What Are the Causes of Lower Back Pain?
Sprain/Strain
Muscles and ligaments can be injured from injury or overuse.
Degenerative Disc Disease (e.g. herniated discs, annular tear)
These are caused by age related degeneration over time, injury, or daily wear and tear that causes the discs to lose water and become compressed, tear, or herniate.
Sciatica (e.g. leg pain from the back)
Herniated discs or bone spurs can cause compression of the nerves that go to the legs.
Osteoarthritis
Facet joints in the spine support up to 60% of your upper body weight and are very small (about the size of the base of your thumb). Facet joints work hard! They can develop osteoarthritis like a knee or hip. Over time, they can degenerate, grow spurs and cause pain in the back or referred pain into the hips and buttocks or legs.
Spinal Stenosis
When bone spurs grow and discs lose height due to loss of water and bulge out, they take up space where the nerves exit out to come down the legs resulting in compression of the nerves. This can cause low back pain and leg pain. The pain down the legs is related to certain positions. For example, when standing and walking, it can make the compression worse resulting in more pain in the legs. However, when sitting, the compression is less and pain is relieved.
Sacroiliitis
The sacroiliac joint is a joint between the sacrum (part of your spine) and the pelvis (ilium). People with pain in this joint often think it is their hip causing the problem. The pain may be due to sprain or arthritis. Steroid injection to the joint is helpful to diagnose and treat the pain.
Scoliosis
This curvature of the spine can be congenital (born with it) or developmental from degeneration of the spine over time.
Myofascial Pain
This is pain in a certain muscle group causing referred pain to a surrounding area. It is muscular in origin and can be very painful.
Compression Fractures/Osteoporosis
Osteoporosis is a disease that causes the bones to lose their density and become weak. Small injuries like a fall can cause vertebral fractures. These fractures can cause a lot of pain or be painless.
Cancer
Cancer in the spine can be due to bone cancer or another type of cancer that has metastasized, or moved to the bone.
Infection
Rarely an infection in the spine can cause low back pain. If you have fevers, chills, night sweats, or weight loss with your low back pain, seek medical attention immediately.
Other Reasons for Low Back Pain
Sometimes low back pain may not be related to the spine or muscles of the back at all. There are other conditions that can cause low back pain such as kidney stones or pregnancy.
Treatments for Lower Back Pain
Physical Therapy
Physical therapy is a first line treatment for low back pain. The point of physical therapy for low back pain is to strengthen the supporting muscles of your spine (core muscles) to support the spine better.
Injections
Injections (e.g. epidural, facet joint, sacroiliac joint, trigger points, nerve blocks) are a way to deliver anti-inflammatory medicines next to inflamed discs, nerve roots, or joints to improve low back pain.
Rhizotomy/Radiofrequency Ablation
Rhizotomy/Radiofrequency Ablation is a procedure performed on individuals with low back pain due to arthritis of lumbar facet joints or SI joints to provide longer lasting pain relief (9-12 months).
Modalities (Horizontal Therapy, TENS unit)
Modalities (Horizontal Therapy, TENS unit) are treatments that help pain without the use of medications or injections. These treatments include ice, heat, electrotherapy, or massage.
Manual Therapy/Osteopathic Manipulation
Manual Therapy/Osteopathic Manipulation is when a professional places hands on muscles and joints to diagnose, treat, and prevent illness or injury. Using osteopathic manipulation, the physician will move your muscles and joints to facilitate healing.
Acupuncture and Chiropractic Treatments
Acupuncture and Chiropractic treatments are complimentary therapies to treat your pain.
Braces
Braces for your back, wrist, elbows, or knees can help treat pain and improve function. We are available to evaluate the cause of your pain and fit you with braces if appropriate.
Medication
Sometimes medications are necessary to treat pain that is resistant to other options. We are willing and able to discuss all pain management options with you to improve your quality of life.
When Should You See a Specialist
We at Comprehensive Rehabilitation and Pain Specialists, P.C. want to make sure that whether you see us or not, that you receive the care that you require. We recommend that you see a specialist like ourselves if you have:
- Pain not resolved after 4-6 weeks with self treatment and relative rest
- Weakness in your muscles
- Trouble walking or balance loss
You should seek medical attention immediately if you have:
- Bowel or bladder loss (wetting or soiling yourself)
- Progressive pain or night time pain
- Fevers, chills, fatigue, or flu-like symptoms
Please contact us if we can be of any assistance in your care.