Lower back pain (Chronic) : Symptoms, causes and treatments

Lower back pain

Everyone will have or already had some pain in their lumbar region, just below the ribcage. Such pain can be so intense that it can interfere with one’s daily tasks like job, school, extracurricular activities among others.

This is such a common health condition that a lot of research has been done to assist people to look out for it for prevention and treat it if one is already suffering. 

Here you will find everything you need to know about Low Back Pain : Symptoms, various causes and treatment.

What is Low Back Pain ?

To start, we suggest you to watch this quick video explaining what is a Low back Pain :

Signs and indications of Low Back Pain

The symptoms ranges from acute to chronic where a person need to have suffered for more than 3 months for the pan to be considered chronic.

After injuries from sports or some heavy lifting individuals can experience a dull ache to a shooting sensation. 

When to seek urgent care

Serious injuries or a very bad fall can yield severe back pain and it will be a good practice to consult medical practitioners immediately.

Moreover, there are other signs and symptoms which should tell individuals it is time to consult especially if such symptoms are accompanied by back pain. And these are:

  • loss of bowel or bladder control, 
  • lack of feeling in the groin area, 
  • leg feebleness,
  •  fever, 
  • A feeling of pain when coughing
  • A feeling of pain when or urinating. 

Also, people that have pre-existing conditions or disease must contact their physicians immediately if they experience back pain. And these signs are: 

  • Diagnosed cancer, 
  • Losing weight without dieting
  • Addiction to steroids
  • Compromised and poor immune system
  • Addiction to IV drug 
  • Pain that gets severe regardless of good rest. 

Causes of lower back pain

Let see the main causes of a pain in the lower back :

Strains

Excessive activities could stretch or tear up muscles and ligaments leading to stiff lower back or lower back muscle spasms. A lot of rest and some physical therapy are good remedies for strains. 

Disc injury

There is an association between age and torn or herniated disc injury. disc injury usually occurs as a result of sudden lifting of heavy items or a twisted back.

When the spinal cord or nerve roots is pushed by the cartilage surrounding the disc, the disc ruptures and that is referred to as hernia.

The extension of the cushion between spinal vertebrae outside its normal position resulting in nerve root compression. as it exits from the spinal cord and through the vertebral bones. This pain is said to last for 72 hours. (source)

Sciatica

Sciatica is the pain that run from the buttock down one leg which happens due to muscle strain following an intense workout or lifting up heavy goods.

Such an intensity could result in disc bulging or worst, disc rupturing. The sciatica cause pain in the legs and feet because the sciatic nerve connects the spine to the legs. Patients with sciatica pain that feels like burning, or pins and needles

Spinal stenosis

The pressure on the spinal cord and spinal nerves caused by the narrowing of the spinal column. The disc degeneration between the vertebrae is the common cause of the spinal stenosis.

This condition lead to nerve roots or spinal cord compression caused by bony spurs or soft tissues (discs). Patients with spinal stenosis presented with numbness, cramping and weakness which is worsened by standing or walking.

Abnormal spine curvatures

A congenital condition with an early (childhood or adolescent) onset. The condition places pressure on: muscles, tendons, ligaments and vertebrae because of the poor posture. Abnormal spine curvatures are caused by Scoliosis, kyphosis, and lordosis.

Herniated Disc

The gel-like discs that cushions the spine’s vertebrae are susceptible to to wear and tear due to aging or injuries. The discs are said to be herniated when they rupture or bulge which put pressure of the spinal nerve roots.

Other conditions

Some diseases and conditions are known to cause lower back pain. These are 

  1. Arthritis when the joints are inflamed it makes it hard to walk and as such it causes strain on your back as it carried your uneven weight.  
  2. Fibromyalgia when the joints, muscles, and tendons are tender leading to over a long time this could lead to low back pain.
  3. Spondylitis a degenerative disorder where the joints between the spinal bones are inflamed. This disorder can alter the normal spinal structure and function. Elderly people are prune to this condition than younger people. 

