Men's Health - Low Back Pain

Low Back Pain

What is low back pain?
Low back pain can range from mild, dull, annoying pain, to persistent, severe, disabling pain in the lower back. Pain in the lower back can restrict mobility and interfere with normal functioning.

Low back pain is one of the most significant health problems. Consider these statistics from the National Institute of Health:

Seventy to 85 percent of all people have back pain at some time in their life.

Back pain is the most frequent cause of activity limitation in people younger than 45 years old.

What causes low back pain?
Even with today's technology, the exact cause of low back pain can be found in very few cases. In most cases, back pain may be a symptom of many different causes, including any/several of the following:

overuse, strenuous activity, or improper use (i.e., repetitive or heavy lifting, exposure to vibration for prolonged periods of time)

trauma

injury

fracture

degeneration of vertebrae - often caused by stresses on the muscles and ligaments that support the spine, or the effects of aging

infection

abnormal growth (tumor)

obesity - increased weight on the spine and pressure on the discs often causes back pain

poor muscle tone in the back

muscle tension or spasm

sprain or strain

ligament or muscle tears

joint problems

smoking

Brief Anatomy of the Lower Back:

The lower back, or lumbar spine, functions in structural support, movement, and protection of body tissues. It is a complex structure of vertebrae, disks, spinal cord, and nerves, and includes:

> five bones, called lumbar vertebrae, stacked one upon the other that connect the upper spine to the pelvis

> six shock absorbers, called disks, which act both as cushions and stabilizers to protect the lumbar vertebrae

> spinal cord and nerves, which act as "electric cables" and travel through a central canal in the lumbar vertebrae, connecting your brain to the muscles of the legs

> small joints, which provide stability and allow for functional movement

> muscles and ligaments, which provide strength, power, support and stability

Functions of the Lower Back:

> Protects the soft tissues of the nervous system and spinal cord, as well as adjacent organs of the pelvis and abdomen.

> When standing, the lower back holds most of the weight of the body.

> When bending, extending or rotating at the waist the lower back is involved in the movement.

protruding or herniated (slipped) disk

disease (i.e., osteoarthritis, spondylitis, compression fractures)

Can low back pain be prevented?
The following may help to prevent low back pain:

practicing correct lifting techniques

maintaining correct posture while sitting, standing, and sleeping

exercising regularly (with proper stretching before participation)

avoiding smoking

maintaining a healthy weight

reducing emotional stress which may cause muscle tension

Treatment for low back pain:
Specific treatment will be determined by your physician(s) based on:

your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Treatment may include:

activity modification
medication
physical rehabilitation and/or therapy
occupational therapy
weight loss (if overweight)
no smoking
following a prevention program (as directed by your physician)
surgery
assistive devices (i.e., mechanical back supports)

Low back pain rehabilitation:
Generally, there are three phases to low back pain rehabilitation. These include:

Phase I: Acute Phase
During this initial phase, the physiatrist and treatment team focus on making a diagnosis, developing an appropriate treatment plan, and implementing the treatment regimen to reduce the initial low back pain and source of inflammation. This may include any/all of the items listed above and/or the utilization of ultrasound, electrical stimulation, or specialized injections.

Phase II. Recovery Phase
Once the initial pain and inflammation are better managed, the rehabilitation team then focuses on helping the patient to restore working function of the body. This includes returning the patient to normal daily activities while implementing a specialized exercise program that is designed to help the individual regain flexibility and strength.

Phase III. Maintenance Phase
The goal of this phase of low back pain rehabilitation is two-fold: educating the patient on ways to prevent further injury and strain to the back, and helping the individual to maintain an appropriate level of physical fitness to help further increase strength and endurance.

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