What causes lower back pain?
There is usually no single identifiable cause for an episode of back pain. Most back pain comes from the soft tissues of the spine (ligaments, muscles and joints). One of the most common factors in back pain is being 'out of condition' and it can be triggered by prolonged sitting or standing in a poor position, or prolonged bending. The problem can also be made worse by heavy or repetitive lifting. Many conditions can cause back and neck pain, ranging from injury to infection to
simply twisting the wrong way. An injury sustained in an automobile or other type of accident can damage muscles, joints, ligaments, and vertebrae.
Acute pain in the lower back that does not extend to the leg is most commonly caused by a sprain or muscle tear, usually occurring within 24 hours of heavy lifting or overuse of the back muscles. The pain is usually localized, and there may be muscle spasms or soreness when the doctor touches the area. The patient usually feels better when resting. A strain is the result of a heavy load or sudden force applied to the muscles before they are ready for activity. The muscle essentially rips, along with the blood vessels within the muscle tissue. This may cause bleeding into the injured area. It can take up to two to three hours before sufficient bleeding or irritation sets in to produce significant pain. This can help explain why many people often can tolerate finishing the task at hand, only to suffer from intense pain later. Sprains refer to an overstretching of one or more of the ligaments of the back. The ligaments can be stretched beyond their natural integrity and in some cases can completely tear. It is common to have both ligament sprains and muscle strains occurring together. This is especially the case in severe falls and motor vehicle accidents.
Degenerative joint disease - The joints that allow mobility and stability are subject to wear and tear. Facet joints allow movement of the spine. These consist of two knobs, or facets, that meet between each vertebra to form a joint. As facet joints degenerate, they may not align correctly, and the cartilage and fluid that lubricates the joints may deteriorate. Bone then rubs against bone, which can be very painful. In degenerative joint disease (also called osteoarthritis), the shiny, smooth cartilage that lines the joint wears away, leaving bone to rub on bone, a painful situation. Degeneration of the disc is called spondylosis. Spondylosis can be noted on x-rays of the spine as a narrowing of the normal "disc space" between the vertebrae. It is the deterioration of the disc tissue that predisposes the disc to herniation and localized lumbar pain ("lumbago") in older patients. Degenerative arthritis (osteoarthritis) of the facet joints is also a cause of localized lumbar pain that can be detected with plain x-ray testing. These causes of degenerative back pain are usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasm, and inflammation.
Herniated spinal disk - Disk herniation is a disorder in which a spinal disk begins to bulge outward between the vertebrae. Herniated or ruptured disks are a common cause of chronic lower back pain in adults. Given their location, torn or bulging disks can readily compress the spinal cord or nerves traveling out of the back. A herniated disc, also called a "slipped disc," is a disc that bulges out from its position between two vertebrae. Disc bulge or protrusion results when the disc bulges out from between two vertebrae without rupturing its surrounding envelope, the annulus fibrosis. Disc prolapse results when the inner jelly-like central part of the disc ( the nucleus pulposis), seeps into the outermost fibers of the surrounding envelope, the annulus fibrosis. Disc extrusion results when a tear occurs in the surrounding envelope of the disc, and the inner jelly-like central part of the disc leaks out of the disc. Sequestrated disc is the term used when disc fragments are separated from the disc, coming to lie well outside the disc space in the spinal canal. A herniated disc has the potential to cause compression against a nerve, producing what is called radicular pain. Radicular pain is also called sciatica. This pain is caused by compression of the nerves as they exit the spinal column. The pain may be felt radiating into the buttock or down the leg, and may be accompanied by a sensation of numbness or tingling in the leg.
Spinal stenosis - Narrowing (stenosis) of the spinal canal can be caused by calcium deposits in ligaments, degenerative joint disease or disk disease, or it may be present since birth. Any of these problems alone or in combination can lead to pressure on the spinal cord or a nearby nerve, causing pain. Conditions that cause spinal stenosis include infection, tumors, trauma, herniated disc, arthritis, thickening of ligaments, growth of bone spurs, and disc degeneration. Spinal stenosis most commonly occurs in older individuals as a result of vertebral degeneration. Spinal stenosis occurs as intervertebral discs lose moisture and volume with age, which decreases the disc spaces. Even minor trauma under these circumstances can cause inflammation and nerve root impingement, which can produce classic sciatica without disc rupture. Spinal stenosis is a less common mechanism for sciatica that results from lumbar spinal canal narrowing, causing pressure on the sciatic nerve roots (or rarely the cord) before their exit from the foramina. It may mimic vascular disease by simulating intermittent claudication. The disorder occurs in middle-aged or elderly patients.
