Low Back Pain

Low back pain relief involves medication, physical therapy, and lifestyle changes to reduce discomfort and improve mobility. If you’ve experienced, or are experiencing, Low Back Pain, know that you’re not alone. In fact, almost 80% of all people will experience low back pain at some point in their life. Moreover, It’s one of the main reasons why a person will seek help from a healthcare provider. While back pain refers to pain that originates in the lower back, the cause of pain can be varied. Causes can include injury or trauma, or an underlying health condition, and can last for a short period of time or can be chronic. 

The specific pain sensations can vary, as well. Moreover, This is why it’s important to partner with an experienced pain management specialist who can accurately diagnose and treat your specific cause of pain. Additionally, The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas has extensive knowledge in all low back pain causes and symptoms and is dedicated to helping their family of patients live a pain-free life. 

What is Low Back Pain?

Low back pain is any pain that is felt in the lower back area. Pain can be a result of any condition, injury or disease that affects the low back. In fact, low back pain is one of the most common musculoskeletal complaints, meaning that the skeleton (including the bones, ligaments, tendons and cartilage) and the muscles that are attached to it have undergone some issue that is leading to pain. 

While the lower back might seem like one general area, there are a lot of structures that could be damaged or irritated, which leads to pain. These structures could include: 

• Vertebrae and discs between the vertebrae
• Vertebral ligaments
• Facet joints
• Muscles in the low back
• Spinal cord
• Peripheral nerves

Additionally, any damage to the internal organs can also lead to pain that is felt in the low back. Most often, the organs in the pelvis and abdomen lead to low back pain, including the liver, pancreas, kidney and spleen. 

Low back pain symptoms can range from mild to severe. In severe cases, a person might not be able to perform daily functions, such as sitting, walking, lying down or exercising, without experiencing intense pain. The good news is that most cases of low back pain are resolved in a few weeks by utilizing conservative methods, including rest, pain relievers and physical therapy. 

Anatomy of the Lower Back

Understanding the anatomy of the lower back is helpful in determining the root cause of low back pain. There are so many structures at play, and proper diagnosis is essential for creating the ideal treatment plan to help each individual patient experience immediate and long term pain relief. Below are the three main structures in the lower back, as well as what generally affects them. 

1. Bony Structures

The 33 individual vertebrae (bones of the spine) connect to provide a flexible and strong support structure that protects the spinal cord. Due to their makeup, and the fact that they are used – and overused! – throughout the day and with almost every movement a person makes, there is a great chance of injury. Health conditions can also affect the structures of the lower back, which can lead to pain. The most common issues that happen to the bony structures of the back, in addition to traumatic fractures, include: 

• Osteoporosis
• Spinal stenosis
• Facet joint osteoarthritis
• Spondylolisthesis
• Neoplasms
• Infections

1. Intervertebral Discs

Intervertebral discs are located in between each vertebrae in the spine. 

These discs not only act as a cushion for the vertebrae, they also help with movement and flexibility. Since we use our back constantly, these discs have a tendency to break down or degenerate with use and time. Discs that are worn have more of a chance bulging or slipping out of place, which can create pressure on the surrounding nerves. Bulging discs are one of the most popular causes of pain. A single event, such as trauma or very heavy lifting, can also result in herniation of the discs, which can lead to disc disease. 

Most commonly, degenerative disc disease is the reason why most people will experience chronic low back pain. Degenerative disc disease occurs when there is thinning and degeneration of the intervertebral discs. 

Not only can this lead to pain, it can also lead to additional medical conditions, including:

• Spinal stenosis
• Irritation to the peripheral nerve 
• Exacerbated facet arthritis
• Nerve impingement in or around the spine

In addition to use and possible trauma, the most common reasons why a person might experience chronic low back pain in regard to intervertebral discs include: 

• Degenerative disc disease
• Facet joint osteoarthritis
• Disc protrusion or extrusion
• Disc infection
• Sciatica
• Herniated disc

1. Spinal ligaments and muscles

In addition to the intervertebral discs, the spine is made up of spinal ligaments and muscles, which provide strength and mobility to the spine. Every twist, turn, bend or jump a person does is made possible by these soft tissue structures. Because the fact that they are always being used – and overused! – the ligaments and muscles in the spine area can experience wear and tear. Repeated movements, heavy lifting, and specific incidences of trauma can lead to strain, stress and irritation. This can happen not only to the muscles and ligaments themselves, but also the nerve roots that connect the spine to the surrounding muscles, skin and lower extremities. Myofascial injuries, which include the muscle and connective tissue, and ligament injuries are a contributing factor for the majority of low back pain occurrences. 

The most common factors for why a person might experience spinal ligament and muscle issues that lead to low back pain include:

• Torn muscle
• Strain or tear to the ligament(s)
• Myofascial pain syndrome
• Strain to the muscle(s)

What Causes Low Back Pain?

