Low Back Pain: Everything You Need To Know

Thousands of of people are suffering from low back pain which often disturbs their daily activities functioning.

What is low back pain?

Low back pain refers to any pain or discomfort experienced in the bottom region of the spine which is called "lumbar spine"

This type of pain is extremely widespread ,it affects 80% of adults and ranked as the number one cause of job-related hazards. Is responsible for more lost working hours than any other medical conditions and represents one of the nation's most costly health problems.

Why is low back pain a problem?

  1. The lumbar region bears most of the body weight
  2. The most flexible region of the spinal column is the lumbar region
  3. Nerves roots that are prone to injury and diseases are found in the lumbar region
  4. The lumbar region has an inherently poor biochemical structure.

What causes low back pain?

Low back pain can be caused by different factors such as:
Acute lumbosacral strain: It is as a result of improper lifting of objects, twisting of back or overstretching which leads to marring of the ligaments and muscle tissues in the lumbar region.

Skeletal irregularities: Some congenital anomalies of the spine such as scoliosis(curvature of the spine), lordosis (abnoraml accentuated arch in the lower back) cause lower back pain because they upset the weight distribution and strain tissues,ligaments and nerves.

Osteoarthritis: Inflammatory disease causing irritation of the vertebrae can cause stubborn low back pain.

Degenerative diseases: There are some disc in the spine that degenerate or deteriorate naturally with age.This can lead to distressing lower back pain.

Ruptured intervertebral disc: A disc in the lumber region becomes ruptured, the nerves on the nerves are pinched, leading to pain as the ligaments and muscles tries to compensates.
Other causes are:

  • Traumatic injury
  • Infection
  • Obesity
  • Pregnancy
  • Kidney diseases
  • Smoking
  • Lack of muscle tones
  • Poor posture
  • Stress
  • Jobs that require repetitive heavy lifting
Low back pain


What are the types of low back pain?

There are two (2) types of low back pain, which are:
Acute low back pain: This type of pain lasts for about 4 weeks or less. It is usually associated with some types of activity that causes undue stress on the tissues of the lower back.

Chronic low back pain: This pain lasts more than 3 months , it is being caused by lack of physical exercise, degenerative disease, spinal stenosis. The nerve roots are been compressed causing pain at the lower back which later radiates to the buttocks and legs. The pain becomes worsen with walking and in particular standing without working.

What are the signs and symptoms of low back pain?


  • Pain
  • Fatigue
  • Immobility
  • Loss of function on the affected part
  • How is low back pain diagnosed?
  • X-ray of the spine
  • Bone scan
  • Computed tomography scan (CT SCAN)
  • Myelogram
  • Ultrasound
  • Electromyogram (EMG)

How is low back pain managed?

  1. Low back pain can be managed through the following measures:
  2. Use of muscle relaxants e.g cyclobenzaprine (flexeril).
  3. Non-steroidal anti-inflmmatory drugs e.g diclofenac.
  4. Thermal or cold compress.
  5. Spinal manipulating e.g chiropracture therapy .
  6. Acupunture.
  7. Massage or yoga.
  8. Lumvsr roll or pillow for sitting.
  9. Side lying position with knees and hips bent during sleep.
  10. Sitting should be limited to 20-50 minutes based on level of comfort.
  11. Avoid twisting, bending, lifting and reaching all of which stress the back.
  12. Invasive treatments e.g epidural corticosteroid injections.
  13. Implanted devices that delivers pain medications.
Low back pain

Strategies for preventing low back pain?

Prevention
  • Maintain healthy weight.
  • Do not sleep in a prone position.
  • Avoid jumping and jarring activities.
  • Avoid high heel shoes.
  • Walk daily and gradually increase the distance and pace of working.
  • Avoid cigarette smoking and tobacco products.
  • Stretch to enhance flexibility.
  • Obtain regular physical activity, including strength and endurance training.
  • Sleep on side with knees flexed and a pillow between the knees.
  • Body mechanics
  • Practice and maintain good posture.
  • Avoid twisting, lifting above waist level and reaching up to any length of time.
  • Push objects rather than pull them.
  • Lift with a large leg muscles not the back muscles.
  • Use a wide base of support.
  • Bend your knees and tightens abdominal muscles when lifting.
  • Work modification
  • Adjusting of work shift
  • Use lumbar support in straight back chair with arm rest.
  • Avoid prolong standing and repititive tasks.
  • Avoid bending, twisting and lifting heavy objects.
  • Adjust the weight of the chair using a foot stool to position knee higher than hips.
  • When standing for any length of time, rest one foot on a small stool or box to relieve continuous vibrations.

References

  • Deyo RA: Treatment for back pain: can we get past trivial effects?Ann Intern Med 141:958,214.
  • Hainline B: Chronic pain: physiological, diagnostic and management considerations, Psychiatric Clin North Am 28:713
  • Landers SJ: Aching backs and shoulders taking a toll,Am Med News 48:33,2008.
  • Medical-Surgical Nursing: Assessment And Management of clinical problems (10th edition)

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