By: Amapola Imbag Mallari MPH, PTRP
Low back pain is a generalized complaint of discomfort over the lumbar area. This reflects an array of injuries over the apophyseal joints, IV discs and the surrounding contractile (muscles and ligaments) and non-contractile (spinal cord, nerves and vascular structures) soft tissues. Nevertheless, worry not because this costly and incapacitating condition is preventable and treatable by laboratory exercises for the back.
About 50% to 80% of adults will have low back pain at some time in their lives. This is also the leading cause of disability in people younger than 45 years of age and the third leading cause of disability in those older than 45 years old. Current studies suggest a lifetime rate of low back pain of about 60% to 90% and an annual rate of about 5%. This condition is equal in men and women but is greater in incidence in women secondary to osteoporosis.
The following are the risk factors for low back pain:
- Occupational Factors. Force, repetition, posture and stress can contribute to low back pain. Exerting too much force on your back can cause injury as overly repetitious tasks can lead to muscle fatigue. In addition, spending too much time in a single posture can make you experience occasional aches and pains at the back.
- Patient Related Factors: Age, sex, spinal mobility, physical fitness, smoking, anthropometric measurements and psychosocial factors are considered as risks for developing this condition.
There are many etiological factors contributing to low back pain. These are:
- Degenerative diseases of the joint disks
- Inflammatory (non-infectious) diseases like Ankylosing Spondylitis (bamboo spine as seen laboratory findings)
- Infectious conditions like osteomyelitis or abscesses inside the spine
- Metabolic bone diseases including osteoporosis
- Neoplastic cases when a metastatic tumor has invade the spine
- Traumatic conditions like vertebral fractures
- Congenital or developmental cases like scoliosis
- Musculoskeletal etiology like muscle strains
- Vascular cases such as hardening of the large arteries (atherosclerosis) running in front of the spine.
- Psychogenic and post-operative and multiple operations on the back
Clinical suspicion of low back pain requires immediate evaluation and prompt therapy. In the absence of historical or physical examination findings, laboratory or plain radiograph findings often are unrevealing. The laboratory results, however, are just meant to supplement such findings as these are often incidental, most especially with acute types of back pains.
As confirmed by history, evaluation and laboratory results, treatment of low back pain begins with the following:
ü Modification of activities of daily living (ADLs) by allowing the patient to adjust lifestyle and work demands;
ü Bed rest for not more than three days (as longer bed rest has not been proven to be more beneficial);
ü Pharmacological treatments such as non-steroidal anti-inflammatory drugs, acetaminophen and narcotic analgesics; and
ü Physical therapy measures like ice massage and local heat, pelvic traction, transcutaneous electraical nerve stimulation and back flexibility exercises such as the McKenzie and William’s back protocols.
Once low back pain has been treated, it will have an impact on the quality of life of an individual. This article is used to educate patients on the perils of this disabling disease and how the health care providers and family members can be encouraged to guide patients to a wide range of treatments.