Many conditions, injuries and diseases can cause low back pain. Pain can be described as dull and achy, or can be sharp and shooting. The most common causes of low back pain include: 

• Sprains and strains: the most common causes of low back pain, sprains and strains can happen as a result of lifting something too heavy, lifting something incorrectly, twisting, bending, or more
• Fractures: trauma can lead to breaks in the bones of the spine, and conditions such as osteoarthritis and spondylolysis increase the risk of fractures
• Disc problems: herniated discs, bulging discs and degenerative disc disease can all lead to pressure on the surrounding nerves, as well as a less strong and stable spine in the long term
• Structural problems: spinal stenosis (narrowing of the spinal column) can lead to severe sciatica nerve pain and low back pain, and scoliosis (curvature of the spine) can cause pain, stiffness and difficult moving

 Low back pain also include: 

• Arthritis: osteoarthritis is the most common type of arthritis that leads to low back pain, and Ankylosing spondylitis can cause inflammation and stiffness in the spine
• Disease: spine tumors, infections and certain types of cancers can lead to low back pain, as well as conditions such as kidney stones
• Spondylolisthesis: this happens when vertebrae in the spine slip out of place, causing both low back pain and leg pain
• Fibromyalgia: a chronic (long-lasting) disorder that causes pain and tenderness throughout the body, as well as fatigue and trouble sleeping

Referred, Acute and Chronic Low Back Pain Causes

Causes of low back pain can be acute or chronic. In some cases, the pain is known as referred pain, meaning that it originates in a different area of the body but is felt in the low back. 

Referred low back pain is most often caused by an issue in the organs in the abdomen and pelvis. The organs that most often lead to  low back pain include the kidneys, liver, pancreas and spleen, and the pain is usually a result of: 

• Cancer
• Enlargement
• Inflammation
• Infection
• Decreased blood supply
• Obstruction

The reason why pain is felt in the lower back is because the nerves in the lower back are located near the aforementioned organs. So when pain is felt in the organ or organs, it can also be felt in the low back. 

Low back pain itself can be either acute, which means it lasts for a shorter period of time, or chronic, meaning long lasting. 

Acute pain is usually the result of a specific traumatic event or injury, including an accident, excessive exercise and slips and falls. Those who suffer from chronic conditions such as osteoporosis, cancer and spinal stenosis are at a higher chance of experiencing pain symptoms related to fractures, ruptured discs and spinal compression. 

The good news is that most acute low back pain caused by a ligament or muscle strain can be resolved using at-home methods, such as rest, over the counter medication, and mild stretching activities. It is important to seek care from a pain management specialist if the pain does not go away or gets worse, or you begin to experience symptoms that greatly affect your quality of life. Your provider will also rule out any underlying causes of pain, possibly from pancreatitis and kidney infection. 

If you suffered a traumatic event and experience any of the below symptoms, it’s important to visit your healthcare provider as soon as possible so you can receive medical attention: 

• Leg paralysis or weakness
• Fever or chills
• Loss of bladder or bowel control
• Spinal cord compression
• Vertebral compression fractures
• Disc herniation

Chronic low back pain is characterized by pain that lasts longer than three months, or longer than what is expected. Pain could begin gradually and then increase in both duration and intensity, and can be felt in both the low back as well as around the hips or through the legs. There are a myriad of reasons why a person might experience chronic low back pain, which is why it’s important to partner with a trained pain management specialist who can properly diagnose the cause of pain and recommend an effective treatment plan. 

In addition to the above causes of low back pain, some additional causes of chronic pain include: 

• Biomechanical factors
• Arthritis
• Psychological and emotional factors
• Spinal stenosis
• Sacroiliac joint disease
• Vertebral body fractures
• Neoplasms
• Infections
• Central sensitization
• Ankylosing spondylitis

What are the Best Treatments for Low Back Pain?

The first step in finding relief for pain is to partner with a pain management specialist who has extensive knowledge in all pain conditions. It’s important to have a proper diagnosis so that both the root cause of pain can be treated, as well as manage the symptoms so that you can avoid any additional complications.  

A pain management specialist will perform a physical exam, review your health and family history, and utilize radiological imaging such as X-rays, CT scans, MRIs, or bone scans to get a more in-depth look into the body. Based on the findings, treatment usually begins with minimally invasive options before considering surgical intervention, and could include: 

• Nutrition and exercise: enjoying proper nutrition, anti-inflammatory foods and light exercise and stretching can improve a person’s ability to heal, have a safe range of motion and utilize the power of endorphins to feel good
• Braces: a useful tool for helping to heal after an acute injury, braces are a great way to help regain flexibility and range of motion
• Biofeedback: learning how to control the body’s processes, such as blood pressure and heart rate, can influence and improve feelings of pain
• Alternative therapies: acupuncture, massage and chiropractic treatment all help to relax muscles, decrease stress, manage muscle spasms and release endorphins
• Physical therapy: participating in a workout tailored specifically to your needs helps to strengthen the muscles around the spine and improve range of motion

More about

• Medications: NSAIDs, acetaminophen, muscle relaxants and membrane-stabilizing medications have proven helpful for treating pain and are especially useful for helping a person to more comfortably enjoy physical therapy
• Injections: epidural steroid injections and trigger points injections help to target a specific area believe to be the root cause of pain and injecting a steroid to reduce inflammation and irritation

• Medial branch blocks: an injection of a local anesthetic in the medial nerve that blocks pain sensations from reaching the brain
• Racz procedure: also known as lysis of adhesions, this procedure involves removing excessive scar tissue from the epidural space
• Stimulation: Transcutaneous electrical nerve stimulation (TENS), spinal cord stimulation (SCS) and peripheral nerve stimulation all use electrical currents that allow a person to feel a tingling sensation instead of pain sensations
• Percutaneous discectomy: removing excess material within the disc to relieve pressure
• Disc denervation: using electrical stimulation to deactivate the nerves that are causing pain

Treatment:

Low back pain isn’t always just a simple diagnosis or treatment. There are a lot of factors that come into play, such as why the pain is happening, where it’s felt, and what additional conditions it might be causing, so it’s crucial to seek care from a trained pain management specialist. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are dedicated to helping their family of patients find quick, comfortable and long-lasting relief from their low back pain symptoms. Please schedule an appointment today.