Spinal Injuries and Conditions
Lower back pain is one of the most common forms of chronic pain. There are many possible reasons for pain in the lower back, with some of the most common reasons including:
- Degeneration of the volume of the nucleus of intervertebral discs.
- Concentric tears of the outer layers of intervertebral discs.
- Smoking and drinking
- Poor Posture
- Poor ergonomics at work
People whose lifestyle includes one or more of these types of factors may further tax the vertebral bones and soft tissues of our lumbar spine that are already required to bear large loads under the best of conditions. When we sit and stand, much of the weight of the trunk, head, and upper extremities becomes concentrated on the structures in the lower spine, which has the job of bearing these pressures and absorbing shocks as we carry large objects, walk, and run. The soft tissues of the back may be up to the job for decades before the joints in the back eventually wear out and the facet joints and discs of our back eventually lose enough volume that they can no longer provide the stability for their back that they used to. For most people, the vitality of the joints and soft tissues in our spine degenerates to the point that we experience lower back pain due to the resulting instability of the joints and other structures. The funny thing is, though, is that the majority of us feel pain while these degenerative changes occur, but that this pain typically goes away when the body has responded to these changes to re-stabilize the spine. There are some cases of chronic back pain, though, where a small percentage of patients continue to feel symptoms of back pain, as well as several associated symptoms such as numbness, referred pain, weakness, burning, tingling, and worst of all, loss of function of the arms or legs being supplied by the nerves that have become compromised as a result of spinal injuries and conditions.
Less common causes of low back pain include specific inflammatory conditions (e.g. rheumatoid arthritis, Spondyloarthropathies), tumors, cancer, and specific diseases of bone, muscle, and nervous tissue. These diseases may be difficult to diagnose because of the similarity of symptoms among both the common and less common causes of back pain. Surprisingly for many patients, doctors often prescribe specific treatments for back pain despite never really arriving at a specific diagnosis for it, or isolating the exact structures involved with the patient's symptoms. Often, doctors recommend anti-inflammatory medications to control the pain, and physical therapy to build core strength to increase the stability of the spine. Building strength in the abdominal muscles and back muscles is considered beneficial to all lower back pain patients, regardless of their specific condition. It is though that doctors cannot determine the anatomic structure of the spine causing the pain in up to 50% of all cases. Doctors label these types of cases as nonspecific back pain. Many cases of nonspecific low back pain may result from spinal injuries and conditions such as muscle injuries that cause chronic spasm (e.g. myofascial pain syndrome), weak muscles, and ligaments that have become strained and lax due to chronic injury.