If you are suffering from lumbar and lower back pain, Sheppard Spine And Sports Clinic can conduct a physical examination to determine what may be causing your problem. Our proven techniques to treat lumbar and back pain can help to significantly reduce your pain. Below is more information about lumbar and lower back pain.
Overview of Lumbar Pain
Lower back pain, which refers to pain in your lumbar spine is very common. Most adults at some point in their lives will have lower back or lumbar back pain. This can be due to a minor back injury that lasts a few weeks, or due to a degenerative condition that leads to chronic back pain.
The majority of lumbar pain is due to strains and sprains, such as by not lifting something correctly. This type of lumbar pain will usually heal on its own with ice packs, heat packs and over the counter medication. But sometimes, lumbar pain can be caused by more serious conditions.
Causes of Lumbar Pain
There are many causes of lumbar pain. It is important for your Sheppard Spine and Sports Clinic practitioner to learn the cause of the pain so that it can be properly treated. Your practitioner will work with you to determine what is causing the pain in your lower back.
Overall, most lumbar back pain is mechanical in nature, but it also may be caused by spondylosis, which refers to the degeneration of the spine that occurs from years of wear and tear in the discs, joints and bones as we age. Some of the most common mechanical causes of lumbar pain are:
- Strains and sprains: Most acute lumbar pain is caused by strains and sprains. Sprains are due to the tearing or overstretching of ligaments. Strains are tears in muscles or tendons. Both of these problems may occur from lifting or twisting improperly, or stretching too much. These movements also can cause lumbar spasms.
- Disc degeneration: This is one of the most common causes of lumbar pain. It happens when the soft discs between the vertebrae get harder and less spongy as we get older. In a normal lower back, the discs give cushioning and height. They also allow us to bend, flex and move the lumbar area. As the discs get harder and older, they are not able to move as well.
- Herniated disc: This can happen when the discs in the lumbar area are compressed or bulge, leading to severe pain.
- Radiculopathy: This lumbar condition is due to inflammation, compression and possibly injury to a nerve root in the lower spine. When pressure is applied to a nerve root, you may experience pain, numbness or tingling in other areas of the body that are serviced by the nerve.
- Sciatica: This is a type of radiculopathy that is due to compression of your sciatic nerve. This is the large nerve that goes through the buttocks and goes down the back of the legs. The compression leads to a shock or burning sensation in the lumbar area, as well as pain the buttocks and down one of the legs. The pain can even extend to the foot in the worst cases.
- Spondylolisthesis: A condition where a vertebra in the lumbar area slips from its normal position and pinches a nerve that exits the spinal column.
- Traumatic injuries: Car accidents, playing sports or falls can lead to serious lumbar pain as injuries occur to tendons, ligaments and muscles. A traumatic injury also may cause the lower spine to be compressed. This may cause a lumbar disc to rupture or herniate.
- Spinal stenosis: This is a narrowing of the spinal column. It can put more pressure on the spinal cord in the lumbar area. It can cause numbness and pain when you walk. It also can cause leg weakness and loss of feeling in the legs.
Risk Factors for Lumbar Pain
There are several risk factors that can boost the chances of having lumbar pain:
- Age: The first problems with lumbar pain typically occur between ages 30-50. Lumbar pain can become more common as we age. As many people get older, loss of bone strength can cause spinal fractures, and muscle elasticity and tone can decrease. Discs lose flexibility and fluid as they age, and this reduces the ability to cushion the vertebrae in the lumbar spine.
- Level of fitness: Lumbar pain is more common with people who are out of shape. If you have a weak back and abdominal muscles, the lower spine may not be properly supported. People who work out rarely and then go out and do strenuous exercise are more likely to suffer lumbar pain than people who make exercise a daily routine.
- Obesity: People who are overweight or gain a lot of weight fast will often stress the lumbar spine and cause pain.
- Genes: Some types of lumbar pain are genetic in nature, such as spondylitis, which is osteoarthritis of the spine.
- Occupation: People who work in jobs that require lifting, pulling or pushing may have problems with lumbar pain. Also, a job where you sit at a desk all day also can cause lumbar pain.
Diagnosing Lumbar Pain
Your medical professional will take a complete medical history and perform a physical examination to determine potential causes of your lumbar pain. During the physical exam, your practitioner will inquire about the site, severity and onset of the pain; how long the symptoms have occurred and any limits in movement; and any health problems that might be related to the pain. Your practitioner also will conduct a back examination and neurologic tests in most cases to determine causes of lumbar pain.
For many patients, imaging tests are not necessary, but some cases may require imaging to rule out more serious lumbar problems. Some of the possible imaging exams that may be performed are X-rays, CT scans, MRIs, myelograms and discography.
Treating Lumbar Pain
How lumbar pain is treated depends upon the results of the physical examination, and whether the pain is chronic or acute. Below are some of the common treatment regimens available:
- Hot or cold packs do not necessarily resolve lumbar injuries, but they can reduce pain and inflammation for many people, leading to greater mobility.
- Strengthening exercises: Not always recommended for acute lumbar pain, but they can be used to increase recovery from chronic lumbar pain. It is especially important to enhance muscle strength in people who have skeletal problems in their backs. Yoga can be very beneficial to strengthen the lower back and reduce pain.
- Physical therapy: PT can increase the strength of core muscles in the lower back and can enhance flexibility and mobility.
- Spinal manipulation: At Sheppard Spine and Sports Clinic, your practitioner is highly skilled in the N.U.C.C.A technique. This is a gentle, pain free form of spinal adjustment that avoids the harsh manipulation techniques of regular chiropractors. It focuses on a gentle adjustment of the Atlas vertebra, which is the top bone in your spine right under the brainstem. This vertebra lacks discs above and below it, and can be easily injured or misaligned. N.U.C.C.A. focuses on the perfect alignment of this vertebra to reduce back pain throughout your back.
- Spinal decompression: Sheppard Spine and Sports Clinic offers the SpineMED System, which is a higher specialized spinal decompression procedure that offers significant lumbar pain relief for many patients. It is a computer operated, biofeedback form of decompression that is far superior to older traction systems that are unable to react and adjust tension automatically.
- Biofeedback: This form of lumbar pain therapy involves the attaching of electrodes to the skin and using electromyopgraphy devices that allow people to reduce their pain by using proven relaxation techniques by controlling breathing, muscle tension, and heart rate.
Can Lumbar Pain Be Prevented?
Recurring lumbar pain can result from poor body mechanics. This type of back pain may be prevented by avoiding movements that strain the lower back, keeping proper posture and lifting heavy objects carefully. To keep your lumbar spine healthy, we recommend the following best practices:
- Stretch before you start any strenuous physical activity.
- Do not slouch when you sit or stand. The lumbar spine can more easily support your weight when the curvature of the spine is reduced. When you are standing, it is important to have your weight balanced on the feet.
- Sit in chairs with proper lumbar support, with the proper height and position for what you are doing.
- Sleeping on your side with knees in a fetal position can open up the spinal joints and relieve pressure on the lumbar area.
- Do not smoke. Smoking lowers blood flow to the lower spine, and leads to degeneration of the spinal discs. It also causes osteoporosis and slows the healing process.
- Low Back Pain Fact Sheet. (n.d.). Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
- Low Back Pain Overview. (n.d.). Retrieved from https://www.practicalpainmanagement.com/patient/conditions/low-back-pain/low-back-pain-overview