Spondylolisthesis - Spondylolisthesis is a relatively common condition, especially among older persons, in which one vertebra slides forward on another. When a tiny defect or fracture in the bones at the back of the vertebrae is also present, the condition is called spondylolysis. In either case, the spinal cord or nerves leaving the cord can be compressed, causing pain in the back or legs. Spondylolisthesis is a condition in which one vertebra slips forward on the one beneath it. It may result from a number of causes, including trauma to the spine or osteoarthritis (wear and tear) of the spine, or it may have been acquired from birth. The amount the vertebra has slipped forward on the one beneath it may be minimal or very significant. There may be no symptoms or there may be back pain and the back may feel stiff. If the slip has caused pressure on a nerve root, pain may be felt in the buttocks or thigh. With a major slip, an increase in the bend of the lower back can be noticed (called increased lordosis). Treatment depends on the severity of the condition and the symptoms. This may range from simple exercises and physical therapy to spinal fusion (hyperlink glossary) to stabilize the spine.
Sciatica - Sciatica is a certain type of radiculopathy that involves inflammation of the sciatic nerve. Pain is experienced along the large sciatic nerve, from the lower back down through the buttocks and along the back of the leg. Sciatica is pain that radiates along the course of the sciatic nerve, most often down the buttocks and the posterior aspect of the leg to below the knee. It may occur with or without lower back pain. It is most commonly caused by peripheral nerve root compression from intervertebral disk protrusion or intraspinal tumor. Compression may be within the spinal canal or intervertebral foramen by disk protrusion, tumor, or bony irregularities (eg, osteoarthritis, spondylolisthesis). The nerves can also be compressed outside the vertebral column, in the pelvis or buttocks.
Osteoporosis with compression fracture - By itself, osteoporosis is painless, but it increases the risk of fracture of the hip, wrist and vertebrae. The fracture itself or the resulting abnormal curvature of the spine or pressure on nerves may be a source of pain. In osteoporosis - a progressive disease that commonly affects postmenopausal women - the bones become weaker and more porous. Although osteoporosis is painless, it increases the risk of fracture of the hip, wrist and vertebrae. Vertebral fractures themselves may be painful, as can be the resulting abnormal curvature of the spine or pressure on nerves.
Pregnancy - A woman's body undergoes significant hormonal and physical changes during the nine months of pregnancy. For most women, this can lead to back pain as an unavoidable side effect during this time. Early in pregnancy, certain hormonal changes result in increased joint laxity. As a result, the spine, abdominal and back muscles, and posture of the lower back change and become more relaxed. Poor posture and poor muscle tone prior to pregnancy can affect how the back adjusts. The lumbar (lower back) curve begins to increase slightly as the pelvis tilts backward. This posture begins to influence the weakened and now fatigued lower back muscles. A woman may experience mildly painful spasms, which can be the first sign of a persistent backache in early pregnancy.
Fibromyalgia - Fibromyalgia may cause chronic back pain and is believed to be a result of inflammation of the body's connective tissue. The condition is characterized by widespread muscle pain, fatigue, and multiple tender points on the body. Fibromyalgia is more common than most people realize. In many sufferers, pain is present most of the time and may last for years. The severity of the pain goes up and down, and the location of the back pain as well as the generalized pain can vary. Lower back pain resulting from a diagnosis of fibromyalgia is real, but can also be subjective. Many people with this condition find that emotional stress makes the pain worse. Fatigue is also a common aspect of this condition. Chronic pain, along with anxiety about the problem and how to get well, can be fatiguing by itself. In addition, the inflammatory process within the body produces chemicals that are known to cause fatigue.
More information on lower back pain and neuropathy - mononeuropathy, diabetic neuropathy, peripheral neuropathy, polyneuropathy, carpal tunnel syndrome, autonomic neuropathy
What is lower back pain? - Lower back pain is pain in the low lumbar accompanied by pain radiating down one or both buttocks or legs in the distribution of the sciatic nerve (sciatica).
What causes lower back pain? - There is no single identifiable cause for an episode of back pain. Most back pain comes from the soft tissues of the spine.
What're the risk factors for lower back pain? - Lower back pain is often triggered by some combination of overuse, muscle strain, or injury to the muscles and ligaments that support the spine.
