods.

Hinge at your hips and bend your knees when lifting.

You should be doing most of the work with your legs rather than with your back! Placing your feet shoulder-width apart will help you stay balanced. A wider stance can also help if you have difficulty bending your knees.

Tighten your stomach muscles before you lift.

They help support and stabilize your back when you lift.

Back Pain - Low

Alternative names
Backache; Low back pain; Lumbar pain; Pain - back

Definition

Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region of your back. It may also radiate from other areas like your mid or upper back, a hernia in the groin, or a problem in the testicles or ovaries.

You may feel a variety of symptoms if you hurt your back. You may have a tingling or burning sensation, a dull aching, or sharp pain. You also may experience weakness in your legs or feet.

It won't necessarily be one event that actually causes your pain. You may have been doing many things improperly -- like standing, sitting, or lifting -- for a long time. Then suddenly, one simple movement, like reaching for something in the shower or bending from your waist, leads to the feeling of pain.

Lumbar Back Sprains and Strains

Most people will experience back pain during their lifetime. Some patients fear the worst, especially when pain is severe. Although back pain can be caused by fracture, disc disorder, or tumor, the most common cause is sprain or strain.

Sprains and strains often result from excessive physical demands on the back. Lifting something too heavy, a sudden fall, car crash, or sports injury can cause soft tissues (ligaments, muscles, tendons) to stretch too much.

Sprains · Strains
The spine includes vertebrae (bones), discs (cartilaginous pads or shock absorbers), the spinal cord and nerve roots (neurological wiring system), and blood vessels (nourishment). Ligaments link bones together, and tendons connect muscles to bones and discs. The ligaments, muscles, and tendons work together to handle the external forces the spine encounters during movement, such as bending forward and lifting.

Back Pain v. Kidney Infection

Q: How can we tell the difference between a muscle strain in the back and the pain that is caused by a kidney infection?
A:

Pain stemming from a kidney infection typically is in the area of the back where the kidneys lie, located to the sides of the spine, just above the hips. Kidney related pain often presents as tenderness in this area. Direct injury or trauma to the back, over the area where the kidneys are located, can cause direct injury to the kidneys themselves, and that is why getting struck in this area is commonly referred to as a "kidney punch."

Kidney infection pain usually comes from the organ itself but often appears as back pain. Kidney pain is also quite tricky because it can radiate to many different parts of the body. It is also acute in origin, meaning that it usually has a very rapid onset, and typically does not last any longer than the infection in the kidneys will last. Kidney infection pain goes away with the healing of a kidney infection, or passing of a kidney stone. Back pain from trauma to the back, however, usually does not go away this quickly.

Back Pain and Surgery

Q: Is surgery the best treatment for a bad back?
A: Bad backs are a frequent reason people opt for surgery, even though studies show that bulging discs usually shrink over time and that disc problems clear up in the vast majority of patients.

The most common back surgeries (laminectomy, spinal fusion, and discectomy) focus on structural repairs to discs or vertebrae. Any of these surgeries may be done alone or combined, depending on the patient. Laminectomy means a part of a spinal bone (vertebrae), called the lamina, is removed to relieve pressure on the spinal cord or nerve roots.

Spinal fusion melds one vertebral bone (the spine comprises a series of vertebral bones) to another to secure an otherwise dysfunctional spine. A discectomy removes a disc because it has become ruptured or herniated.

Pain Management for Chronic Back Pain

Introduction to pain management for chronic back pain
Pain, especially intractable or chronic pain, used to be something many patients simply had to learn to “live? with. In recent years, however, researchers have learned a great deal about pain and its physiological and psychological basis, leading to pain management treatments that can provide complete or partial pain relief.

Untreated pain can interfere with the healing process by affecting the immune system and leading to other undesirable results. In cases of back pain, discomfort can impede the rehabilitation process by interfering with exercise and increasing the risk of psychological distress.