What is lower back pain?
It may be a limited musculoskeletal symptom or caused by an
assortment of diseases and disorders that affect or extend from the lumbar
spine. Low back pain is occasionally accompanied by overtraining, which can be
pain that entails the sciatic nerve and can be felt in the lower back, the
buttocks, the backs and sides of the thighs, and the calves. More serious
causes of LBP may come with fever, night pain that awakens someone from sleep,
loss of bladder or bowel control, numbness, burning urination, swelling or
sharp pain. In many cases complementary holistic therapies for lower back pain
can provide pain relief.
Types of lower back pain
Low back pain is a symptom which affects 80 percent of the
general United States population at some point in life having sufficient
severity to cause lack of work. As mentioned, it is the second most common
reason for visits to primary care physicians, and is estimated to cost the
American economy $75 billion annually. One third of the nation’s disability
associated costs are associated with LBP, a condition primarily affecting
individuals between the ages of 45-60.
The structures of the typical lumbar area of the spine
contain the spinal nerves, discs between each vertebrae, ligaments, tendons,
muscles and muscle tissues, the spinal cord inside the fascia and nerves
extending outward from the backbone through vertebral foramina (openings in the
bone). The lumbar vertebrae are different from the cervical (neck area) and
thoracic (upper back) vertebrae, being normally thicker for increased weight
bearing aid, and resting atop the sacrum, the triangular shaped bone involving
the buttocks. The discs between either side of the spine cushion and absorb the
shock that might otherwise be transmitted via the spine. Sometimes, the disks
may “rupture” or herniate external through their fibrous sheath, or
covering, putting pressure on the nerves. Nerve pain from other local organs
might also be causative, in which case identification and therapy is far more
involved, usually a whole lot more serious, and may indicate a life threatening
Hazards for low back pain are raised with fracture and
osteoporosis, narrowing of the spinal canal in the fascia (stenosis), spinal
curvatures, fibromyalgia, osteoand rheumatoid arthritis, pregnancy, smoking,
stress, age greater than 30, or disorder or illness of the organs of the lower
In addition to dividing low back pain into three categories
based on length of symptoms–acute, sub-acute or chronic–lower back pain may
be described as:
• Localized. In localized pain that the patient will feel
discomfort or distress when the physician palpates, or presses on, a specific
surface area of the lower spine.
• Diffuse. Diffuse pain is spread over a larger area and
comes from deep tissue layers.
• Radicular. The pain is caused by irritation of a nerve
root and radiates from the region. Sciatica is a good illustration of radicular
• Referred. The pain is sensed at the lower spine, but
actually is brought on by disease or inflammation elsewhere, like the kidneys
or other constructions of or near the lower abdomen including the intestines,
appendix, bladder, uterus, ovaries or the testes.
Lower back pain causes
The lower spine where back pain occurs comprises the five
vertebrae (referred to as L1-L5) in the lumbar region, which supports a lot of
the weight of the upper body. The distances between the vertebrae have been
maintained through round, rubbery pads known as intervertebral disks which act
like shock absorbers throughout the spinal column to cushion the bones as the
body moves. Bands of tissue called ligaments hold the vertebrae in place, and
tendons attach the muscles to the spinal column. Thirty-one pairs of nerves
have been suspended into the spinal cord and they control body movements and
transmit signals from the body to the brain. [National Institute of
Neurological Disorders and Stroke, National Institutes of Health]
Acute and sub-acute pain
Lumbar strain or anxiety is the most common cause of severe
low back pain. It is pain that doesn’t usually stretch to the leg and usually
happens over 24 hours of heavy lifting or overuse of the back muscles. The pain
is usually localized, and might be accompanied by muscle aches or soreness to
touch. The patient usually feels better when resting. Acute strain may follow a
sudden motion, particularly a lifting and simultaneous twisting motion,
nevertheless injury is usually preceded by overuse or lack of exercise and tone
particularly of the opposing muscles (the abdominals, by way of instance),
improper use, long periods of sitting or standing in one place, inferior
vertebral alignments or ailments compromising nutrition of the supportive
structures. Acute low back pain due to lumbar strain (roughly 60 percent of
victims ) usually concludes with a week using conservative treatments, such as
reducing but not eliminating activity. Subacute pain is connected with a
duration of 6–12 months, by that time 90 percent of men suffering low back
pain and injury return to work. This class accounts for one third of all
disability related costs. LBP persisting past three months is deemed chronic.
Symptoms of acute LBP might be accompanied by stiffness (guarding), constipation,
bad sleep and trouble finding a comfortable position, problems walking and
other limits on normal selection of movement.
Chronic lower back pain
Persistent low back pain has a lot of different potential causes.
a) Mechanical. Chronic pressure on the muscles of the lower back could be brought on by obesity, pregnancy, or jobrelated stooping, bending, or other stressful postures. Construction, truck driving accompanied by vibration, jack hammering, sand blasting and other resources of chronic injury and strain to the trunk or nerve pressure additionally contribute.
b) Malignancy or other condition: Low back pain at night which isn’t relieved by lying down might be caused by a tumor in the cauda equina (the roots of the spinal nerves controlling atmosphere in and motion of the thighs ), or metastasized cancer which has spread to the spine from the prostate, breasts, or lungs.
