Lower Back Pain
One of the most common concerns for adults, lower back pain can range from mild to totally debilitating. Nearly everyone will experience lower back problems at some point in his or her lifetime, and the causes and symptoms can vary widely. In addition to discomfort, lower back pain often results in lost productivity. For individuals under the age of 45, back pain is the second most frequent reason for missing work after a cold.
The lower, or lumbar, spine helps to support your whole body, connecting the upper portion to the lower portion and holding it upright. Additionally, the lumbar spine allows you to bend, turn, and twist as needed. This complex structure also makes it possible to stand, walk, and lift. The lower spine is essential for so many basic and advanced movements that it’s easy to forget about when it is functioning properly. When injured, however, your ability to work, play, or complete everyday tasks can become severely limited. As a result, your quality of life suffers. Our board certified orthopaedic surgeons understand how debilitating back pain can be, and they offer a comprehensive selection of leading minimally invasive spinal treatments that can help provide relief.
For more information about lower back pain and treatment, please contact our office today. We can answer your questions and help you schedule a consultation right away.
What is the lower back?
The lower back is made up of several different structures, including bones, muscles, and ligaments, which allow you to stand up and move around. Each of these tissues assists the others in their day-to-day use, and they include:
- Lumbar vertebrae: five bones stacked one on top of the other. They connect with the upper back bones (thoracic spine) and the sacrum and coccyx (tail bone).
- Discs: Six discs serve as shock absorbers or cushions between each vertebra to help protect the bones.
- Spinal cord and nerves: The spinal cord and the spinal nerves run up and down your back through a central canal located within the vertebrae. These cables link your brain to your leg muscles.
- Small joints: Joints are designed to provide turning, twisting, and bending movements for greater function and stability.
- Muscles and ligaments: These soft tissues surround the spine, providing strength, power, support, and stability.
How is lower back pain diagnosed?
In many instances, lower back pain is not severe and can be managed with non-surgical treatments. When you arrive for your initial consultation, one of our experienced orthopaedic surgeons will examine your spine and legs, discuss your symptoms, and ask if you’ve experienced an injury. Our thorough evaluation can be completed in office, often without the need for expensive or inconvenient tests.
In the event your pain is more severe or minimally invasive techniques prove ineffective, our physicians may order imaging tests. Each test is designed to reveal different anatomical systems and tissues. X-rays, for instance, allow us to see your bones and the conditions that may be affecting them, including arthritis. CT (Computerized Tomography) and MRI (Magnetic Resonance Imaging) scans show the soft tissues in the area. Additional tests may include bone scans and electrical tests (EMG, or Electromyography), which are designed to help us analyze bone activity and assess whether nerve or muscle damage has occurred, respectively. Your orthopaedic surgeon will discuss which tests will be needed and why during your appointment.
What are the common causes of lower back pain?
While lumbar spine discomfort is common, the causes can range significantly from patient to patient. Generally speaking, back issues can occur as a result of the natural process of aging, wear and tear from recreational activities, and accidents or injuries. Your treatment will be customized to suit your unique diagnosis, anatomical needs, and desired outcome. Some of the most frequently occurring causes of lower back pain include sprains and strains, age, osteoporosis and fractures, and a protruding or herniated disc.
Low Back Sprain and Strain
The lower back is made up of many tissues that all work together to provide mobility, support, and strength. The muscles and ligaments in this area make it possible to perform a wide range of activities that require standing, walking or running, and lifting. If overworked or in poor condition, the lower back muscles may become strained. Sprains are also common, and this concern can happen when a ligament, which links the five lumbar vertebral bones together, becomes injured. Typically, a sudden, aggressive movement can cause a sprained ligament, particularly if that tissue has weakened or become stiff as a result of disuse or overuse.
