Chronic Low Back Pain?
Low back pain (LBP) is a very common condition that many people experience at some point in their life. Although not a disease in itself, low back pain is a symptom of many different underlying diseases or injuries. For example, a muscle sprain in the lower back is usually followed by a sudden jolt of pain. Pain does two things; it tells the body that there is an injury that needs to be healed and it tells the person that caution is needed to prevent further damage. This acute (short-term) low back pain should disappear within a few days or weeks. However, low back pain can recur regularly and can last for several months or even years. This persistent or long-term pain is known as chronic pain. The pain signals that cause this pain no longer work correctly and do not serve the intended useful purpose.
What causes chronic low back pain?
Chronic low back pain can originate from various structures in the back and can be traced in some cases to a specific cause, for example:
- Disc protrusion: the discs between the vertebrae may become weaker and bulge outwards. In an extreme case this may lead to a prolapsed disc.
- A prolapsed disc (‘slipped disc’ or ‘herniated disc): a disc bulges so far out that it puts pressure on the spinal nerves running in the back. The patient may feel this as pain in the legs since these nerves in the lower back run all the way down to the toes.
- Spinal stenosis: the spinal column runs through a narrow opening in the vertebrae. If this opening becomes too narrow, through a process called stenosis, the nerves may become trapped or squeezed, which causes pain.
- Collapsed vertebra: the vertebrae give much of the structural support to the spine but these may become damaged as a result of disease or injury. Severe osteoporosis may result in a vertebra collapsing and by doing so, disturb the surrounding structures.
- Facet joint osteoarthritis (“degenerative arthritis” or “osteoarthritis of the spine”): a degenerative condition that develops gradually over time where the pain is caused by the breakdown of the cartilage between the facet joints in the spine.
The above causes may explain where the pain originates, but may not necessarily explain the degree of pain, as it can differ from person to person. The pain may be mild, or it can be so severe that the affected patient is unable to move. The intensity and frequency of low back pain is often also influenced by psychological components such as stress, depression, and anxiety.
What are the symptoms of chronic low back pain?
- Dull aching pain
- Sharp pain
- Tingling or burning sensation
- Weakness in the legs or feet
Depending on the cause of the pain, low back pain patients may also have pain in their legs, hips, or feet.
What can chronic low back pain patients do?
There is a wide range of treatments that patients may use to control their chronic low back pain. However, it is important to be realistic about the expectations of any treatment. Although every patient’s goal is to completely eliminate their pain, reducing pain to a level that is manageable is perhaps a more achievable goal for many patients. If you think that you might have chronic low back pain, please fill out the ‘my pain questionnaire’ and speak to your doctor.