Low back pain (LBP), or lumbago, is the fifth most common reason for physician visits in the US, affecting nearly 60-80% of people throughout their lifetime. More than 80% of all health care costs can be attributed to chronic low back pain, and nearly a third of people seeking treatment for low back pain will have persistent moderate pain for one year following an acute episode. It is estimated that nearly seven million adults in the United States have activity limitations as a result of chronic low back pain.
Scientific research overwhelmingly points to the effectiveness of conservative treatments, such as physical therapy, seeing a chiropractor, massage, etc for decreasing low back pain.
The lumbar back supports the weight of the entire upper body and provides mobility for everyday motions such as twisting, lifting and bending. Muscles in the lower back are responsible for flexing and rotating the hips while walking, while also supporting the spinal column. Nerves in the low back supply sensation and power to the muscles in the pelvis, legs and feet.
Most acute low back pain is caused from injury to the muscles, ligaments, joints, or discs. The body reacts to injury by mobilizing an inflammatory healing process, which can cause an increase in pain.
With a significant overlap of nerve supply to many of the discs, muscles, ligaments and other spinal structures, it can be difficult for the brain to accurately sense where the pain originates.
Low back pain may start suddenly, or slowly increase with an increase in symptoms over time. Low back pain can present as a wide variety of symptoms ranging from mild to severe and debilitating.
Low back pain may begin as acute due to a specific injury, but can become chronic. Managing pain appropriately at the early stage can help limit time and severity of symptoms.
If your low back pain is accompanied by loss of bowel or bladder control or numbness in the groin or inner thigh, you should visit your local emergency department immediately.
Most often, mechanical issues and soft-tissue injuries are the cause of low back pain. These injuries may include compression of nerve roots, damage to intervertebral discs and/or improper movement of the spinal joints. The single most common cause of low back pain is a torn or pulled muscle and/or ligament. Common causes of sprained and strained lower back muscles include prolonged poor posture, lifting heavy objects (especially if twisting), sudden movements such as a fall or motor vehicle accident, or sports injury.
Scientific research overwhelmingly points to the effectiveness of conservative treatments, such as physical therapy, chiropractic, massage, etc. for low back pain. Published guidelines suggest conservative treatment as the best first option for patients, while also reducing overall health care costs by decreasing the need for imaging scans (xray, MRI, etc.), prescription narcotics and surgical referrals.
A September 2013 study found that there was no significant difference in outcomes between patients who chose spinal fusion surgery, as compared to those who chose the non-operative treatment (physical therapy, chiropractic, etc.).