Lower back pain is a common problem that has been reported as the leading cause of disability and absenteeism from work in all parts of the globe, and affecting approximately 32 million people in the U.S. About 80 percent of adults experience low back pain at some point in their lifetimes.
The prevalence of lower back pain has led to a continually growing collection of treatment strategies comprised of prescription drugs, chiropractic care, surgery of various types, psychotherapy, and lifestyle adaptations that include exercises and other natural techniques.
To understand LBP's overarching cause, we have to take a look at the structure of the back and spine. The spine's main function is to act as a strong shield that protects the sensitive vertebral column with its array of nerve endings that, together with the brain, constitute the heart of our central nervous system. The spine also needs to be malleable enough to permit bending and flexibility.
The problems begin right there, for the spine itself is an intense hub for nerve endings and can thus harbors a complex assortment of areas that can develop non-kidney related pain. For example, there can be strains to the large back muscles, injuries to the ligaments that protect the spine, disc or individual vertebra dislocations, and many more possibilities for joint or nerve damage.
The good news is that much of the non-kidney related pain that we often experience will simply go away on its own after a few days or weeks. In fact, the relevant and much documented statistic is that half of the back pain we experience will dissipate on its own within two weeks, and 90% within three months. The leftover pain, i.e. the pain that will not go away either on its own or as a result of some treatment, becomes known as chronic pain, i.e. pain that lingers for at least 12 weeks.
It is thought that some 32 million Americans experience lower back pain at any given time.
Half of the American workforce reveals they've had low back pain in the past year.
Americans spend over $50 billion a year on non-kidney related lower back pain.
Nearly one third of female adults suffer from lower back pain compared to a quarter for men, yet men claim their pain affects work 33% more so than women.
54% of U.S. citizens who have non-kidney related low back pain conduct their work while sitting.
Most causes of back pain are not associated with serious conditions like cancer, arthritis, or broken bones.
Back pain is one of the top reasons why people visit the doctor every year.
If none of the above responses resolve the problem, then it is time to go to the doctor for testing.
Fortunately, these two conditions are rare.
Studies have revealed that 90% of people with non-kidney related lower back pain in America never find out what caused their pain. Only 10% of Americans can attribute their lower back pain to an identifiable cause. In addition, the vast majority of (non-kidney related) cases of low back pain are chronic, meaning that the pain persists and recurs regularly, or that it lasts for longer than 12 weeks.
The sciatic nerve is your body's longest nerve and one of the most important. It begins at your spinal cord, runs through your hips and buttocks, and then branches down each leg. Sciatica is caused by a variety of low back conditions, including lumbar degenerative disc disease.
The kidneys are vital organs that are located in the upper abdominal area against the back muscles on both sides of the body. The kidneys serve to continually rid the body of excess fluids and waste material. Kidney-related pain is caused primarily either by urinary tract infections or kidney stones, this latter usually producing symptoms of extreme and relentless pain, until the stones are either removed or made to dissolve.
Kidney pain can be on the left, right, or both sides of the lower back area.
When the diagnosis points to an infection, antibiotics are used for kidney treatment, often together with ibuprofen (Tylenol) or acetaminophen (Motrin). On the other hand, kidney stones can pass naturally or, when needed, can be taken out surgically.
This is the most common cause of vertebral compression fractures, especially in women over the age of 50. Women are almost twice as likely as men to have a compression fracture.
This is a degenerative disease that generates muscle pain, stiffness, pain in the low back and legs, and fatigue, and women are 3 times more likely to develop it than men.
This is a degenerative joint disease that constitutes the most common type of arthritis. It produces pain in the knees, hips and lower back. It is prevalent in both men and women up to age 45, but beyond that, it is more prevalent in women.
This makes sitting painful, and women are 5 times more likely than men to develop it. It affects women at an average age of 40 and can become chronic.
The sacroiliac joint serves as a shock absorber between the upper body and pelvis commonly producing low back and leg pain. It produces chronic pain that is more prevalent and frequently more severe in women.
This is a disorder that produces widespread pain and fatigue and that is difficult to diagnose and treat. Over 80% of those who develop fibromyalgia are women.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in pain management to alleviate the symptoms of pain. These are pain suppressant drugs that work by blocking the effects enzymes in the body and reducing inflammation. Examples of NSAIDs are Celebrex, Motrin, Advil (ibuprofen), Indocin and several other medications.