Some diseases and conditions are known to cause lower back pain. These are;

  • Kidney conditions
  • bladder conditions
  • being pregnant
  • endometriosis
  • ovarian cysts
  • uterine fibroids
  • cancer

Some bad habits leading to back pain

Career path

Employment involving lifting, pulling, or spinal cord twisting predisposes the culprits to low back pain. Moreover, an office job can be equally risky especially if your sit all day long chair is uncomfortable. 

Hand Bag

The lower bag is the one that gets to support your backpack, handbag, briefcase over your shoulder. Thus, you must ensure that your bags are not overstuffed at all times to prevent lower back pain.

Or rather use a wheeled suitcase or bags when you are planning to carry a lot of heavy stuff. 

Training 

Physical activity is good for your heart but if it is done excessively it can cause overextended muscles that yield low back pain.

The best way to avoid pain is to spread your training throughout the week instead of doing it on a weekend only as this puts a strain on your body. 

Posture

Your weight is supported by your back, and if you have a habit os slouching, then you are hurting your back. Thus when standing, you need to use both feet so as to keep your weight evenly distributed.

Also, your lower back and shoulders back must have a lumbar support with your feet resting on a foot stool. 

Other risk factors for low back pain

The onset of back pain is usually the early thirties and the older you get the more attacks you are more likely to experience. These factors predispose you to lower back pain.

  • Being overweight
  • Being sedentary
  • Lifting heavy stuff on the job

The diagnosis of low back pain

Only doctors can diagnose the lower back pain, and with the medical history coupled with physical examination to determine the severity of the pain.  It is important for the doctor to also check if the pain has any effect on your range of motion. 

Also, your responsiveness to sensation need to be checked out to see if the nerve cells are affected by the low back pain.

For patients with severe signs and symptoms especially the loos of nerve functions, monitoring is mandatory before subjecting one to expensive tests. Some of these cases might be resolved during the monitoring process using the easier treatment.

However, if after few weeks of close monitoring the patient is still in debilitating pain, then test must be done to get to the root of this pain. However, when patients present with irregular bowel movement, weakness, fever, weight loss couples with the pain, then test are done pronto! 

Some of the test are

  • X-rays, 
  • CT scans, 
  • ultrasounds, 
  • and MRIs 
  • Electromyography (EMG)

Moreover, these tests are meant to screen for bone or disc problems looking at the ligaments and tendons in your back. All these test have proved effective in determining the problem so a patient is given the right treatment for the right condition. 

Treatment : Lower back pain is curable

There various ways to treat lower back pain and the treatment varies from home based – complicated hospital procedures. Some of the remedies and treatments for low back pain are listed: 

Home care

Acute low back pain can be treated using self-care methods. Applying ice on your back for 48 hours is just what the doctor recommends. In like manner, between 48 – 78 hours then applying heat on your lower back. 

Also, you can have a constant switching between heat and ice can be effective remedy as it relaxes your muscle and treat acute injuries. 

This is referred to as the RICE protocol because during those 3 days, the injured person should Rest from their normal day-today routine.  And then the application of Ice on the lower back, and Compression daily not forgetting the Elevation your legs (RICE protocol).  

Simultaneously, over-the-counter drugs like ibuprofen (Advil, Motrin IB), or acetaminophen (Tylenol) can be consumed relieve pain while using home based remedy. 

Sleeping suggestions

  • Putting the pillow between your legs while lying on your side
  • Placing a pillow or on your back while lying on your back.
  • Placing a rolled up towel or a pillow beneath your thigh. 
  • Relaxation of stiff and knotted muscle through massage or warm baths. 

However, you must consult with your medical doctor if the pain has not subsided after 3 days or 72 hours for medical care. 

Medical treatment

The treatment of low back pain includes; 

  • medications
  • medical appliances
  • physical therapy
  • medicines treatment

The dosage and the drugs application is determined by the symptoms presented. The nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common family of drugs as they are the best in relieving pain and treating any inflammation. 

