If you have low back pain (LBP), you are certainly not alone. Almost everyone at some point has back pain that interferes with their work, daily activities, and/or recreation. Americans spend at least $50 billion each year on LBP-related treatments and it is the most common cause of job-related disability and a leading contributor to lost work time. Back pain is second to headaches as the most common neurological condition in the United States. Fortunately, most occurrences of LBP go away within a few days. Others take much longer to resolve or can lead to more serious conditions.
There are two types of low back pain – acute and chronic. Most episodes of acute LBP last from a few days to weeks, are not neurological, and usually do not carry a high level of surgical risk. The cause of LBP can be difficult to isolate because it’s often the culmination of many events over time with climax being something as mundane as “bending over to pick up a pencil” that by itself is not likely to cause an acute onset of LBP. Low back pain can also be caused by trauma such as sports injuries and even car accidents, among other things.
Chronic low back pain, by definition, is LBP that lasts more than 3 months and the cause can also be difficult to identify and is often cumulative (see above) and/or related to a prior condition such as degenerative disk or joint disease. A real problem is the rate of recurrence or where pain may subside but returns at various rates of frequency and duration. This category affects a high percentage of the population and represents the true challenge in spine care management.
As people age, their bone strength and muscle stretch, strength, and tone usually decreases due to lack of activity. When the disks begin to lose fluid and flexibility, their ability to cushion the vertebrae and function as “shock absorbers” also decreases. Disks can tear, bulge, and/or herniate which results in localized LBP and/or radiating pain that follows the course one or more of the 31 pairs of nerve roots (eg., “sciatica” down the back of the leg). Soft tissues such as joint capsules and ligaments lose their capacity to stretch and can tear more easily, resulting in a sprain or strain (muscle/tendon injury). Other conditions that either cause or contribute to LBP include arthritis, obesity, smoking, pregnancy, stress, poor posture and/or physical health, and can lead to unsatisfied patients if these co-contributors are not properly identified and discussed. Less commonly, LBP can be caused by a more serious condition such as cancer, fracture, infection, spinal cord compression, and various internal conditions. Emergency care may be indicated in these circumstances.
Your doctor of chiropractic will perform a complete examination, consider other contributing causes, and will treat the problem(s) causing the LBP condition. If needed, working with other allied health care providers will be arranged. Exercise, dietary recommendations, ergonomic or work modifications, spinal manipulation, and modalities will all be considered to help eliminate or control of the LBP. Methods of self-managing the LBP will also be emphasized.