The pain is made worse by sitting or lying down, and improves when the individual gets up. It is most commonly seen in males between the ages of 16 and 35. Ankylosing spondylitis is frequently confused with mechanical back pain in its early phases. Other signs include morning stiffness, a positive family history, and positive laboratory results for HLA-B27 antigen (an autoimmune mark ) and an elevated sedimentation rate of blood. This illness may have food allergy associated elements, like an allergy to wheat, worsened by drinking beer.
D) Herniated Spinal Disk: Disk herniation is a disorder where a spinal disk begins to bulge outward between the vertebrae. Herniated or ruptured disks are a frequent cause of chronic low back pain in adults. Pressure imposed on adjacent nerves results in pain which may worsen on movement, with coughing, sneezing or intra-abdominal strain, and be accompanied by tingling of the skin at the area served by the nerve (dermatome). Deep tendon reflexes (DTRs) can be reduced, and the straight leg raising test may be positive. The crossed straight leg raising test, which can be more specific to herniated disk, which may also be positive.
E) Psychogenic: Back pain that is out of proportion to a slight injury, or that’s unusually prolonged, might be related to a somatoform disorder or other psychological disturbance. Psychosocial factors such as lack of job, job dissatisfaction, legal issues, financial compensation issues are a few of the’non-organic’ variables which may be related or causative. Indicators of low back pain in this configuration are usually diffuse, non-localized, and might consist of other stress related symptoms. A group of five evaluations called the Waddell tests may be used to diagnose LBP of psychogenic origin.
F) Low back pain with leg involvement
Low back pain which radiates down the leg usually indicates involvement of the sciatic nerve. The nerve can be pinched or irritated with herniated discs, tumors of the cauda equina (the ending portion of the backbone ), abscesses at the distance between the spinal cord and its covering, spinal stenosis, and compression fractures. Some patients experience weakness or numbness of the legs, in addition to pain. There might be spasming of those muscles otherwise stimulated by the nerve, and a positive leg raising test.
Natural lower back pain treatments
A thorough differential diagnosis is important before any
therapy is considered. There are occasions when natural treatments and holistic
therapies for lower back pain might be beneficial, and other times when more
invasive therapies are necessary.
Chiropractic treats patients by manipulating or adjusting
sections of the backbone. It’s one of the most common types of alternative
treatment in the USA for relief of back pain caused by straining or lifting
injuries, and continues to be demonstrated through many randomized trials to be
advantageous. Added recommendations of shoe orthotics, exercise, cold packs to
reduce and inhibit swelling immediately following injury followed one to two
weeks later by hot packs and cold packs to stimulate healing, hydrotherapy, and
life style adjustments may be recommended. Nutritional supplements known to be
beneficial to joint reduction and ethics, hydration support, and wound repair
may also be advocated, including glucosamine sulfate, with or without
chondroitin, MSM,, along with a variety of mineral and vitamin cofactors.
Acupuncture (Traditional chinese medicine)
Practitioners of traditional Chinese medicine treat low back
pain with acupuncture, massage, acupuncture, and the use of herbal poultices.
They may also use a technique called moxibustion that involves the usage of
glass cups, and heated atmosphere derived use of a burning braid or stick of
herb with a distinctive aroma.
Herbal medicine and anti-inflammatory enzymatic therapy
Herbal medicine can utilize a variety of anti inflammatory
and sedative herbs to help relieve low back pain due to spasm. For this purpose
and readily available at a local healthfood store are herbs like chamomile
(Matricaria recutita), hops (Humulus lupus), passion flower (Passiflora
incarnata), valerian (Valeriana officinale), and cramp bark (Viburnum opulus).
Bromelain from pineapples has anti-inflammatory action. Intake of fresh grape
juice, preferably made from from dark grapes, on a daily basis at a time other
than mealtime has also been found to be helpful. Minor backaches might be
relieved with the application of a heating paste of ginger(Zingiber officinale)
powder and water, allowed to sink for 10 minutes, and followed by an eucalyptus
Aromatherapy with soothing essential oils of blue chamomile,
birch, rosemary, or lavender could be effective when rubbed into the affected
area after a hot bath.
Other remedies may be recommended depending on the symptoms
presented by the individual.
Body yoga and work
Massage and the numerous other body work
techniques can be very helpful in treating low back pain. Yoga, practiced
regularly and performed properly, can be used with meditation or imagery to
both treat and prevent future episodes of lower back pain.
Prevention of lower back pain
Low back pain due to muscle strain can be prevented by natural
therapies, lifestyle choices, including regular physical exercise and weight
control, avoiding smoking, and learning the correct techniques for lifting and
moving heavy items. Exercises designed to strengthen the muscles of the lower
back and the opposing abdominals are also suggested. Simple actions may also
help prevent low back pain, like putting a little, firm pillow supporting the
lower back when sitting for long periods, using a soft pillow for sleep which supports
the lower neck without producing an unnatural angle for shoulder and head rest,
employing a swiveling desk chair with a postural support or stool which
maintains the knees at a higher level than the hips, standing on flexible
rubber mats to avoid the effect of concrete flooring at areas of employment by
way of example, and wearing supportive, soft soled shoes, avoiding the use of