Low Back Pain: Everything you need to know
Have you ever had low back pain before? Are you having low back pain right now?
Did you know that about 80% of Americans suffer from debilitating low back pain at some point in their life? This statistic is astounding! With all of that being said, this doesn’t have to be you.
There is a simple answer to avoiding this situation… Prevention.
Most low back pain sufferers have one thing in common. Poor low back biomechanics during routine activities such as bending over, picking up your kids, sitting, exercising, and even brushing your teeth.
Your lumbar spine (the lower part of your spine) is designed to have a natural curve. This curve helps disperse the forces of gravity and weight evenly throughout your spine. Over time the curve of your lumbar spine can become greater or less than it’s designed to be. This puts significantly more pressure on your discs, muscles, and ligaments of your low back. Did you know sitting without maintaining your low back curvature increases the load on your spine by 30-40%?
Let’s look at some of the most common low back conditions.
Lumbar Strains and Sprains
A lumbar strain is an injury which occurs to the muscles of the low back. Conversely, a sprain is an injury to the ligaments and/or the joints. Both sprains and strains have similar pain and symptom presentations but need to be treated differently. Injuries to the low back muscles, joints, or ligaments typically cause your normal movement patterns to become dysfunctional. These injuries can also cause instability of the lumbar spine. Most commonly, patients who experience these injuries feel pain while walking, sitting, exercising, or even sleeping.
Some of the main causes of a Lumbar Sprain & Strain are:
- Poor movement mechanics
- Chronically poor posture
- Heavy lifting
The good news is that with proper education, you can prevent yourself from many of these causes. Arguably the largest contributing factor to a sprain/strain of the low back is poor physical conditioning. A major group of people that are affected by this situation are desk workers that sit for most of the day. This person typically has poor posture which weakens your spinal muscles and can destabilize your spine over time. This situation can be avoided with maintaining good posture and a strong core.
Another way that poor posture and/or improper exercise can lead to a low back sprain/strain is overuse. Luckily, there are some easy steps that can be taken to prevent an overuse injury to your spine. Maintaining proper posture during exercise and movement throughout your day is paramount. Utilizing correct lifting techniques can also reduce episodes of low back pain and ultimately help build a strong healthy spine.
Stenosis translates to an abnormal narrowing in a structure. When discussing your low back, we’re talking about the canal that contains your spinal nerves. When this condition becomes severe, compression can occur causing pain, numbness, and even radiating pain. Stenosis is usually caused by degeneration of the spine due to aging but there are other ways it happens:
- Degeneration of the lumbar spine
- Lumbar Disc herniation compressing spinal nerves
Degeneration of the spine is inevitable with aging. However, the degree at which we degenerate can be slowed down with healthy lifestyle choices. Some habits tips to prevent this from happening are:
- Utilize proper bending techniques
- While lifting, using your legs to generate power instead of your back.
- Avoid smoking.
- Maintain and active lifestyle of movement and exercise
- Keep your inflammation levels to a minimum.
Osteoporosis affects primarily women as we age. Research has showed time and time again that the best way to prevent this is to perform weight bearing exercise.
Most (2/3) of facet syndrome cases occur in the cervical spine (neck), however some (1/3) occur in the low back. Facet joints are small joints in your spine that are help rotate your spine and limit excessive movement. Facet pain is usually at its worst when moving from a sitting position to standing or going from bent over to standing.
Main physical causes of this condition are:
- Excessive weight
- Overuse (sports or working)
- Whiplash/motor vehicle accident
- Pre-existing or advanced arthritis
- Sitting for prolonged periods
Once again, the biggest contributing cause of facet syndrome is poor physical conditioning with weak spinal stabilizer muscles. People with facet issues typically have poor posture and weak core musculature. Proper postural habits are the best way to prevent facet syndrome from occurring. Proper posture takes stress off the spine and can reduce the detrimental effects of sitting. Proper lifting techniques are also a major way to prevent facet syndrome and help to build a healthy spine.
Lumbar Disc Disorder
Your low back (lumbar spine) is made up of 5 bones with an intervertebral disc between each one. These discs are shock absorbers for your spine. They are made up of two distinct parts: the annulus fibrosis is a tough, strong outer layer designed for support.
The nucleus pulposis is the inside part of your dis which is a jelly like substance designed to absorb shock up and down your spine. Around your discs there are many ligaments, muscles, and connective tissue which keep everything in place.
During the normal aging process our discs dry out causing compression and degeneration. As this breakdown occurs, our discs lose strength and become more prone to damage. As this occurs, bulging discs, ruptures, and herniations become more common. As these degenerative changes occur, your spines ability to move becomes compromised and limited. Poor movement, poor strength, and degeneration spell trouble for your low back. This is where herniations become very common. Imagine a jelly donut filled with strawberry jelly. Now squeeze the donut and watch the jelly shoot out. This is what happens to your disc when a herniation occurs. There are varying degrees of severity depending on how far the jelly travels but all can lead to low back pain.
Some signs and symptoms of disc issues are:
- Leg and or foot pain
- Leg and or foot weakness
- Leg and or foot numbness
- Changes in sensations in one or both legs
- Changes in Bowel or Bladder Function
The symptoms you may experience from a disc herniation will vary depending on the spinal level that’s affected. If there is compression of a spinal nerve, the pain will likely be felt in your butt, leg, or foot. If there is no compression of your spinal nerves, the pain will likely stay in your low back.
The most common spinal levels to herniate are L4-L5 or L5-S1. This is due to the size of the discs and the orientation of your spinal curves.
The most common way that people herniate an intervertebral disc is bending over and twisting. Usually this involves picking up a heavy object, but it can also happen from picking up something small like a toothbrush.
Risk Factors for Lumbar Disc Disorders
- Age and Gender – the highest incidence in men between the ages of 30 and 50.
- Obesity – being overweight puts added stress on lumbar discs.
- Sedentary lifestyle – lack of exercise and poor core body strength.
- Smoking – Smoking decreases oxygen supply to the discs causing more rapid degeneration.
- Improper lifting – using your back muscles instead of your legs to lift heavy objects. Twisting while lifting
- Poor Posture
- Repetitive activities that strain your spine – jobs that require constant lifting, pulling, bending, or twisting.
- Frequent driving – staying seated for long periods and the vibration from the car can put pressure on your discs.
Treatment of Lumbar Disc Disorders
Conservative care should ALWAYS be your first course of treatment for the management of low back pain. Disc problems are no exception. Your clinical treatment options will depend on your age, overall health, and tolerance to treatments.
Typically, the first few days are focused on “centralizing” the pain from your legs to your spine, decreasing inflammation, and preventing further damage from occurring. Chiropractic adjustments/manipulations and soft tissue mobilization therapies can be administered as tolerated. Supportive home exercises should be performed to promote healing and pain relief. We will always educate you on why your problem started and way you can avoid it in the future. One thing to ABSOLUTELY avoid when it comes to low back pain is bed rest! The sooner you’re up and moving, the better your prognosis.
As your treatment progresses and your pain and inflammation levels decrease, its time to prevent the problem from returning. We can begin working on rehabilitative exercises to restore the strength and coordination of your core and low back.
If you fail to respond to conservative treatment, or in cases of severe neurological loss, a referral for a surgical consultation will be recommended.
How we can help
Our chiropractors are trained in a variety of techniques which allows them to create a custom treatment plan for you! This means faster pain relief, fewer visits, and lasting results. If you have any questions, send us a message and let us help you. Low back pain can be scary, but we can help!