Low Back Pain

Back pain is the third most common reason for patient visits to physicians offices, and affects up to 80% of the adult population at some time. The precise cause of low back pain is poorly understood and only 10-20% of all patients have their pain attributed to an accepted, definable diagnosis. In the majority of cases low back pain tends to disappear with time. In about 90% of patients symptoms resolve within 3 months of onset. True low back pain is defined as pain located between the lower rib cage and the buttocks. This pain may occasionally extend down to the level of the knee but not beyond. If back pain is associated with numbness, tingling or weakness in the legs then it is possible that irritation of neurologic structures is present. In a patient with only low back pain, the best form of treatment initially consists of a brief period of rest (one to two days) followed by gradual return to regular activities. Some patients feel that heat (heating pad, warm bath/showers) applied to the lower back gives some relief. Pain medications (nonsteroidal anti-inflammatory) are frequently also helpful. With time most back pain resolves itself. Signs which should prompt more careful investigation include neurologic symptoms (numbness, tingling, weakness, poor bladder/bowel control, burning sensations), as well as night pain, associated fevers, weight loss or systemic symptoms. When an episode of low back pain has subsided it is recommended to begin a program of gradual conditioning involving aerobic-type exercises. Improved aerobic conditioning has been found to reduce the risk of low back pains. Poor physical condition and repeated twisting or lifting as well as activities involving vibrations (driving, certain manual labor) can set the stage for repeated episodes of low back pain.

Explanation

Back pain is the third most common reason for patient visits to physicians offices, and affects up to 80% of the adult population at some time. The precise cause of low back pain is poorly understood and only 10-20% of all patients have their pain attributed to an accepted, definable diagnosis. In the majority of cases low back pain tends to disappear with time. In about 90% of patients symptoms resolve within 3 months of onset. True low back pain is defined as pain located between the lower rib cage and the buttocks. This pain may occasionally extend down to the level of the knee but not beyond. If back pain is associated with numbness, tingling or weakness in the legs then it is possible that irritation of neurologic structures is present. In a patient with only low back pain, the best form of treatment initially consists of a brief period of rest (one to two days) followed by gradual return to regular activities. Some patients feel that heat (heating pad, warm bath/showers) applied to the lower back gives some relief. Pain medications (nonsteroidal anti-inflammatory) are frequently also helpful. With time most back pain resolves itself. Signs which should prompt more careful investigation include neurologic symptoms (numbness, tingling, weakness, poor bladder/bowel control, burning sensations), as well as night pain, associated fevers, weight loss or systemic symptoms. When an episode of low back pain has subsided it is recommended to begin a program of gradual conditioning involving aerobic-type exercises. Improved aerobic conditioning has been found to reduce the risk of low back pains. Poor physical condition and repeated twisting or lifting as well as activities involving vibrations (driving, certain manual labor) can set the stage for repeated episodes of low back pain.

Frequently Asked Questions