Sprains and strains are the most frequent source of lower back pain. Fortunately, you can help reduce the possibility of experiencing these conditions by maintaining your health and fitness. Factors that can increase your risk for injury or disease include:
- Poor conditioning
- Improper movement or use
The natural process of aging and disease can also affect the condition of your bones, muscles, and ligaments. Taking excellent care of your body can help you maintain soft tissue strength and elasticity as well as bone density well into maturity. Lifting and moving objects properly, exercising regularly, eating a nutritious diet, and quitting or avoiding smoking can limit the impact of normal aging.
As mentioned above, the natural process of aging can change the condition of your lower back over time. Additionally, genetic predisposition to diseases or disorders, such as degenerative disc disease and arthritis, may cause the discs and joints of the lower back to deteriorate faster than expected. Nearly everyone, as they grow older, will experience normal wear and tear without significant discomfort or reduced mobility. However, advanced conditions, including bone spurs and inflamed joints, can cause stiffness and pain in the affected area.
Osteoporosis and Fractures
Bones naturally lose their strength, or density, over time. Osteoporosis is a bone disease that can cause the lumbar vertebrae to deteriorate more rapidly, particularly in postmenopausal women. As the bones weaken, there is an increased risk of compression and fractures, which can occur as a result of a fall, lifting something heavy, or even regular activity.
Protruding or Herniated Disc
Between each vertebra is a cushion called a disc. The soft, jelly-like center of the vertebral disc is known as the nucleus. Surrounding the nucleus is a firmer substance known as the anulus. As a part of the natural aging process, the nucleus begins to grow tougher, mimicking the stiffer quality of the anulus. Usually around middle age or as a result of a disease or disorder, cracks or fissures in the anulus may occur, causing discomfort. In some cases, the nucleus may extend outside of the disc or rupture completely, which is known as a slipped or herniated disc. If the nucleus or anulus material puts pressure on a nerve, you may experience pain, numbness, or tingling in the leg.
What is the best treatment?
Fortunately, lower back pain often can be addressed using a combination of non-surgical techniques, which may include prescription medication, physical therapy, special exercises, a period of inactivity, or other minimally invasive suggestions. Your orthopaedic surgeon will advise you on the best course of action during your initial consultation. It’s important to note that inactivity may not necessarily apply to work or certain sports or recreational experiences, but you should follow your physician’s recommendations to optimize your outcome. Our approach to spine and pain management emphasizes your comfort and results foremost.
In addition to treating existing pain, our skilled orthopaedic surgeons are also committed to improving your health and well-being in the long term. Once the discomfort has initially subsided, we may recommend a physical rehabilitation program that can strengthen the lower back and abdominal muscles as well as increase overall flexibility. Furthermore, smokers and patients who are overweight will be encouraged to address these issues to help reduce the risk of recurring back problems. We believe preventive measures are some of the best ways to maintain a healthy, functional spine and avoid future injuries.
When is surgery needed?
At the Orthopaedic Institute of Central Jersey, we emphasize minimally invasive, conservative treatments first. In most cases, both chronic and acute lower back pain can be reduced or eliminated without the need for surgical intervention. If non-invasive treatments cannot provide significant relief, an operation may be able to relieve pressure caused by a slipped disc, arthritis, or another condition.
Some of the natural effects of the aging process cannot be avoided, including the gradual reduction of bone density, bone strength, and muscle and ligament elasticity. However, there are many ways for you to help slow the process down, including:
- Exercise regularly to maintain strong, supportive muscles
- Lift and move objects correctly, and ask for help with heavy or awkward items
- Maintain a healthy body weight
- Avoid smoking
- Utilize proper posture when sitting and standing
You can rest assured that our skilled orthopaedic surgeons are extensively trained in the diagnosis and treatment of the entire musculoskeletal system and all its various tissues. Regardless of the nature of your lower back pain, we strive to provide exceptional care from the moment you walk in the door.
For more information about lower back pain and our treatment options, please contact our office today. Our friendly and knowledgeable medical team will be happy to answer questions and help you schedule a consultation.