Low Back Pain
Overview
Low back pain is a very common condition. Fortunately, more than 70% of cases improve within 2 weeks, and over 90% resolve within 4–6 weeks without serious complications.
Back pain is often caused by inflammation or strain of muscles, joints, or intervertebral discs in the lower back. Certain activities such as frequent heavy lifting, bending, or twisting can worsen symptoms. Poor posture, improper ergonomics, infections in other parts of the body, certain allergic conditions, chronic arthritis, and psychological stress may also contribute to worsening back pain.
Warning Signs
In some cases, a physical examination and further investigation may be required to determine the cause. Patients should inform their doctor of any changes in symptoms. Follow-up appointments may be scheduled within 1–3 weeks. Seek medical attention immediately if you experience:
- Unexplained weight loss
- Persistent night pain
- Fever
- Difficulty urinating
- Weakness in the legs
Diagnosis
X-ray is not usually the first step in evaluating back pain. It is typically recommended in cases involving trauma (such as falls or car accidents), in patients over 50 years old, or those with underlying health conditions. Imaging studies may also be considered if pain persists longer than 6 weeks. CT scans or MRI may be required in cases of chronic radiating pain to the legs, to better identify structural abnormalities.
Types of Low Back Pain
1. Acute Low Back Pain
Acute low back pain lasts for 6 weeks or less and does not radiate down the leg. It is commonly caused by muscle strain, ligament sprain, or inflammation around the spine. Most patients improve within a few days after treatment.
2. Acute Radiating Leg Pain (Sciatica)
This type of pain lasts up to 6 weeks and radiates from the lower back to the hips and legs. It is often caused by a herniated disc compressing a nerve. Recovery may take longer than simple low back pain, and nerve irritation typically results in more severe symptoms.
3. Chronic Low Back Pain and Sciatica
Pain lasting longer than 6 weeks is considered chronic. Conditions such as spinal stenosis or nerve compression are possible causes. Specialized treatment is often required, and patients may be referred to specialists such as physiatrists, spine surgeons, orthopedic surgeons, or neurosurgeons.
Treatment
The following measures may help relieve symptoms. Consult your doctor if pain persists or worsens:
- Adequate rest and lying flat to reduce pain
- Cold and warm compresses to reduce pain and swelling
- Anti-inflammatory medications such as ibuprofen or aspirin
- Adjusting daily posture and activities
- Physical therapy for spinal rehabilitation
- Interventional treatments (e.g., injections)
- Surgical treatment in selected cases
