Important structures of the low back that can be related to symptoms there include the bony lumbar spine vertebrae, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Common causes of low back pain (lumbar backache) include lumbar strain, nerve irritation, lumbar radiculopathy, bony encroachment, and conditions of the bone and joints. Each of these is reviewed below.
Lumbar Strain (Acute and Chronic)
A lumbar strain is a stretch injury to the ligaments,
tendons, and/or muscles of the low back. The stretching incident results in
microscopic tears of varying degrees in these tissues. Lumbar strain is
considered one of the most common causes of low back pain. The injury can occur
because of overuse, improper use, or trauma. Soft-tissue injury is commonly classified as
"acute" if it has been present for days to weeks. If the strain lasts
longer than three months, it is referred to as "chronic."
Nerve Irritation
The nerves of the lumbar spine can be irritated by mechanical pressure
(impingement) by bone or other tissues, or from disease, anywhere along
their paths -- from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment,
and inflammation of the nerves caused by a viral infection (shingles).
Physical Therapy
Understanding cervical spine disease and injuries requires basic knowledge of anatomy and biomechanics.
A physical therapist is a specialist trained to work with you to restore your activity,
strength and motion following an injury or surgery. Physical therapists
can teach specific exercises, stretches and techniques and use
specialized equipment to address problems that cannot be managed without
this specialized physical therapy training.
Physical therapists are trained to identify deficiencies in the
biomechanics of the body. Working with a physical therapist can target
specific areas of weakness in the way our bodies work. They can relieve
stress and help the body function without pain.
Physical therapists are knowledgeable about surgical procedures and
treatment goals, and can tailor their efforts to improve your
well-being. After surgical procedures, it is important that therapy is
guided by the surgical procedure. Physical therapists are knowledgeable
about your body's limitations after surgery and can help ensure a
successful outcome.
Strengthening of the muscles around the cervical spine joint may help decrease the
burden on the Neck. Preventing atrophy of the muscles is an important
part of maintaining functional use of the cervical spine.
Contact campus Physical Therapy Center for an appointment with a physical therapist at
650.994.7800
Lumbar Radiculopathy
Lumbar radiculopathy is nerve irritation that is caused by damage to the
discs between the vertebrae. Damage to the disc occurs because of
degeneration ("wear and tear") of the outer ring of the disc, traumatic
injury, or both. As a result, the central softer portion of the disc can
rupture (herniate) through the outer ring of the disc and abut the
spinal cord or its nerves as they exit the bony spinal column. This
rupture is what causes the commonly recognized "sciatica" pain of a herniated disc that shoots from the low back and buttock down the leg. Sciatica can be
preceded by a history of localized low-back aching or it can follow a
"popping" sensation and be accompanied by numbness and tingling. The
pain commonly increases with movements at the waist and can increase
with coughing or sneezing. In more severe instances, sciatica can be
accompanied by incontinence of the bladder and/or bowels. The sciatica
of lumbar radiculopathy typically affects only one side of the body,
such as the left side or right side, and not both.
Bony Encroachment
Causes of bony
encroachment of the spinal nerves include foraminal narrowing (narrowing of the
portal through which the spinal nerve passes from the spinal column, out of the
spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative
to another), and spinal stenosis (compression of the nerve roots or spinal cord
by bony spurs or other soft tissues in the spinal canal).
Bony and Joint Conditions
Bone and joint conditions that lead to low
back pain include those existing from birth (congenital), those that result from
wear and tear (degenerative) or injury, and those that are due to inflammation of
the joints (arthritis).
Congenital bone conditions
Congenital causes (existing from birth) of low
back pain include scoliosis and spina bifida.
Degenerative joint and bone conditions
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
Arthritis
The spondyloarthropathies are inflammatory
types of arthritis that can affect the lower back and sacroiliac joints. Examples of spondyloarthropathies include reactive arthritis (Reiter's disease), ankylosing spondylitis, psoriatic arthritis, and the arthritis of inflammatory bowel disease.