{"id":2295,"date":"2023-02-23T20:01:02","date_gmt":"2023-02-23T20:01:02","guid":{"rendered":"https:\/\/comcorpus.pt\/?page_id=2295"},"modified":"2023-05-18T17:23:24","modified_gmt":"2023-05-18T17:23:24","slug":"lower-back-pain","status":"publish","type":"page","link":"https:\/\/comcorpus.pt\/en\/pathologies\/lower-back-pain\/","title":{"rendered":"Lower back pain"},"content":{"rendered":"

Usually between the last ribs and above the buttocks<\/p>\n

Lower back pain<\/h3>\n

This term refers to the presence of pain in the area of the lumbar spine, usually between the last ribs and above the buttocks. Lower back pain is often accompanied by pain that radiates down the lower limbs. It is therefore a symptom and not a disease, which means that it can indicate different clinical conditions.<\/p>\n

Almost everyone experiences lower back pain at some point in their lives. This pain can be mild or severe and can vary in duration. It is a fairly common and disabling symptom, affecting an estimated 65\u00a0% to 80\u00a0% of the population at least once. Lower back pain is also one of the most common causes of disability retirement, reflecting its personal and professional impact.<\/p>\n

It can be classified as acute (with sudden onset and lasting less than 6 weeks), sub-acute (between 6 and 12 weeks) or chronic (lasting more than 12 weeks). This classification is important because of the different impact it has on the patient, but also because of the different causes and treatments of these different types of lower back pain. In most cases, the cause is mechanical, but in others it is psychological (psychogenic) and these are more difficult to diagnose.<\/p>\n

The anatomy of the spine is complex and includes the vertebrae, the intervertebral discs and a whole range of muscle structures, ligaments and nerves. There are different regions in the spine: cervical, thoracic, lumbar and sacral. In this last region, the vertebrae are fused together. The lumbar region consists of five vertebrae. When we walk or run, the discs absorb shocks and prevent the vertebrae from rubbing against each other. They contribute to the movements of the spine, facilitating its flexion and torsion. Each disc is made up of a fibrous ring and a gelatinous core to absorb shocks.<\/p>\n

Symptoms<\/h3>\n

Lower back pain varies greatly from person to person and in its intensity. It can be slow or sudden, intermittent or constant. Sometimes lower back pain can feel like a stabbing pain or a cramp. These characteristics depend on the underlying cause of the back pain. It may be accompanied by pain that radiates down the lower limbs. The pain tends to improve with lying down or resting and is usually associated with morning stiffness. Conversely, pain is increased with sitting, bending over or lifting weights. Standing and walking also aggravate lower back pain. You may have a limp or a lack of strength in one leg.<\/p>\n

\"Lower<\/a>Depending on the cause, there may be other symptoms that are important in assessing the severity of each case and may be useful in diagnosis. For example, lower back pain may be accompanied by weight loss, fever, recurrent skin infections or urinary tract infections, among other issues.<\/p>\n

The most worrying cases are those that do not improve after three months, those that do not respond to treatment and those that occur in patients with a history of neoplastic disease.<\/p>\n

Non-specific lower back pain is usually caused by an imbalance between the load carried at work or in daily life and the ability of the spine to support that load. In this situation, there is pain but no structural change in the lumbar spine. However, it causes a significant reduction in daily activities and can lead to incapacity for work.<\/p>\n

Causes<\/h3>\n

In most cases (around 90\u00a0%) no cause is found for lower back pain and it is referred to as \u2018non-specific\u2019. This type of injury can occur at any age \u2013 degenerative changes to the spine start to occur after the age of 30 and increase the risk of lower back pain \u2013 especially in people who have jobs that involve heavy physical activity, such as heavy lifting or repetitive movements. Lower back pain is common in sports such as baseball, golf, running, football, rowing, and weightlifting. It is more common in women because of their smaller stature, lower muscle mass and bone density, and more fragile joints.<\/p>\n