What're signs and symptoms of lower back pain? - Symptoms of the back pain will depend on the condition that's causing the pain. Pain can be constant or intermittent.
How is lower back pain diagnosed? - The diagnosis of low back pain can be complicated. Most cases are initially evaluated by primary care physicians rather than by specialists.
What're the treatments for lower back pain? - Treatment of low back pain is aimed at symptom relief or preventing interference with the processes of healing. Acute back pain is treated with nonsteroidal anti-inflammatory drugs.
How to relieve acute lower back pain? - Acute back pain is treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Applications of heat or cold compresses help to relieve lower back pain.
How to relieve chronic low back pain? - Patients with chronic low back pain are treated witha combination of medications, physical therapy, andoccupational or lifestyle modification.
What's the physical therapy for low back pain relief? - Types of treatment used by the physical therapist will depend on the nature of low back pain being treated.
What's lower back pain exercise? - Low-stress aerobic exercise can prevent debilitation due to inactivity during the first month of symptoms and thereafter may help patients relieve lower back pain.
How to prevent low back pain? - Low back pain due to muscle strain can be prevented by lifestyle choices, including regular physical exercise and weight control, avoiding smoking.
What is autonomic neuropathy? - Autonomic neuropathy is a disease of the non-voluntary, non-sensory nervous system caused by damage to nerves supplying the internal body structures.
What causes autonomic neuropathy? - Autonomic neuropathy is a form of peripheral neuropathy affecting the autonomic portion of the peripheral nervous system. The causes are multiple.
What're the symptoms of autonomic neuropathy? - The symptoms of autonomic neuropathy depend upon what organs are affected and may include abdominal swelling, heat intolerance, nausea, vomiting.
How is autonomic neuropathy diagnosed? - Diagnosis of autonomic neuropathy can be made by eye examination and other tests guided by the suspected cause of the disorder.
What's the treatment for autonomic neuropathy? - Treatment for autonomic neuropathy is supportive and may need to be long-term. Several treatments may be attempted before a successful therapy.
What is diabetic neuropathy? - Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. Diabetic neuropathies occur in both type 1 and type 2 diabetes.
What types of diabetic neuropathy are there? - There are three types of neuropathy that occur in people with diabetes. They're peripheral neuropathy, autonomic neuropathy, focal neuropathy.
What causes diabetic neuropathy? - The exact causes of diabetic neuropathy are unknown, several factors may contribute to diabetic neuropathy.
What're the symptoms of diabetic neuropathy? - Symptoms of diabetic neuropathy depend on the types of neuropathy. Diabetic neuropathies are classified as peripheral, autonomic, proximal, and focal.
How is diabetic neuropathy diagnosed? - A diagnosis of diabetic neuropathy is based mostly on your medical history and physical examination.
What's the treatment for diabetic neuropathy? - The goal of treating diabetic neuropathy is to relieve discomfort and prevent further tissue damage. Analgesics may be prescribed for relief of pain.
What is polyneuropathy? - Polyneuropathy refers to any illness that attacks numerous nerves in the body. Polyneuropathy affects the nerves of the autonomic nervous system.
What is chronic inflammatory polyneuropathy? - Chronic inflammatory polyneuropathy is a disorder involving slowly progressive or repeated episodes of loss of movement or sensation.
What is carpal tunnel syndrome? - Carpal tunnel syndrome is a painful disorder in the hand caused by compression of a nerve in the carpal tunnel, characterized by discomfort and weakness in the hand.
What causes carpal tunnel syndrome? - Carpal tunnel syndrome is caused by the swelling of the nerve that runs through the carpal tunnel in the wrist due to repetitive and forceful movements of the wrist.
What're the risk factors for carpal tunnel syndrome? - Risk factors for carpal tunnel syndrome include diseases, some drugs, direct injury, activities that require repeated motions, and even pregnancy.
What're the symptoms of carpal tunnel syndrome? - Symptoms of carpal tunnel syndrome include burning, tingling or numbness of the fingers, difficulty gripping tools or other implements, and problems making a fist.
How is carpal tunnel syndrome diagnosed - An accurate medical history and the clinical examination will establish the diagnosis of carpal tunnel syndrome.
What's the treatment for carpal tunnel syndrome? - Carpal tunnel syndrome is initially treated with splints. Nonsteroidal anti-inflammatory drugs may be used to relieve pain.
