Low back pain overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Low back pain is a common musculoskeletal disorder which affects the lumbar segment of the spine. It can be either acute, subacute or chronic in its clinical presentation. Typically, the symptoms of low back pain do show significant improvement within two to three months from its onset. In a significant number of individuals, low back pain tends to be recurrent in nature with a waxing and waning quality to it. In a small proportion of sufferers this condition can become chronic. Population studies show that back pain affects most adults at some stage in their life and accounts for more sick leave and disability than any other single medical condition.
An acute lower back injury may be caused by a traumatic event, like a car accident or a fall. It occurs suddenly and its victims will usually be able to pinpoint exactly when it happened. In acute cases, the structures damaged will more than likely be soft tissue like muscles, ligaments and tendons. These tissues can account for chronic low back pain as well. With a serious accident, or when osteoporosis or other causes of weakened vertebral bones is present, vertebral fractures in the lumbar spine may also occur. At the lowest end of the spine, some patients may have tailbone pain (also called coccyx pain or coccydynia). Others may have pain from their sacroiliac joint at the bottom of the lumbar spine, called sacroiliac joint dysfunction.
Chronic lower back pain usually has a more insidious onset, occurring over a long period of time. Physical causes may include soft tissue injury or pathology as previously described, nerve root irritation radiculopathy, osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae, spinal disc herniation, vertebral fracture (such as from osteoporosis), or rarely, a tumor (including cancer) or infection. Psychological or emotional issues can also have a profound impact upon low back pain.
Natural History, Complications and Prognosis
Many people will feel better within 1 week after the start of acute low back pain. After another 4-6 weeks, the back pain will likely be completely gone.