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Lower Back Pains

June 11, 2017

Low Back Pain, Sciatica, Sciatic Nerve Pain

Lower back pains are a common problem throughout our society.

The low back is also referred to as the lumbar spine. The lumbar spine is a highly complex group of structures that are designed to work as a functional unit. The components of the lumbar spine include bones, joints, intervertebral discs, nerves, ligaments,  muscles ,blood vessels, the spinal cord, and nerves. These structures all work together to provide support for the upper body as well as movement and a passageway for nerves as they pass along your way to the internal organs and lower extremities. The correct functioning of the lumbar spine is integral to the overall functioning of the body. Although the lumbar spine is intricately designed, it is often injured and/or subject to various degenerative changes or diseases.

When it is functioning correctly, the lumbar spine allows us the mobility to move about with bending and twisting as well as the ability to walk correctly. The organs of the abdomen and pelvis as well as the nerves and muscles of the legs are dependent on correct function of the structures in the lumbar spine.

 Lumbar Strain/Sprain

Lumbar strains or sprains are most common source of low back pain is a sprain or strain of the lumbar spine involving the ligaments, tendons, or muscles. Similar minor injuries can also occur to the joints and discs. In most cases, the body is able to repair these minor injuries after only a short period of time. In fact, the vast majority of these minor injuries resolved without any specific treatment within a few weeks.

However, if the injury is more serious or if it is a disease process  that is causing the pain, the symptoms will likely not resolve on their own. In the case of severe diseases such as tumors, spinal infections, and osteoporotic compression fractures, the pain will likely persist and worsen over time rather than improve. The severe problems usually require medical and/or surgical attention to achieve the best outcome. Other degenerative problems such as degenerative disc disease, spinal stenosis, spondylosis, spondylolisthesis, and bulging or herniated discs may or may not get better on their own.

During the healing process, the body mounts an inflammatory response that causes the sensation of pain. This pain can be quite severe For the self-limited problems, this pain is temporary.

that caused the sensation of pain also call in specific cells into the area that help repair the injury. Some of these cells include white blood cells, bone producing osteoblasts, fibroblasts to produce connective tissue, and macrophages along with osteoclasts to help clean up and remodel debris.

Mechanical and Radicular Back Pain

Generally lower back pain can be divided into two types. Mechanical back pain is the most common type. This is also referred to as axial back pain. This type of pain is generally localized in the lower lumbar region. It may extend into the buttocks or thighs but rarely goes below the knees. The type, distribution, and severity of mechanical back pain is usually variable based on the position and stress on the lumbar spine.

The second most common type of back pain is called radicular pain. This type of pain occurs when a nerve root is compressed or becomes irritated or inflamed. The distribution of radicular pain is usually felt along the typical distribution (dermatome) of the nerve root affected. While mechanical back pain usually has a dull, aching, or stabbing sensation; radicular pain is often described as an electric sensation that has a sharp burning characteristic. Radicular pain can also have a component of numbness associated with it.

While mechanical back pain is commonly seen on one or both sides of the lumbar spine, radicular pain is usually felt only on one side. Another word that is commonly used to describe radicular pain is "sciatica".

Other Causes of Lower Back Pain

Some processes such as lumbar stenosis can cause symptoms known as neurogenic claudication. This is a pain and weakness that develops after walking for a short distance. What is occurring is that the narrowing in the spine or the openings that the nerve roots exit out of causes limited blood flow in the nerve roots. Like most structures in the body, the nerve roots also require blood to function properly. When they do not have enough blood pumping through the tiny vessels supplying them, they stopped functioning properly. They start sending aberrant pain signals while at the same time they are unable to transmit the electrical signals to the muscles that allow the legs to function properly.

While mechanical low back pain and radicular pain are the most common types of low back pain, pain that is felt in and around the lumbar spine can be caused by many other problems, many completely unrelated to the structures of the lumbar spine.

We have already mentioned some of these. Infections and tumors can be very serious and even life-threatening issues affecting the lumbar spine.

Autoimmune processes such as rheumatoid arthritis and ankylosing spondylitis can cause severe back.

Disease processes occurring in the organs of the body can sometimes refer pain that is interpreted as low back. Some examples of this include pancreatitis, kidney stones, ulcerative colitis, and even on rare occasions a heart attack.

 

Resources:
Lower Back Pain Symptoms, Diagnosis, and Treatment
Sciatica and Radicular (Nerve Related) Back and Leg Pain
Low Back Pain

 

About the Author
Dr. John B. Adams is board certified in Pain Management by the American Board of Medical Specialties and the American Board of Interventional Pain Physicians. With almost 2 decades of experience, he offers patients access to state-of-the-art pain management, emphasizing a multidisciplinary approach to pain management utilizing precision injections, neuromodulation technology, physical therapy, behavioral medicine and judicious use of medications including help with patients titrating off opiates (narcotic pain medications).

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