Lower back pain is one of the leading reasons people in the United States visit their doctors. It will inhibit the lives of millions of Americans this year.
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Lower back pain is one of the leading reasons people in the United States visit their doctors. It will
inhibit the lives of millions of Americans this year. In fact, an average four out of five adults will
experience low back pain at some point in their lives. So the question, "What is causing my lower
back pain?" is not uncommon.
Lower back pain can be excruciating. It can be caused by a large variety of injuries or conditions,
such as:
* lower back muscles may be strained
* discs between the vertebrae may be injured
* large nerve roots extending to arms and legs may be irritated
* smaller nerves that supply the lower back spine may be irritated
* joints, ligaments, or even bones may be injured
When lower back pain occurs with other symptoms such as fever and chills, a serious medical
condition may be present. You should see a doctor immediately.
Three categories of lower back pain
Your lower back pain will fall into one of three categories, which your doctor bases on your
description of the pain.
1. Axial lower back pain - mechanical or simple back pain
2. Radicular lower back pain - sciatica
3. Lower back pain with referred pain
1. Axial Lower Back Pain
Axial lower back pain is the most common of the three. It is felt only in the lower back area with no
pain radiating to other parts of the body. It is sometimes called mechanical back pain or simple
back pain.
* Description: Axial lower back pain can vary greatly. It may be sharp or dull, constant or
2. intermittent. On a scale of 1 to 10, you may rate its intensity #1 or a full #10. It may increase with
certain activity - when playing tennis, for example. It may worsen in certain positions - such as
sitting at a desk. It may or may not be relieved by rest.
* Diagnosis: Axial lower back pain might be diagnosed by you rather than your physician. You
know it started when you were helping a friend move a heavy couch. On the other hand, it may be
your doctor who determines that you have strained or otherwise damaged back muscles, have a
degenerated disc, etc.
* Treatment: The cause of your axial lower back pain does not matter when it comes to treatment.
You will want to rest for a day or two. Follow this by gentle back pain exercises and stretching. If
you have more pain after exercise, use a heating pad on low or medium setting. Take an
appropriate over-the-counter pain medication. Follow your doctor's advice.
* Prognosis: Symptoms of axial lower back pain disappear with time, and about 90% of patients
recover within four to six weeks. If you do not feel better within six to eight weeks, additional
testing and/or injections may be needed to diagnose and treat the source of the pain.
* Caution: If your pain is chronic, or so severe that it awakens you during the night, see your
doctor.
2. Radicular Lower Back Pain
Radicular lower back pain is commonly referred to as sciatica. It is felt in the lower back area,
thighs, and legs.
* Description: Radicular lower back pain often begins in the lower back, and then follows a specific
nerve path into the thighs and legs. Your leg pain may be much worse than your back pain. It is
often deep and steady. It may readily be reproduced with certain activities and positions, such as
sitting or walking.
* Diagnosis: Radicular lower back pain is caused by compression of the lower spinal nerve. The
most common cause is a herniated disc with compression of the nerve. Other causes might be
diabetes or injury to the nerve root. If you had previous back surgery, scar tissue may be affecting
the nerve root. Elderly adults may have a narrowing of the hole through which the spinal nerve
exits.
* Treatment: Conservative treatment is the best place to begin. Rest for a few days in a bed or
chair. Follow this by gradual introduction of gentle exercises specifically for back pain relief. Follow
your exercise with additional rest, applying a heating pad on low to medium setting. Soak daily in
Epsom salts baths. Take an appropriate over-the-counter pain medication. Your doctor may want
to use selective spinal injections.
* Prognosis: Symptoms of radicular low back pain may decrease with the conservative treatment
outlined above. Give your back and legs six to eight weeks to improve. If surgery is needed after
that, it typically provides relief of the leg pain for 85% to 90% of patients. The back pain itself is
more difficult to relieve.