What causes low back pain?
This is easily the most common cause of disability worldwide. 80% of adults would have suffered from it sometime during their life. There is no one cause for low back pain, and nor is there an easy way to determine what is the root cause of the pain. However, like with most other causes of chronic disease and disability, the biochemical cause is inflammation.
How is low back pain diagnosed?
As in many lifestyle related causes, addressing the cause helps with the back pain. It may not be a pill or ‘quick fix’ intervention that will help with pain in the long term. Movement and exercise help especially with nutrition of the disc which is an avascular structure and depends on its nutrition from the surrounding bone.
By taking a detailed history and examination of the patient we get a good idea of what is causing the low back pain, and broadly speaking it is usually categorised as serious cause or a mechanical cause. Intensity of pain is not always a reason to worry about the cause being sinister but taking a detailed history and examination and often also an imaging scan, helps us reassure patients about their cause of back pain. Mechanical causes often have a background of reduced activity and prolonged sitting in a poor posture.
What are the treatment options for low back pain?
Very often mechanical back pain requires exercise or a therapist’s attention to help it. Sometimes mere reassurance of the cause not being a ‘serious cause’ is enough to reassure patients who can then adjust heir lifestyle. In some patients who are stuck in a cycle of pain, it can be useful to break the pain cycle with injections into the back before the long-term lifestyle strategy is implemented but injections are not as effective as modifying lifestyle.
Recovery can take a few days to months and is often better to prevent than treat once pain pathways are established.