What is it: Low back pain is a universal human experience — almost everyone has it at some point. The lower back, which starts below the ribcage, is called the lumbar region. Pain here can be intense and is one of the top causes of missed work. Fortunately, low back pain often gets better on its own. When it doesn’t, there are effective treatments.
Statistics: According to the AHRQ, in 2007 a total of $30.3 billion was paid to providers, such as doctors, physical therapists and others, as well as to pharmacies. The Journal of the American Medical Association reports that spine care costs reached $85.9 billion in 2005.
Back pain is the most commonly reported pain condition in America. About 65 million Americans have had a recent episode of back pain, and 8% of all adults are so bothered by back pain that it limits their daily activities in some way.
Important Facts: Most people get their first taste of low back pain in their 30s. The odds of additional attacks increase with age. Other reasons your low back may hurt include: being overweight, inactive lifestyle, and jobs that require heavy lifting
Muscle spasms are the most common cause of low back pain. That’s why some treatments include muscle relaxers. You can strain a muscle with an unexpected pull or twist. Your risk of muscle spasms increases if you have weak stomach muscles, tight hamstrings, any back weakness, or a pelvis that tilts forward more than normal.
Treatment Duration: Low back pain can be treated with complementary and alternative medicine like spinal manipulation, massage therapy, and yoga.
If back pain has left you inactive for a long time, a rehabilitation program can help you strengthen your muscles and get back to your daily activities. A physical therapist can guide you through stretches, strength exercises, and low-impact cardio that will help you be fitter without straining your back.
Do’s/Don’ts: “The worst posture is sitting and leaning forward,” Shamie says. This makes you lock your pelvis and flex your spine, putting pressure on the front of the vertebrae, where your discs are. The more you arch forward and exaggerate the curve of the spine, the more pressure you’re putting on your discs. “This uneven pressure on a disc puts it at high risk of rupture,” Shamie explains.
Prevent it: Get up and move at least once every 20 minutes, unless you’re driving. Keep your spine properly aligned by holding reading material at eye level (when sitting or standing) rather than bending over. Don’t lean over a desk or table to work. Whenever possible, your spine should be straight.
Common Myths: Firmer may not always be better. People who sleep on a medium-firm mattress are twice as likely to report that their back pain decreased while lying in bed or getting in or out of bed.
Myth: A Week Of Bed Rest Is The Best Treatment For Low Back Pain — Bed rest alone can actually make back pain worse. It can also lead to other conditions, like weakened muscles and blood clots in the legs. One study showed that patients who continued their normal activities after a bout of low back pain had more flexibility than those who rested in bed for a week. Staying in the same position for too long can also make your joints stiff.
Lumbar Arthritis (DDD, DJD)
What is it: Lumbar arthritis is a degenerative condition that develops over time in response to the normal demands that are placed on the five lumbar vertebrae. It is symptomatic to varying degrees in different individuals and is a significant cause of disability.
Important Facts: With age, the intervertebral disks begin to lose their elasticity and hydration. This loss of elasticity decreases the ability of a disk to handle the weight it must bear. The disks become shorter which changes the position of the vertebrae and their associated connecting fibers in relation to the rest of the spine. Over time, a situation develops whereby bone lays directly on bone, causing pain and decreasing range of motion.
Statistics: Low back pain is extremely common affecting 60-90% of the population.
Treatment Duration: Lumbar arthritis is usually responsive to conservative management. During an acute attack of low back pain, relative rest that avoids activities that aggravates the symptoms may reduce inflammation. For long term relief, lifestyle modification must be undertaken. Weight loss when appropriate will have a tremendous impact on back pain because it is the lumbar spine that bears the weight of the body. Exercise is also critical and can help reduce weight and increase muscle strength to support the lower back.
Common Myths: Myth: Bad Back Pain Can Result in Paralysis
Fact: The spinal cord ends in the upper part of the low back (lumbar 1). Further down the low back there are only nerve roots, which are very tough structures. In most cases, a great deal of back pain does not usually indicate a back problem that could lead to paralysis.
Myth: Severe Back Pain Correlates to the Level of Back Damage
Fact: With acute pain, the level of pain correlates to the level of damage (e.g. if you touch a hot iron, you will immediately feel a great deal of pain). However, with chronic back pain (greater than 6 weeks), the amount of pain does not typically correlate the amount of damage.