Antidepressants, though intended for depression, have been found to be effective treatments for certain kinds of pain, one of which is lower back pain. It is thought that they increase neurotransmitters in the spinal cord that decrease pain signals. Most antidepressants don't work right away – they may take a few weeks to provide some relief. Of different classes of anti-depressants, tricyclic antidepressants are most commonly prescribed for pain. Examples include Amitriptyline, Imipramine (Tofranil), Clomipramine (Anafranil), Doxepin, Nortriptyline (Pamelor), and Desipramine (Norpramin).
Selective Serotonin Reuptake Inhibitors (SSRIs), are a relatively new class of anti-depressant and anti-anxiety medication, usually prescribed in non-kidney related pain management techniques together with psychotherapy.
Muscle relaxers are a group of drugs that have a sedative or calming effect on the body. They work through the brain, as opposed to directly on the muscles. Muscle relaxants are widely prescribed for acute back pain, often in addition to an over-the-counter or prescription pain medication. Usually, doctors will prescribe them for a short time to relieve lower back pain caused by muscle spasms. Muscle relaxants are generally used for a few days (up to two weeks), but they can sometimes be prescribed for chronic back pain. One side effect of these medications is drowsiness so use caution if taking them during the day.
Corticosteroid drugs reduce spontaneous discharge in an injured nerve, which in turn reduces inflammation and neuropathic pain. They may be given orally, intravenously or via injections directly into joints. Commonly prescribed corticosteroids for pain include Prednisone, or prednisolone, and Dexamethasone.
Opiods are high strength pain killers, and they represent the most widely prescribed class of medications in the U.S., despite their addictive and potentially harmful nature. Over the last decade, the number of prescriptions for the strongest opioid drugs has increased nearly fourfold, with only limited evidence of their long-term effectiveness or risks.
The rising use of legal prescription opioids, primarily painkillers such as Oxycodone and Hydrocodone (Oxycontin and Vicodin), has become a growing problem leading some patients from pain care to addiction. Deaths and other negative health outcomes from these prescription drugs and heroin have spiked, and surveys suggest that hundreds of thousands of patients nationwide may be on potentially dangerous dosages. However, sometimes opioids may be necessary to relieve severe pain for a temporary period of time. Discuss with your doctor whether the benefits outweigh the risks for your particular situation.
Physical therapy is usually prescribed as an initial attempt at mitigating pain before pursuing more aggressive treatment options. Physical therapists can provide possible treatments and techniques such as electrical stimulation, muscle-release techniques, heat, or ultrasound, to aid your back muscles and soft tissues for pain relief. Physical therapy will typically focus on decreasing back pain, increasing function, and teaching the patient exercises to do at home to prevent future back problems.
Contingency Management and Cognitive Behavioral Therapy (CBT) focus on modifying the patient's expectations and behaviors related to pain, building coping skills, and improving overall health. Psychotherapy treatments like cognitive-behavioral therapy (CBT) have shown benefits for those experiencing pain, especially when applied in tandem with pharmacotherapies.
If you have back or joint pain, there will be times when all you want to do is lie in bed all day. Lying in bed used to be what doctors prescribed the most, although it has been shown in many studies that it is stretching, exercise and staying flexible that does your back pain, and overall health, the most good.
There are many simple stretches and exercises that can be performed in 20 to 30 minutes as part of your daily routine. If you are just starting out, even a simple act of sitting upright on an exercise ball for 30 minutes a day will engage your core muscles.
The muscles in your abs and back play a critical role in supporting your lower spine. These muscles don't get a good workout during the course of a normal day—they need to be specifically targeted through stretches and exercise.
Specific stretches are often prescribed by physical therapists, and it is important to follow their instructions before you commit yourself to a wrong type of movements that may do more harm than good. Appropriate stretching of the muscles along with practice exercise workouts will help improve range of motion and generate stress relief and relief for less than optimally used muscles.
Generally speaking, people with LBP should concentrate on stretching the lower back muscles, abdominal muscles, hips, and legs.
These exercises comprise the use of various types of exercises to stabilize your core muscles and may include use of exercise balls, balancing machines or specific stabilizing exercises. By keeping your trunk steady as you move one or more of your extremities, you can begin to develop your dynamic stabilization.
Though back pain can be uncomfortable and debilitating, it is typically temporary and will resolve on its own or with treatment within a few weeks or months. If pain medications are not providing relief, ask your doctor about alternative treatments like acupuncture. Remember – 80% of adults have back pain sometime in their lives, so you are not alone. Fortunately there are many options for treatment and relief, so there is a good chance that one of these methods will work for you.