December 8, 2023

Low back pain is a common problem, affecting more than 85 percent of adults. It is often due to non-specific causes. It is not clearly due to a known disease, abnormality, or serious injury to the spinal column. Studies show that less than one percent of back pain is caused by infection or cancer and less than 10 percent is caused by trauma, specific nerve disease and other diseases.

Non-specific back pain (no identifiable cause) usually improves on its own in a few weeks’ time. Warm compress may help alleviate pain and once able, a person can resume his exercises and activities since these can help speed up recovery.

Serious causes include tumor or cancer and infection like tuberculosis. Low back pain may also be caused by compression fractures due to weakening and thinning of the bones brought about by osteoporosis. In these situations, a person has other diseases or risk factors like diabetes mellitus.

Other causes of low back pain are the following:

1. Changes associated with aging – the so-called “wear and tear that leads to small breaks in disc spaces between the bones of our back (spinal discs). Bone spurs or bony growths develop and contribute to back pains.

2. Excessive wear and tear can cause bulging of spinal discs which can impinge or press on a nerve. If the outer covering of a disc becomes very weak or is torn, slipped disc can develop. The low back pain becomes associated with leg pain or leg weakness

3. Osteoarthritis or inflammation of joints between the vertebrae or bones of the back can also cause bone spurs to develop.

4. Occupational back pain – caused by poor posture while sitting or standing at work, driving long distances, frequent lifting, lifting of heavy objects, and sitting for prolonged periods. 

5. Younger adults may have low back pain due to ankylosing spondylitis, an inflammatory disease. There is stiffness of the back which improves with activity.

6. Spondylolisthesis – this occurs when there is too much pressure or stress on the bones of the back so that one vertebra moves or slips forward. 

7. Stenosis or narrowing of the canal or space inside the vertebrae. This occurs when bone spurs develop. The person may have low back pain associated with pain in the lower legs when walking. 

8. Muscle spasm can also cause back pains.

Most persons with low back pain improve within weeks and may not need extensive tests. X-rays, CT scan or magnetic resonance imaging are procedures that are be done when deemed necessary – when the information gained will help in the treatment of the low back pain. 

X-rays may be done in people who present with risk factors for or have signs of cancer and compression fracture due to osteoporosis. X-rays do not show enough detail to diagnose disc herniation or spinal stenosis. X-rays also expose the person to radiation. 

CT scan or MRI may be done to diagnose a herniated or bulging disc or spinal stenosis. Either or both of these tests are done when a person with low back pain is at risk for or is suspected to have infection, cancer, fracture, if surgical procedure is planned, or if low back pain lasts for more than four to six weeks and the cause is not clear. These procedures are performed only after careful consideration of exposure to radiation (CT scans) and the usefulness of the tool in the overall management of the low back pain. 

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