Other medication include :

  • muscle relaxants
  • codeine for pain relief as a narcotic drug 
  • other anti-inflammation steroids 
  • corticosteroid injections
  • food supplements (e.g Omega XL)

Acupuncture

This is another way to treat low back pain. There are more reports on people who claimed the treatment helped but there are few where it did not. However, most reviews reported that for chronic low back pain where patients needed to use the acupuncture treatment the treatment worked. 

Surgery

This has to be the last option after all have failed unless the patient present with fecal incontinence or bladder control, loss of neurological functions.  

Various types of surgeries :

  • A discectomy the removal of the bony part of the spinal cord called, the lamina so as to bring pressure relief that is caused by a nerve root pressed on by a bulging disc or bone spur.
  • A foraminotomy the surgery where the bony hole called foramen in the spinal canal where the nerve root exist is opened up.  
  • Intradiscal electrothermal therapy (IDET) a catheter is used to insert a needle into the disc for 20 minutes heating. The procedure is said to thicken the walls of the disc and cut down the bulging on the inner disc and thus treat nerve irritation.  
  • A nucleoplasty the insertion of a wand-like device into the disc using a needle in order to remove the material in the inner disc. The tissues are heated and shrunk by the device’s radio waves. 
  • Radiofrequency lesioning or ablation interrupting the nerve communication using radio waves through the insertion of a special needle into the nerves to heat it which destroy it. 
  • Spinal fusion the removal of the discs between two or more vertebrae and then bone grafts or special metal screws are used to fuse the vertebrae. 
  • A spinal laminectomy, the removal of the lamina in order to make the size of the spinal canal bigger. This relieves spinal cord and nerves pressure. 

Massage Therapy

This therapy work better when combined with some physical therapies. It is evident that massage, stretching and exercise are good combinations that relieves back pain. 

Physical therapy

The whole point of introducing a physical therapy is to avoid bed rest for people with low back pain. This is because physical therapy is meant to improve function and prevent disability from getting worse. 

Exercise is one prominent therapy that is effective in treating chronic low back pain. However, in the early day, patients will need a professional supervision to train patients and to ensure they don’t further injure themselves. 

Although exercises come highly recommended, it might inaccessible to most people who cannot afford to pay for the program as such programs could be pricey. Moreover, patients may tend to be inconsistent with their attendance to training programs for one reason or another.

In addition, patients are given a choice between group or individual therapy. However, it is recommended that the exercise types are varied to avoid monotonous approach that lead to poor adherence. 

Various types of physical therapy

These treatments must use a holistic approach that treat the patients’ psychosocial like patients fear of movement, self-efficacy, fear of disability respectfully. The social aspect encourages physical engagements with other people like through group activities coupled with medications on demand. 

Pilates

This physical therapy incorporates breathing and stretching in a controlled manner. Most systematic reviews recommended Pilates as one off the most effective rehabilitation tool that has significantly reduced pain and disability in most people who used it.  

Yoga

This has been reported to improve functionality and slightly reduced pain in patients with chronic low back pain. A study showed the efficiency of Yoga where patients who took yoga for 12 weeks had fewer symptoms of lower back pain than those who had to read books on caring for your back pain. 

Walking

One of the easiest form of physical therapy that is free of charge. However, for patients who have lost functionality or have a temporary disability, this could be challenging to do. And as such, patients should commit to the therapy for a long-term to ensure that the therapy is done steadily without putting pressure on the patient.

The long-term commitment to coordinated walking therapy has been reported to be as effective as other non-pharmacological interventions. People who could lost the motion abilities regained it over time through walking therapy. Walking is definitely a good therapy. 

Manipulation and Mobilization therapies

By means of manual adjustment the chiropractor practitioner will apply a sudden thrust on the joint to manipulate the spinal cord. this method can improve the movement of the patient and thus give patients better lives. 

The chiropractors and osteopathic doctors use the lab tests, diagnostic radiographs and the physical examination to decide which treatment is appropriate in manipulating the patient’s lower back. The treatment is integrated approach like nutritional counseling and exercise.

