Low back pain is a very common issue, affecting nearly 80% of the population at some point during their life. The severity may vary from mild soreness to debilitating pain. Pain in the lower back may lead to symptoms of numbness, tingling, and pain in the legs and buttocks. There are numerous structures in the lower back which may cause pain but the most common issues stem from lumbar disk and facet joint issues. True muscle strains in the lower back are less common, though patients may have muscle pain due to muscle spasms. These structures may be aggravated over time through repetitive stress from excessive sitting activity, lifting heavy objects, or lifting with improper technique. They may also be injured during a traumatic event, such as a fall or a car accident.
If you would like to learn more about the anatomy of the back or spine, this video may help:
With a fresh onset of low back pain, the best initial treatment is to avoid any activity which increases pain. Sometimes this means avoid bending forward, prolonged sitting, or prolonged walking or standing activity. Anti-inflammatory medications may be appropriate, but it is best to consult a physician before beginning a medication regimen. Ice may help decrease pain during the first 48 to 72 hours. Heat may bring relief after this point.
If symptoms persist for more that a few days, it may be best to consult a physician and consider physical therapy. In many cases, physical therapy is the initial first course of treatment before further studies, such as X-rays or MRIs are performed. Physical therapy is typically aimed at reducing pian, increasing mobility, re-educating muscles, and returning people to their prior activities.
If there is severe pain or loss of strength or sensation in one or both legs, a physician should be consulted immediately, as this may be a sign of a more serious issue.
Difficulty sleeping is a common issue with people dealing with pain in the lower back. In most situations, the best positions are laying on your back with pillows under the legs/knees to slightly elevate them. This places the pelvis and lower back in a position which applies less stress to irritated structures. If side sleeping is preferred, bend the knees and place a pillow between them. This will help align the pelvis and lower back and limit irritation during sleep.
The answer is, it depends. Limiting walking is typically recommended during the first 2 to 3 days after the onset of pain but after that, mild walking activity may be appropriate. Movement is typically good, as long as it does not increase symptoms. It is best to start with a short walk and see how you feel. If pain is increased, you may want to limit the activity for a few more days. In many cases, standing and walking is more tolerable than sitting activity.
Many people who have low back pain ask how to crack their lower back? Spinal manipulation can be a useful tool for treating some sources of low back pain but it should be performed by a skilled professional. The "cracking" sound is actually the sound of the synovial fluid in the facet joints of the spine releasing a gas due to a quick change in volume of the joint capsule. When this happens, the pain receptors in the joint can slow their input and endorphins are released. It's kind of like hitting the reset button. This may help to decrease pain and increase mobility. The sensation can be addictive though. Repetitive self-manipulation may irritate the low back.
Most of the time, pain in the lower back is caused from structures in the spine. But, in rare cases, pain in the low back may be referred from the kidney. Pain that is referred from the kidney typically does not change with position. Symptoms from the kidney may also include nausea, abdominal pain, and abdominal spasms, as well as shoulder pain.
The Jacksonville Orthopedic Institute has a team of experts to help with your Low Back Pain. Whether you are a Professional Athlete to Average Joe, the JOI Spine Team has the expertise and technology to provide you with world-class care. Come see us....We'll Treat You Like A Pro!
By: Ehren Allen, PT, COMT