Lower Back Pain

Physical pain is an unpleasant sensory and emotional experience associated with damage or trauma of a part of the body, or movements of the body to the point of strain or trauma. Your pain may be due to damage to an area due to injury, or you may experience an increasing pressure to a section of the body when it is moved into a position beyond what it was designed to withstand (like if you were trying to pull your arms behind your body). Lower back pain is a musculoskeletal disorder that causes pain either in the lower back and/or as referred pain radiating from the lower back down the front or back or the legs. Though back pain may refer to pain in the upper, middle, or lower back, lower back pain is the most common cause. Low back pain is the second most common neurological medical illness, trailing only the headache. Lower back pain is often classified according to the length of time symptoms persist: acute (<4 weeks), subacute (1-3 months), and chronic (>3 months).

Mechanical problems: Though there are hundreds of exotic metastatic cancers (e.g. osteogenic sarcoma) and disease(Diffuse Idiopathic Skeletal Hypertosis) that may cause back pain, the majority of cases are caused by an underlying mechanical problem of the structures of the back involved in movement of the spine or protection of the vertebral bones.



The mechanical problems may be of the sprain and strain variety. Sprain and strain injuries include reversible sprains and strains of the muscles and ligaments of the back, due to injuries or overuse. Other mechanical causes of back pain involve degenerative changes to the vertebral bones of the back, the spinal canal that runs through the vertebrae, or degenerative changes to the facet joints and intervertebral discs of the back. Spinal disc herniation is one of the most common of the mechanical causes of low back pain. a spinal disc herniation occurs when the fibrous outer shell of the intervertebral disc becomes torn, allowing the gooey, thick contents of its interior (nucleus pulposus) to pour out.

This tear in the shell may also cause the disc itself to become misshapen to the point where the spine becomes less stable and less protective of the vertebral bones above and below it. The tear may cause the now malformed disc to protrude into the space occupied by the nerve root, causing moderate to severe pain. The spinal disc herniation and loss of some of its contents into the spinal area may trigger the release of inflammatory chemical mediators which may directly cause intense pain, without significant nerve compression.

Other mechanical problems of the back that may factor in lower back pain include abnormal foot pronation, retroversion or enteversion of the pelvis, or Scheuermann's kyphosis.

Inflammatory Causes: Lower back pain is often due to either osteoarthritis or arthritic conditions associated with autoimmune disease. Arthritis defined is inflammation of one or more joints, which may result in limited movement, stiffness, swelling, aching, and pain. Osteoarthritis is the typical wear and tear arthritis, basically it results from the joint cartilage wearing down through age or overuse. Inflammatory arthritis conditions as the result of autoimmune disease include rheumatoid arthritis, Psoriatic arthritis, and seronegative spondylarthritides.