If you want to know more about this practice, we suggest you our ultimate guide on chiropractic.

Exercise therapy

Here is a sample of effective exercises for lower back pain. If you want to know more, please read our article about the best exercises and stretches for low back pain.

Partial Crunches

The core strength workout is used to build strength in the patient’s lower back, partial crunches are introduced into a patients’ routine. This way of exercise is known to strengthen both the lower back and stomach muscles. 

Hamstring Stretches

Some of the muscles that support the work of the lower spine are found at the back of the leg.  Thus, this exercise target that area in order to relieve pressures on the leg thus improving the patients lower back. 

Aerobic Exercises

Cardiovascular system is better strengthened by aerobics exercises. These include; biking, swimming, walking, etc. swimming is good because it supports the body weight and gives one’s back a break as long as the patient does not do twists. 

Some useful tips to exercise your low back

Pelvic clock Device
  • Keep your feet shoulder-width apart while lying on your back. 
  • With narrow part facing down place your pelvic clock at the base of your spine
  • your pelvis is slightly elevated off the ground by the pelvis clock 
  • your pelvis can move in different motions enabled by the dome. 
  • Move the pelvic clock back and forth or in circular movements to exercise your pelvis. 
Bird Dog
  • Bow down 
  • Get your abdominal muscles tightened 
  • lift and extend your one leg behind you while keeping your hips level.
  • Hold it for five seconds.
  • alternate legs.
  • This exercise should be done repeatedly for eight to 12 times
Press-up Back Extensions
  • keep your hands underneath your shoulders after lying on your stomach.
  • By pushing down your hands you should begin to feel your shoulders lift away from the floor.
  • set your elbows on the door directly beneath your shoulders as comfortable as possible.
  • hold this position for several seconds.
Wall Sits
  • at a distance of about 10 to 12 inches, stand with your back facing the wall.
  • Your spine should be flat against the wall as you lean on it.
  • until your knees are bent slightly, slowly slide down the wall. pressing your low back into the wall.
  •  count to 10 while holding this position, then carefully slide back up the wall.
  • To this 8 to 12 times.

Q&A on lower back pain

Q. Are there drugs that could relieve lower back pain that are available over-the-counter? 

A. yes, definitely. Any nonsteroidal anti-inflammatory drugs (NSAIDs) should do as they will bring down the swelling and discomfort. Also look at codeine for pain relief as a narcotic drug or corticosteroid injections but you might need a prescription for those. 

Q. I have chronic constipation and lower back pain, should I be worried?

A. the combination of two conditions or disorders are worrying. You have to consult the doctors immediately. Research show that patients with fecal incontinence coupled with lower back pain do not need to do other physical therapies, but are taken for lab and other tests as a matter of emergency. 

Q. can lower back pain be cured?

A. Yes. There are various treatments. If the patient had an injury and it is not severe, there are few remedies that could be used like homebased therapies, physical therapy and some medication. However, if the pain persists, then severe interventions will ensue like relevant surgery.

Q. what are the known chronic lower back pain symptoms?

A. more than 3 months of lower back pain. Or after injuries from sports or some heavy lifting individuals can experience a dull ache to a shooting sensation. In severe cases that need immediate consultation patients could have a lack of feeling in the groin area, leg feebleness, fecal incontinence or bladder control, etc. 

Conclusion

Lower back pain is one of the most common health problems that affect many people. Aging predisposes you to this condition and some types of employment makes people prune. However, there are many ways to treat this condition.

The public need to know that surgery is not the first intervention to treating lower back pain as it is expensive and more taxing on individuals in many other ways. Therefore, people need to adhere to regular physical activities, and modify their daily activities to prevent this condition from happening to them. 

One of the worrying problems is obesity that also put too much strain on your legs and spinal cord leading to chronic low back pain. Thus, eating healthier and exercising benefits you in more ways than one. So, let choose to live healthier lives. 

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