Chronic Lower Back Pain

Lower-back pain is the number one cause of job-related disability in the United States, and one of the leading causes of lost workdays. Only headaches and colds are more common than back pain.

Both sustained physical activity and a sudden jolt can cause acute lower-back pain. While the pain can be intense, it generally doesn’t last long. On the other hand, chronic lower-back pain – which lasts for more than three months – is more debilitating and more difficult to treat.

Much of the chronic pain is caused by damage to the discs – the spongy, multi-function structures that lie between the spine’s vertebrae – in the lower part of the back right above the pelvis (an area known as the lumbar region). And much of that damage is caused by poor body mechanics – the way people stand, walk, lift, carry, reach, bend, sit and sleep.

The intervertebral discs – essentially the spine’s shock absorbers – are under constant pressure, especially in the lower back, which supports the weight of the upper body. The five vertebrae in the lumbar region are naturally arched toward the front of the body, so bending forward compresses the front of these disks, which over time can force them out of position to press on one or more of the nerves emanating from the spinal cord.

This condition – known as a bulging, herniated or ruptured disc – can cause pain in the lower back and elsewhere, especially the buttocks, thighs and even below the knee (sciatica). And that pain can be severe.

Treatment of Lower-Back Pain

So how is chronic lower-back pain treated?

Basic diagnostic methods include physical examination, review of the patient’s medical history and patient descriptions of the onset, location, severity and duration of the pain and of any limitations in movement. Imaging techniques such as X-rays, MRI and CT scans also can be employed to pinpoint the source of pain.

Once the reason behind the pain is determined, the most frequently prescribed treatment is physical therapy and not surgery.

Depending on the individual patient’s condition, physical therapy programs usually include exercises designed to strengthen back and abdominal muscles and to promote proper posture and balance. These can include stretching, swimming, walking and even yoga. But education also is a key element.