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Back Pain (Low Back Pain)

Almost everyone will experience low back pain at some point in their lives. This pain can vary from mild to severe and can be of short or long duration. However it may be, low back pain can make many of the daily activities difficult.Back Pain (Low Back Pain)

Anatomy
Understanding your spine and how it works can help you understand why you suffer from low back pain.

Your spine is made up of small bones called vertebrae, which are located one on top of the other. The muscles, ligaments, nerves and intervertebral discs are additional parts of your spine.Back Pain (Low Back Pain)

Parts of the lumbar spine.

Vertebrae
These bones connect to create a duct that protects the spinal cord. The spine is divided into three sections that create three natural curves in your back: the curves of your neck (cervical), chest area (thoracic), and waist (lumbar). The lower section of your spine (sacrum and coccyx) is made up of fused vertebrae.Back Pain (Low Back Pain)

Five lumbar vertebrae connect the upper part of the spine with the pelvis.Description
Low back pain differs from one person to the other. The pain may be progressive or come on suddenly; It can be intermittent or constant. In most cases, low back pain goes away in a few weeks.Back Pain (Low Back Pain)

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DISEASES & CONDITIONS
Disk herniation in the lumbar spine (Herniated Disk in the Lower Back)

DISEASES & CONDITIONS
Stenosis of the lumbar spine (Lumbar Spinal Stenosis)

Cause
There are many causes of low back pain. Sometimes it happens after a specific movement like lifting something or leaning. Even aging causes many back problems.Back Pain (Low Back Pain)

As we age, our columns age with us. The passage of time causes degenerative changes in the spine. These changes can start at age 30 – or earlier – and can make us prone to low back pain, especially if we overdo our activities.

These changes due to aging, however, do not prevent people from living productive lives and usually without pain. We have all seen the 70-year-old marathoner who, without a doubt, has degenerative changes in her back!Back Pain (Low Back Pain)

Excessive activity
One of the most common causes of low back pain is muscle pain due to excessive activity. The fibers of the muscles and ligaments can stretch too much or be injured.

Tear of the lumbar ligament.

This usually happens around the first softball or golf game of the season, or too much work in the garden or shoveling snow in a day. We are all familiar with this “stiffness” and discomfort in the waist – and other areas of the body – that usually disappear after a few days.Back Pain (Low Back Pain)

Disc injuries
Some people develop low back pain that does not go away after a few days. This may mean that there is a disc injury.

Disc tear. Sometimes with age small tears may occur on the outside of the disc (ring). Some people who have these tears do not feel any pain. Others may feel pain for weeks, months and even longer. A small group of people can develop constant pain that lasts for years and is quite disabling. It is still not well understood why some people feel pain and others do not.Back Pain (Low Back Pain)

Herniated disc. Another common type of disc injury is a herniated or “displaced” disc.

A disk herniates when its gelatinous center (nucleus) pushes against the outer ring (fibrous ring). If the disc is very worn or injured, the core may push out completely. When the herniated disc protrudes into the spinal canal, it presses on the sensitive spinal nerves, causing pain.

Herniated disc.

Because a disc in the lower back usually presses on the nerve root that travels toward the leg or foot, pain is often felt in the buttock or lower leg. This is called sciatica.

A herniated disc often occurs in lifting, pulling, bending or twisting movements.

Disk degeneration
With age, the intervertebral discs begin to shrink and wear out. In some cases, they can collapse completely and cause the facet joints in the spine to rub together, causing pain and stiffness.Back Pain (Low Back Pain)

Disc degeneration.

This “natural wear” of the facet joints is called osteoarthritis. It can lead to back problems including spinal stenosis in the future.

Degenerative spondylolisthesis
Changes due to aging and natural wear make it difficult for the joints and ligaments to keep the back in the proper position. The vertebrae move more than they should, and one vertebra can slide forward on top of another. If they slide too much, they may begin to press on the spinal nerves.Back Pain (Low Back Pain)

Spondylolisthesis.

Spinal stenosis
Spinal stenosis occurs when the space around the spinal cord is reduced and puts pressure on the spinal cord and nerves.

When the intervertebral discs collapse and osteoarthritis develops, your body can respond with the growth of new bone in your facet joints to help support the vertebrae. Over time, this growth – called spurs – can cause a narrowing of the spinal canal. Osteoarthritis can also cause the ligaments that connect the vertebrae to increase in thickness, causing the spinal canal to narrow.Scoliosis
This is the abnormal curvature of the spine that can develop in children, most often during their teenage years. It can also occur in patients who have arthritis. The deformity of the spine can cause low back pain and possibly leg symptoms if there is pressure on the nerves.Back Pain (Low Back Pain)

Additional causes
There are other causes of low back pain, some of which can be serious. If you have a vascular or arterial disease, have a history of cancer or pain always present despite your level of activity or position, you should consult your doctor.

symptom
Back pain varies. It can be intense or sharp. It can be a dull, fixed pain or feel like a muscle spasm. The type of pain you will have will depend on the underlying cause of your low back pain.

Most people find that resting or reclining improves back pain, regardless of the underlying cause.

People suffering from low back pain may experience any of the following:Back Pain (Low Back Pain)

Low back pain is intensified by leaning forward or lifting an object.
Staying seated can aggravate the pain.
Standing or walking can aggravate the pain.
Back pain comes and goes, and usually follows a course of ups and downs with good and bad days.
The pain can extend from the back to the buttock or outer part of the hip, without extending to the leg.
Sciatica is common with a herniated disc. This includes pain in the buttock and leg and even numbness, tingling, or weakness that continues to the foot. It is possible to suffer from sciatica without having back pain.
Regardless of your age or symptoms, if your back pain does not improve in a few weeks, or if it is accompanied by fever, chills or unforeseen weight loss, you should consult your doctor.Back Pain (Low Back Pain)

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Tests and diagnosis
Background and physical examination
After discussing your symptoms and your history, your doctor will examine your back. This will include looking at your back and pressing in different areas to see if you feel pain. Your doctor may make you lean forward, backward, and side to side in search of limitations or pain.Back Pain (Low Back Pain)

Your doctor may measure the function of the nerves in your legs. This includes checking your knee and ankle reflexes, as well as testing for strength and sensation. This will tell your doctor if the nerves are seriously affected.

Tests with images
Other tests that can help your doctor confirm your diagnosis include:

X-rays Even though you only see bones, a simple x-ray can help determine if you have the most obvious causes of back pain. It will show broken bones, changes due to aging, curves or deformities. X-rays do not show discs, muscles and nerves.

Magnetic Resonance (MRI). This study can create better images of soft tissues, such as muscles, nerves or vertebral discs. Conditions such as herniated disc or infection are more visible in an image by MRI.Back Pain (Low Back Pain)

Bone density test. If osteoporosis is a concern, your doctor may order a bone density test. Osteoporosis weakens the bone, which can easily fracture. Osteoporosis itself does not cause back pain, but fractures in the spine can do it.Back Pain (Low Back Pain)

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