Whether you’ve had low back pain for a few days or a few months, the results are the same. Low pain pain hurts, it causes many to have difficulties with simple daily tasks and it can certainly put people in a grumpy mood.
If you have low back pain you are certainly not alone. In fact, experts believe that 80% of the population will experience a bout of low back pain within their lives. Take a look at some of these statistics.
- Low back pain impacts 31 million Americans at any one time.
- Back pain is the number 1 cause of lost work days in the U.S.
- Low back pain is the leading cause of disability for those under 45 years of age.
- Approximately 2/3 of the costs of
- Americans spend $50 billion on back pain every year
Those who suffer from back pain understand how disabling it can be. Some can have localized pain that remains in one are of their low back while others may have pain that radiates into the buttock area or leg. In addition the type of pain can also vary. Some suffer from deep aching while others may feel sharp pain, especially with specific movements.
Whatever the symptoms feel like, the cause of the pain is what most, who experience low back pain, what to better understand. Where is the pain coming from?
The Structures of the Lower Back
In order to understand where pain comes from, we first must understand the basic normal anatomy of the low back. So, let’s have a quick anatomy lesson of the low back region.
The lower back is made up of 5 lumbar vertebrae, separated by intervertebral discs (jelly doughnut-like structures). These vertebrae surround and protect the spinal cord and the large nerves that descend from the lower cord. These vertebrae also allow movement when we bend forward, backward, side to side or even rotate. Nerves exit out of the sides of the vertebral areas and these nerves descend into the pelvis, buttocks, legs and feet.
The base of the low back is called the pelvis. The pelvis is made up of several strong bone structures called the sacrum and one pelvic bone on each side of it. The tailbone, or coccyx, sits at the bottom. This area is also a region where many nerve structures are found.
In front of the pelvis and vertebra are a variety of organs including the intestines, reproductive structures, bladder and other important soft tissue.
On top of, and surrounding the vertebrae and pelvis are vast muscular structures that gives us the ability to move. Other additional important soft tissue elements, like ligaments and tendons, attach the many structures found in this area together.
Common Causes of Low Back Pain
Now that we have a better understanding of the normal low back structure, let’s talk about the potential causes of low back pain. There are many ways that low back pain can occur. Most forms of low back pain occur with treatable outcomes. However, some forms of low bak pain provide signs that other, more ominous problems exist. This is why you should always be evaluated when you have low back pain that isn’t resolving.
Soft Tissue Pain
Overuse or injury to muscle, ligament or tendon can cause pain in that particular area. Often those with muscle injuries describe the pain as ‘sharp’ when the injury happened, but then changes to a dull ache or throbbing sensation.
Soft tissue pain is usually isolated to the specific area of the involved muscle(s) and the pain will increase should you try to engage that specific muscle. For example, if you strain the right lower back muscles while lifting, trying to use these large muscles again will often aggravate the problem.
Mechanical low back pain
Mechanical spine pain (often called subluxation) occurs when the free-flowing movement of the spinal joints is not working properly. This abnormal motion pattern (or lack of motion pattern) can cause the area to become inflamed or produce abnormal pressures on small structures in the area, like nerves, causing pain.
Mechanical low back pain can cause pain (dull ache or sharp) that is generalized in the area, but has been known to cause radiating symptoms when a nerve become involved.
Disc herniation or disc bulge
Separating the vertebrae are padded structures, called intervertebral discs. These discs are like jelly doughnuts (with a jelly-filled center). Discs provide the cushion that provides shock protection and also allows for the movement of one vertebrae on another.
Discs are susceptible to certain types of injuries. Most commonly, the disc structure tears and the jelly-like substance inside can ooze out of the disc. This can in itself cause pain, however, if that jelly-like substance pushes out far enough and comes in contact with a nerve, the pain can significantly elevate. Because of the nerve involvement, this can cause the symptoms of nerve pain.
Tears in a disc can occur because of aging of the disc or due to a sudden injury. Those occurring from sudden injury often cause a sharp pain directly over the affected area.
The pelvis is the strong bone structure that serves to protect us and supports the hips that allows us to move. This region has a significant amount of soft tissues including tendons, ligaments, muscles and nerves. Although the strength of this area is superb, pain in this area can also be concerning.
Since there are so many ‘connections’ in the region (hips, sacroiliac joints, lumbosacral joint) there are many possibilities of cause of pain. Pain in this area can often feel “deeper” and feel dull and achy or be sharp in nature.
Nerves are delicate structures that are found throughout our bodies that carry signals to and from the brain. In the low back, the nerves that come off of the lumbar spine are slightly larger and traverse into the buttock area, legs and feet.
If a nerve is irritated, in any way, symptoms may occur. This includes pain, numbness, tingling, burning or even weakness of muscle. Since nerves extend for some distance, the symptoms may occur throughout the entire extent to the nerve involved.
Previously we spoke of disc herniations. It is common that a disc herniation, which involves a nerve and the compression of that nerve, causes a variety of symptoms.
Nerve involvement can also occur when muscles, which can form the tunnels for the nerves, tighten and pinch off the nerve. This is called a nerve compression syndrome.
Low back pain can also occur following an injury to the low back region. This may involve a variety of structures, like bone, muscle, nerve, etc. Severity levels of pain due to injury can depend upon the severity of the injury. However, the severity of pain and the severity of injury are not directly related. In other words, a person can have a serious injury with little pain. In contrast, another person can have a minor low back injury with significant pain.
The types of injuries are varied. Injuries can be anything from lifting incorrectly to a car accident. Injuries that include trauma are always worrisome due to the possibility of fractures or internal damage.
Another common cause of low back pain is degenerative changes of the spine. With ‘wear and tear’ and injuries, the spine can build up arthritis over time. These arthritic changes can cause ‘bony bridges’ to form in the area, which take up the needed space for nerves. A very common type of arthritis of the joints is called osteoarthritis.
Osteoarthritis can increase in severity over time. It can begin as minor changes on the ends of the bones. In time, these change can continue to worsen causing other structures, like nerves, to become involved. Severe osteoarthritis can cause bones to fuse together causing reduced motion, pain and trapped nerves.
Those who have chronic osteoarthritis often complain of dull achy pain in the region where the osteoarthritis has formed. It is not uncommon to have several joints simultaneously degenerating.
These are seven causes of low back pain that with proper treatment, can resolve fully or often receive significant pain relief.
With the common occurrence of low back pain, it is necessary for those low back pain sufferers to find the proper healthcare provider that is able to both properly identify and effectively treat their type of low back pain.
As you can see, not every person has the same cause of their low back pain. Without understanding the source of the pain, a proper treatment plan for resolving the condition is simply not possible.
Fortunately, there are certain providers that can identify and properly treat low back pain and get you on the road to recovery.