How to prevent carpal tunnel syndrome? - Prevention of carpal tunnel syndrome is aimed at becoming aware of the repetitive motions. Early use of a splint is helpful.
What is mononeuropathy? - Mononeuropathy is disorder of a single nerve or nerve trunk. Mononeuropathy involves damage or destruction of an isolated nerve or nerve group.
What're some of the specific mononeuropathies? - Some of the other common forms of mononeuropathy include sciatic nerve dysfunction, radial nerve dysfunction, cranial mononeuropathy, carpal tunnel syndrome.
What causes mononeuropathy? - Mononeuropathy is most often caused by damage to a local area resulting from direct trauma, prolonged pressure on the nerve and compression.
What's the treatment for mononeuropathy? - Treatment of mononeuropathy is aimed at maximizing the ability to use the affected body part. Physical therapy exercises may be useful.
What's common peroneal nerve dysfunction? - Common peroneal nerve dysfunction is a disorder caused by damage to the peroneal nerve, characterized by loss of movement of or sensation in the foot and leg.
What is radial nerve dysfunction? - Radial nerve dysfunction is a form of peripheral neuropathy involves impaired movement or sensation of the back of the arm and hand.
What is ulnar nerve dysfunction? - Ulnar nerve dysfunction involves impaired movement or sensation in the wrist and hand caused by damage to the ulnar nerve.
What is cranial mononeuropathy VI? - Cranial mononeuropathy VI is a disorder that causes double vision, associated with dysfunction of cranial nerve VI.
What is cranial mononeuropathy VII? - Cranial mononeuropathy VII is a mononeuropathy that involves the seventh cranial nerve, the nerve that controls movement of the muscles of the face.
What is cranial mononeuropathy III (compression type)? - Cranial mononeuropathy III is a disorder associated with dysfunction in the third cranial nerve, which causes double vision and eyelid drooping.
What is cranial mononeuropathy III (diabetic type)? - Cranial mononeuropathy III is a complication of diabetes caused by damage to the third cranial nerve.
What is axillary nerve dysfunction? - Axillary nerve dysfunction is a condition involving impaired movement or sensation of the shoulder because of damage to the axillary nerve.
What is distal median nerve dysfunction? - Distal median nerve dysfunction is a form of peripheral neuropathy affecting movement of or sensation in the hand, caused by damage to the distal median nerve.
What is femoral nerve dysfunction? - Femoral nerve dysfunction is a condition involving impaired movement or sensations in the leg, caused by damage to the femoral nerve.
What is tibial nerve dysfunction? - Tibial nerve dysfunction is a condition involving impaired movement or sensation in the leg, caused by damage to the tibial nerve.
What is peripheral neuropathy? - Peripheral neuropathy is a common neurological disorder characterized by sensory loss, pain, muscle weakness and wasting of muscle in the hands or legs and feet.
What types of peripheral neuropathies are there? - To aid in diagnosis and treatment, the symptoms are classified into principal neuropathic syndromes based on the type of affected nerves.
What causes peripheral neuropathy? - Peripheral neuropathy is nerve damage caused by a systemic illness such as diabetes. Neuropathy involves damage to the axon of the nerve cell or the myelin sheath.
What're the risk factors for peripheral neuropathy? - Diabetes is the biggest risk factors for peripheral neuropathy. Other risk factors including include nutritional deficiencies, medications and chemical exposures.
What're the symptoms of peripheral neuropathy? - Symptoms of a peripheral neuropathy include sensory loss, pain, muscle weakness and wasting of muscle in the hands or legs and feet.
How is peripheral neuropathy diagnosed? - Diagnosis of peripheral neuropathy is based on clinical syndrome. Exact diagnosis requires a combination of medical history, medical tests, and process of exclusion.
What're the treatments for peripheral neuropathy? - Treatment goals for peripheral neuropathy may be to determine underlying cause and treat it, cure of the disorder, and control of symptoms.
Is peripheral neuropathy preventable? - Steps that a person can take to prevent peripheral neuropathy include vaccines against diseases that cause neuropathy.
What's the prognosis of peripheral neuropathy? - Prognosis for neuropathy depends on the underlying cause. The outcome for peripheral neuropathy depends heavily on the cause.
What is neuropathy? - Neuropathy is disease or disorder affecting the cranial nerves or the peripheral or autonomic nervous systems. Neuropathy is a disturbance in the function of a nerve or particular group of nerves.
