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Low Back Pain
By Thomas Lundsten, M.D.
Low back pain is one of the most common appointments to a family practice. Low back pain affects 5.6% of adults daily and over 70% of people relate an episode of low back pain. The most common cause of sudden onset of low back pain is caused by muscle strain. If you strain a muscle in your back, it can hurt to move. The pain is usually only in the lower back.
Another cause of sudden onset of low back pain is a bulging disc. A disc is a cushion between each spinal vertebrae (bones).
When the disc bulges it herniates and can irritate a nerve. This can cause the low back pain but usually causes irritation down your thigh or leg. This can be pain, numbness, tingling or even weakness of the leg. This radiating symptom is called sciatica.
The injury to your back usually comes from straining to lift heavy objects or by twisting your back. People often hurt their backs when they are moving heavy furniture, playing sports, and gardening or involved in a motor vehicle accident. When the pain is caused by a muscle it can last up to 6-8 weeks. Usually an xray is not necessary immediately.
There should be improvement in a few weeks. If there is not much improvement with simple measures an xray or scan (CT or MRI) may be ordered.
To help heal the pain, we recommend initially rest in bed for a day or two and then gradually get back to normal activity. We recommend avoiding things that make the pain worse like sitting for long periods of time, lifting heavy objects, bending or twisting. Gentle walking helps you to get better more quickly. Medication can be used like OTC (over-the-counter) meds for the pain and swelling. These would include Ibuprofen (Advil/Motrin), Naproxen (Aleve) or Acetaminophen (Tylenol).
You may be prescribed some stronger medications for pain or muscle spasm. Moist heat, such as a warm bath or shower, is also good. You also may be given some information on gentle exercises to stretch your back muscles and make them stronger. At times you may be referred to a physical therapist or chiropractor for more extensive therapy.
The best treatment of low back pain is prevention. You should stay active, keep in shape, lose weight if necessary and exercise regularly. Being inactive can lead to low back pain. Biking, walking and swimming are excellent for your back. Proper lifting of heavy objects is also important. You should lift by using hips and knees then squat to pick up the object. Keep you back straight and hold the object close to your body. Don't twist while you are lifting.
In conclusion most people have episodes of low back pain but with proper preventative measures, understanding of the causes and treatment the flare-ups will be far less frequent.
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