1. UNDERSTANDING THE LOWER BACK
Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a 'disc'. The discs are made of strong rubber-like tissue which allows the spine to be fairly flexible. Strong ligaments also attach to adjacent vertebrae to give extra support and strength to the spine. The various muscles that are attached to the spine enable the spine to bend and move in various ways.
The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body.
2. WHAT ARE THE TYPES OF LOW BACK PAIN?
Simple low back pain
This is the most common type. Simple low back pain means that the pain is not due to any underlying disease that can be found. In some cases the cause may be a sprain (an over-stretch) of a ligament or muscle. In other cases the cause maybe a minor problem with a disc between two vertebrae, or a minor problem with a small ‘facet’ join between two vertebrae. However, these causes of the pain are impossible to prove by test and so it is often impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.
So, simple back pain is 'mechanical' in the sense that it varies with posture or activity.
Nerve root pain
Nerve root pain can arrange in severity from mild to very bad. The irritation or pressure on the nerve may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot.
- Cauda equina syndrome – is a particularly serious type of nerve root problem. This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on. Problems with bowel and bladder function (usually unable to pass urine, numbness in the ‘saddle area’ (around the anus), and weakness in one or both legs. (rare, but an emergency)
Less common causes of low back pain
- Arthritis – inflammation of the joint
- Osteoarthritis – arthritis occur in older person
- Ankylosing spondylitis – causes pain and stiffness in the lower back
- Rheumatoid arthritis – affect the spine and other joints.
3. HOW CAN I TELL WHAT KIND OF BACK PAIN I HAVE?
Most cases of low back pain that develop suddenly (acutely) are due to simple low back pain. Many people just 'get on with it' and treat it themselves - and indeed most get better quickly.
However, if in doubt, see your doctor for a check-over and advice.
4. DO I NEED ANY TESTS?
In most cases, no test are needed, if you have sudden onset nerve root pain, and symptoms of pain.
Tests such as x-rays or scans may be advised if nerve root pain persists or is severe, or if another serious cause of the pain is suspected.
5. WHAT ARE THE TREATMENTS FOR SIMPLE LOW BACK PAIN?
The following advice and treatment is commonly given for a sudden 'acute' bout of simple low back pain. Most people recover quickly.
Exercise and keep going
Continue with normal activities as far as possible, do normal activities as soon as you are able to do.
- Anti-inflammatory painkillers such as diclofenac or naproxen
- A stronger painkiller such as codeine
- A muscle relaxant such as diazepam.
- Physical treatments visit a physiotherapist, chiropractor, or osteopath for physical -treatment
- Other treatments
a. Nerve root pain – people with persistent back pain that is caused by prolapsed disc pressing on a nerve may benefit from an operation.
b. Other causes of back pain – treatments depend on the underlying cause. For example, pain caused by types of arthritis maybe treated by various anti-arthritis medicines.
6. CAN FURTHER BOUTS OF BACK PAIN BE PREVENTED?
Evidence suggests that the best way to prevent bouts of low back pain is simply to keep active, and to exercise regularly like walking, running, swimming etc.
7. IN SUMMARY - SOME POINTS TO REMEMBER
- Acute low back pain is usually not a serious condition - even if the pain is bad.
- Most people recover quickly - often within a week or so.
- Nerve root pains and 'slipped discs' are uncommon - and most of these get better by themselves anyway.
- More serious causes of back pain are even more uncommon. Surgery is only rarely needed.
- Stay as active as possible and return to normal activities as soon as possible, including work. People with back pain who get active, and back to normal activities as soon as possible (including work) are likely to recover more quickly and are less likely to develop chronic (persistent) back pain compared to those who rest and do little exercise.
Please note that this leaflet is meant to give you information that will guide you on your health. It is advised to SEE YOUR DOCTOR for follow up if you have any medical issues.
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