What types of neuropathy are there? - Types of neuropathies include peripheral neuropathy, polyneuropathy, neuropathic arthropathy, cranial neuropathy, autonomic neuropathy, compression mononeuropathy.
What causes neuropathy? - Diabetes is a frequent cause of neuropathy, the other causes of neuropathy are herpes zoster infection, chronic or acute trauma (including surgery) and various neurotoxins.
What're the symptoms of neuropathy? - Symptoms of neuropathy include loss of sensation, paresthesias and dysesthesias, pain, postural hypotension, impotence, abnormal sweating, and sensory ataxia.
How is neuropathy diagnosed? - Neuropathy may be diagnosed by variety of tests, including electromyography and nerve conduction studies. Nerve and muscle biopsy is useful for autoimmune or vasculitic neuropathies.
What's the treatment for neuropathy? - Treatment of neuropathy is often directed at the symptoms or the underlying cause of the neuropathy. Symptomatic treatments include medical therapy, physical and occupational therapy.
What medications relieve neuropathic pain? - A major goal of treatment for neuropathy is relieving neuropathic pain. Three major of medication are used in the treatment of neuropathic pain.
What is sciatica? - Sciatica is pain, tingling, or numbness produced by an irritation of the sciatic nerve. The sciatic nerve supplies the back of the leg and buttocks.
What causes sciatica? - Sciatica is a form of peripheral neuropathy. Of the identifiable causes of sciatic pain, lumbosacral radiculopathy and back strain are the most frequently suspected.
What're the symptoms of sciatica? - The symptoms of sciatica vary widely, the most common symptom is pain that radiates through one buttock and down the back of that leg.
How is sciatica diagnosed? - Diagnosis of sciatica involves a straight-leg-raising test, magnetic resonance imaging (MRI) and computed tomography scans (CT scans).
What's the treatment for sciatica? - Most cases of sciatica can be effectively treated by physical therapy and appropriate changes in environment. Initial treatment for sciatica focuses on pain relief.
How to prevent sciatica? - Once the pain of sciatica passes, there are exercises, stretches and other measures that may prevent it from returning.
What is brachial plexus injury? - brachial plexus injury is an injury to the nerves that travel from the neck and down the arm. These peripheral nerves are called the brachial plexus nerves.
What causes brachial plexus injury? - A brachial plexus injury is caused when the head and neck are forcibly moved or hit to one side, stretching the brachial plexus on the opposite side.
What're the symptoms of brachial plexus injury? - A brachial plexus injury usually causes intense pain from the neck down to the arm. Loss of strength in the affected arm or hand is a common symptom
How is brachial plexus injury diagnosed? - To diagnose a brachial plexus injury, a doctor may ask the patient about his or her symptoms and examine the head, neck, shoulder, arm and hand.
What's the treatment for brachial plexus injury? - The goal of treatment for brachial plexus injury is to enable the patient to return to sport or activity as soon as possible while not worsening the injury.
What's postherpetic neuralgia? - Postherpetic neuralgia is pain that persists after an episode of shingles (herpes zoster) has resolved. Postherpetic neuralgia causes pain after shingles heals.
What causes postherpetic neuralgia? - Postherpetic neuralgia results when nerve fibers are damaged. The condition is caused by damage to and then regrowth of nerves affected by shingles.
What're the symptoms of postherpetic neuralgia? - The symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred.
What's the treatment for postherpetic neuralgia? - Treatment for postherpetic neuralgia also depends on the type of pain the patient experience. Tricyclic antidepressant medications relieve pain.
What is the thoracic outlet syndrome? - Thoracic outlet syndrome is a condition in which the nerves or vessels behind the collar bone (clavicle) become compressed or stretched.
What causes thoracic outlet syndrome? - The common underlying cause of the thoracic outlet syndrome is compression of the nerves and arteries of the arm in the Thoracic Outlet.
What're the symptoms of thoracic outlet syndrome? - Symptoms of thoracic outlet syndrome include pain, numbness and tingling, weakness and fatigue or swelling and coldness in the arm and hand.
How is thoracic outlet syndrome diagnosed? - There are no specific diagnostic tests for thoracic outlet syndromes. The diagnosis is made by ruling out other diseases.
What's the treatment for thoracic outlet syndrome? - Treatment of thoracic outlet syndrome focuses on relief of the symptoms caused by compression of the nerves and blood vessels.