The lumbar spine, also known as the low back, is composed of a variety of interconnected bones, joints, ligaments, muscles, and nerves that work in tandem to support the weight of your body. While the complexity of this system helps you with flexibility and strength, it also leaves your lower back vulnerable to pain and injury. If you are experiencing low back pain, there are several potential causes. In this blog, we will go over the causes of lower back pain, as well as the symptoms, diagnosis, and treatment options.
Causes of Low Back Pain
Low back pain is most commonly caused by soft-tissue injuries, such as intervertebral disc damage, nerve root compression, and improper spinal joint movement. The most common cause of acute low back pain is a pulled muscle or ligament.
Muscle Strain or Ligament Sprain
A low back strain or sprain can happen very suddenly or it can evolve over time. A strain occurs when a muscle is stretched too far, tearing it and causing damage. A sprain is essentially the same issue, but it affects the ligaments, which function to keep bones together. Both of these conditions have the same symptoms and are treated the same way; the only difference is whether it affects the muscles or ligaments. This may happen when you lift something heavy or twist when you lift. They can also happen due to athletic activities, a fall, or poor posture over time. While these can be uncomfortable, in general, the pain tends to be short-lived.
The discs in your spine are the cushions between the vertebrae and are filled with a jelly-like substance. If this material ruptures, it can cause the disk to bulge and press against a nerve, causing back pain.
Degenerative Disc Disease
When you are born, your intervertebral discs are full of water. Over time, the discs slowly lose hydration, wearing down. As the disc becomes more dehydrated, it has a harder time resisting forces, and this can cause tearing and pain that can lead to herniation. The disc can also collapse, contributing to stenosis.
As we wrote about in a previous blog, the facet joints are a common source of pain when the cartilage begins to wear away. If there is any dysfunction in these joints, they can cause pain on their own, or they can hurt in response to disc pain.
Sacroiliac Joint Dysfunction
The sacroiliac joint connects the bottom of the spine, known as the scrum, to your pelvis on each side. This strong joint is primarily used to absorb shock and tension between the upper and lower halves of your body. If there is too much motion or even too little in this joint, it can become inflamed and painful.
Spinal stenosis is a condition that causes pain due to the narrowing the spinal canal around the nerve roots. This can be central, foraminal, or both, and can occur at different levels of the low back.
This condition is when a vertebra slips over an adjacent vertebra. There are five different types of spondylolisthesis, but it is most common for it to occur due to a fracture of the pars or the degeneration of the facet joints. The pain occurs due to instability in the back or nerve compression in the legs.
Osteoarthritis is a painful condition that is the result of wear and tear on disc and facet joints. It can occur at multiple levels of the spine and involves inflammation, pain, and instability in the spine.
Spinal fractures or dislocations can cause chronic pain. If you experience low back pain after any trauma, such as a car accident or a fall, it’s imperative to have it evaluated by a medical professional as soon as possible.
If a fracture happens in the cylindrical vertebra (where the back curves into itself), it can be suddenly very painful. This is more common in older people, as it is typically caused by osteoporosis or weak bones.
Symptoms of Lower Back Pain
Low back pain is characterized by some combination of the following symptoms:
- Dull, aching pain, often accompanied by muscle spasms, aches in the pelvis and hips, and limited mobility
- Radiating pain in the buttocks, legs, and feet, also known as sciatica
- Worse pain after sitting for a long period of time
- Pain relief when switching positions — many causes of low back pain feel more comfortable in certain positions than others
- Pain that is better after you wake up and begin moving around — this indicates that you need a new mattress, as you aren’t getting enough blood flow at night
Diagnosing Low Back Pain
When diagnosing low back pain, it is imperative that your doctor is able to understand the underlying cause, rather than just treat the symptoms. You will need to give a thorough description of your symptoms and medical history. From this, we should be able to surmise the source of your pain. However, we may also request a few physical exams to narrow down the cause of your pain. For example, we may need to test your range of motion and reflexes, as well as a palpation test and leg raise test. In some cases, we will need to investigate further, in which case, a diagnostic image test of some kind may be necessary, such as an x-ray, MRI, or CT scan. We also commonly use injection studies at our spine clinic.
In our next blog, we will begin to go over the different treatments used to address low back pain problems so you can have a full understanding of this condition. At ClinTech Center for Spine Health, we are able to provide you with the answers you need to address your low back pain. If you’re looking for a spine surgeon in Johnstown, we are more than happy to help! Contact us today to schedule a consultation.