The most common causes of lower back pain are musculoskeletal disorders related to degenerative, inflammatory, infectious, tumour, traumatic or postural processes. There are also congenital musculoskeletal conditions associated with lower back pain. Other possible causes are some abdominal diseases (especially in the pancreas and kidney), vascular diseases (e.g. abdominal aortic aneurysm), neurological diseases or due to changes in the intervertebral discs. Some cases may be of psychological origin. Rheumatic diseases and osteoporosis can also cause lower back pain, as can tuberculosis and brucellosis. Other risk factors include prolonged standing or sitting, obesity and poor muscle mass development.<\/p>\n

Injuries to the intervertebral discs cause longer-lasting lower back pain. These injuries can be small \u201ctears\u201d in the fibrous ring of the disc, which become more common with age and in some cases cause no pain. However, pain is common and can last for months. Other disc injuries associated with lower back pain include herniated discs, which can cause sciatica. Over time, discs lose their water content, become smaller and can collapse, causing the vertebrae to rub against each other. This friction process causes pain and stiffness and is called osteoarthritis. The ageing process and overuse of the spine can make it difficult to hold the vertebrae in the correct position, allowing them to slide over each other and compress the neighbouring nerve roots. Narrowing of the spinal canal is another cause of pressure on the spinal cord and nerves. This narrowing can be a result of the growth of bone tissue, the spurs, stimulated by disc herniation and osteoarthritis, whose function is to better support the vertebrae. These spurs eventually narrow the canal. Similarly, osteoarthritis causes thickening of the ligaments, which also narrows the spinal canal. Scoliosis, an abnormal curvature of the spine, is also a cause of lower back pain and related leg symptoms if nerve compression occurs.<\/p>\n

Diagnosis<\/h3>\n

Clinical history and physical examination are very important. The choice of complementary diagnostic tests is based on this assessment and may include imaging studies (x-ray, CT scan, MRI), bone scintigraphy (bone scans) and\/or laboratory tests. Osteodensitometry may be important in assessing the presence of osteoporosis. X-rays may show arthritic changes in the spine, such as disc space collapse, bony spurs, hypertrophy of the inter-articular joints, or slippage of one vertebra over another (spondylolisthesis), but the specificity of these changes is limited because they are present in most people, even asymptomatically.<\/p>\n

Treatment<\/h3>\n

Treatment depends on the cause and the main aim is to relieve the pain. To achieve this, painkillers, anti-inflammatories and\/or muscle relaxants may be useful and should be chosen and prescribed by the physician on a case-by-case basis. In some situations, corticosteroids may be indicated, as may joint infiltrations.<\/p>\n

The use of heat or cold, massage, ultrasound or electrical stimulation may be important. Some stretching, weightlifting or cardiovascular exercises will help restore mobility and strengthen the lumbar muscles, which will help to relieve pain. In some cases, support belts are used to provide symptomatic relief. Chronic lower back pain may be associated with depressive symptoms, in which case antidepressants can play an important role in providing relief.<\/p>\n

In some cases, surgery may be indicated, but should not be considered until six months to a year after the onset of symptoms. On the other hand, surgery should only be considered when the specific cause of the back pain is known. Surgery can fuse the vertebrae together so that they heal as a single bone, eliminating movement in that vertebral segment. This option is considered when movement is the cause of pain, such as in scoliosis or severe degeneration. Another option is to replace an injured disc, maintaining the flexibility and mobility of the spine.<\/p>\n

Prevention<\/h3>\n

It is not always possible to prevent the development of lower back pain. However, we can control risk factors, such as overexertion, obesity and osteoporosis, by diagnosing and treating associated conditions.<\/p>\n

Whenever you have to lift a weight, it is important to bend your legs and keep your back straight. Good posture and aerobic exercise, such as walking or swimming, combined with exercises that build muscle strength in the lower back and abdominal area are very helpful.<\/p>\n

Good weight control, no smoking and maintaining correct posture in all positions are essential.<\/p>\n

Treatment for lower back pain requires a prior medical assessment. Com Corpus has a large clinical team<\/a> at its physiotherapy clinic in Lisbon<\/a> to ensure the appropriate communication between the physician and the physiotherapist who will treat you. \u00a0You will need to make a physical and rehabilitation medicine<\/a> or sports medicine appointment<\/a>\u00a0with one of our physiatrists<\/a> for physiotherapy sessions at Com Corpus.<\/p>\n

If you need treatment for lower back pain, contact<\/a> our physiotherapy clinics in Lisbon<\/a>.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

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