Ian is a Senior Orthopedic Officer, and a palliative care specialist currently working at Fort portal Regional Referral Hospital.
Low back pain is a common disorder, described usually as a sharp persistent, or dull pain felt in the part of the back; just above the waist, within the waist, and immediately below the waist.
The pain at times spreads to one or both of the lower limbs (Sciatica), typically behind the thigh. It may also be associated with a feeling of numbness, tingling sensation, or heat in the muscles of the lower limbs. It affects 70% of all people at some point in their lives. The condition may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks).
Usually, pain develops after movements that involve lifting twisting, or forward bending.
According to Paul W Stratford (associate professor school of rehabilitation science, McMaster University) low back pain is an important public health problem in all industrialized countries as it accounts for more than 60% of all activity limitation disorders in adults aged less than 45 years.
Common causes of low back pain
Acute pain may come as a result of injury to the structures that provide stability to the spine such as muscles and ligaments. These kinds of injuries are common in athletes, but may also result from motor vehicle accidents or direct blows to the back using heavy objects.
They include sprains, fractures to the lumbar vertebrae, injury to the intervertebral discs, and subluxations. Following injury, or disease, the makeup of the discs may change: blood vessels and nerves may grow into the disc interior and herniated disc material can push directly on a nerve root. Any of these changes can also cause pain.
The lower back is subjected to a lot of mechanical stress and strain, as it supports all the weight of the upper body. The lumbar region (lower back) is made up of five (bones) vertebrae, named L1 to L5. In between these vertebrae are fibrocartilaginous discs, which act as cushions, preventing the vertebrae from rubbing against each other while at the same time protecting the spinal cord. Nerves come from and go to the spinal cord through specific openings between the vertebrae, providing the skin with sensations and messages to muscles.
The vertebrae form small joints with each other called facet joints which are responsible for directing and limiting motion of the spine. It is at the cartilaginous discs and the facet joints that the degenerative processes take place.
The discs are made up of specialized cells that can survive without blood. They are thus not supplied by either the circulatory or the nervous system. Repeated stress can therefore cause the discs to shrink; lose flexibility and the ability to absorb physical forces over time. This increases strain on other parts of the spine. Vertebrae at times may start rubbing over each other, ligaments of the spine thicken and bony growths develop on the vertebrae. As a result, there is reduced space through which, the nerve roots pass as they leave the spinal cord. Reduction in this space results in compression of the nerve root, causing pain.
3. Medical conditions
Medical conditions such as tumors and conditions affecting the female reproductive system may cause acute low back pain. These include endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids, and other pelvic inflammation diseases. Nearly all pregnant women report pain in the lower back during pregnancy due to changes in their posture and center of gravity causing muscle and ligament strain. Low back pain may also be referred pain from diseased internal organs like gallbladder disease, kidney stones, kidney infections, and many others.
Signs that indicate a serious problem include a previous history of cancer, unexplained weight loss, impaired bladder or bowel control, significant motor weakness or loss of sensation, association with fever, and urinary tract infection.
What you can do to prevent back pain
Many of the activities we do knowingly or unknowingly, may cause injury to the back or speed up the process of degenerative changes in the lumbar spine. Simple changes in the way one carries out some of these activities can help a great deal in minimizing low back pain. Here are some tips on how to deal with the commonest offenders.
Avoid poor Lifting technique
Poor lifting techniques can cause both acute injury and serious chronic problems. You need to avoid being in a hurry while moving a heavy object because it is important to plan ahead before lifting. Here is a simple guide on how to lift properly;
- Take time and examine the object you want to move and ensure that it’s not too heavy for you to lift. If it is, find help, and ensure that you and your lifting partner understand the plan. Stand close to the load, and be as central to it as possible. Lifting the object close to the body will make you more stable.
- Keep the feet about shoulder-width apart because too close or too far apart will hinder movement and may cause instability. Face the direction you want to move the object to so as to avoid twisting movements in the back.
- Bend the knees keep the back straight and think about the motion before you lift. Focus on keeping the spine as straight as possible.
- Lower to and rise from the ground only by bending your knees, rather than bending at the waist. Never bend your back to pick something up. You may practice a little before you actually take on the object. Tightening your abdominal muscles may come naturally. It helps in better weight distribution and is good for minimizing excess force on the spine.
- As you rise, lift through the legs. Remember to keep your eyes slightly upwards as this helps maintain a straight spine.
Some postures may seem comfortable and convenient while sitting to watch a movie while doing some work in the kitchen, or doing some work on the computer. However, most of these convenient postures may in the long run be risky to the back.
Whatever you may be doing, you need a position that will not compromise the safety of your spine. This will have a lot to do with the choice of chair.
Sitting in an office or other places for long periods can cause significant discomfort in the back. You can however minimize this by sitting with the right posture.
You should keep the lower back supported, keep the spine straight and have your knees level with your hips. If necessary use a footrest. Your chair height should be such that you can use the keyboard (when using a computer) with your wrists and forearm straight and level with the floor while the elbows are by the side of your body. This will help prevent strain injuries to the wrists and elbows as well.
Try to avoid crossing your legs which may cause impairment in circulation. Let the screen be directly in front of you preferably at arm’s length, with the screen top at around eye level. If the screen is low or too high, you will have to bend or stretch your neck and end up with neck discomfort.
Position objects you need to use frequently such as telephone or stapler within easy reach to avoid unnecessary repeated stretching or twisting.
Learn about proper sleeping posture
When you sleep try to maintain positions that will keep the spine in a neutral position and not arched.
It is important to use the right kind of bed. A thick soft mattress into which you sink is most likely going to cause your back to curve in an undesirable way and put extra strain on the back.
Choose a firm bed with a soft, but firm mattress to allow the weight of the pelvis as well as that of the chest to sink only slightly in whichever position you lie. This helps maintain the natural curves of the spine. If you already have back pain, try using a high-density foam mattress.
Engage in physical exercise
Physical exercises strengthen the muscles of the back and abdomen which are important for the stability of the spine. Exercising regularly is also great for managing body weight, which can cause excess load on the spine. It is also good for the heart. Sporting activities are great forms of exercising. Jogging and bicycle riding is a healthy way to end a stressful day and will usually guarantee quality good night sleep.
You should consult a physiotherapist for aerobic exercises which are safe for you. In addition to regular physical exercise, eating a healthy balanced diet rich in calcium and vitamin D will help prevent osteoporosis, which can lead to compression fractures of the vertebral bones.
If your back pain is associated with any other symptoms such as fever, weight loss, etc, you need to consult a doctor for proper assessment and management.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 Ian Batanda
How do you Deal with low back Pain? Share your experience
Ian Batanda (author) on May 08, 2014:
Thanks a lot for your comments. There are many simple things that we can do at home daily to improve back health. its just that many times we over look them.
Candice Harding on May 07, 2014:
You can also alleviate your lower back pain with swimming and some basic stretches. I have tried several patented pain relief methods to help eliminate my back pain and have yet to try one that did not help. Because every person's back pain is different, it's good to take recommendations and try new things, but not to get attached to a method that isn't working for you.
jstrong196 on December 19, 2013:
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