Low back pain is one of the most common causes of visits to the emergency room. It is outranked only by headaches. Back pain can be chronic or acute, from apparent injury or an insidious onset because of degenerative changes in the spine. Understanding low back pain means we first have to understand a little bit about the anatomy and the structures that can cause pain. We can divide the back/spine into four portions, the cervical or the neck area, the thoracic or the mid-back, the lumbar or the low back, and the sacrum and coccyx, which is the tailbone or seat area.
Structures either contained or forming the back/spine include the vertebral bones, which stack on top of each other, protecting the spinal cord and the upper and mid-back, and the nerves in the low back. Between the vertebrae, we have the intra-vertebral discs, which are cushions that act as shock absorbers, give space for the spine, and allow mobility. The spinal cord travels down from the base of the brain and runs in the spinal canal extending down to the first lumbar spine area. Then of course, you have ligaments, tough fibers flexible tissue that can hold the vertebral bodies in place. Muscles can pull the spine in different directions allowing us to bend, extend and flex from side to side and twist. Tendons connect these muscles to the bone. These structures can be injured, causing low back pain, mid back pain, or neck pain.
About Back Pain
Hereditary factors as well as general health and fitness levels can also affect back pain. In general, people who are in an ideal body mass index, with a moderate level of fitness tend to have or recover more quickly from back elements.
Certain jobs that involve prolong sitting lifting or pushing can contribute as well.
As we age, and most patients over 45 years of age, tend to have at least one onset of back pain causing them to miss time from work. Genetics can also play a role in back pain, especially conditions that cause early degeneration of the lumbar discs, early arthritis, or congenitally misshapen or small canal of the spine. Because of the complex nature of the spine, diagnosing the cause of pain involves a detailed history and physical, imaging studies when appropriate, electrodiagnostic studies, and injections which may be both diagnostic and therapeutic.