Low Back Pain: Symptoms, Causes, Risk Factors, Healing Cycle & Treatment
What is low back pain?
Low back pain is a prevalent musculoskeletal condition that affects adults. The prevalence of low back pain is high, accounting for approximately 84%. The pain may originate from different potential anatomic sources that may include intervertebral discs, nerve roots, abdominal cavity organs, fascial structures, bones, muscles, and joints. Chronic low back pain arises when the pain in the lower back region persists for a minimum of 12 weeks. (1) The evaluation of low back pain involves imaging with conservative management of the affected individual. Magnetic resonance imaging (MRI) can be useful for the identification of soft tissue lesions, inflammatory conditions, nerve root or cord compression, and malignancy of the spine. (2) This article describes the symptoms, causes, and risk factors of low back pain along with the discussion of the healing cycle and pain-relieving strategies.
Symptoms of Low Back Pain
The symptoms of low back pain are as follows.
- Decrease in the range of motion
- Numbness or tingling sensation
- Muscle weakness
- Stiffness of the back
- Loss of sensation
- Pain in the lower back
Causes and Risk Factors of Low Back Pain
The causes and risk factors associated with the development of low back pain are as follows.
- Poor posture of the body
- Diseases including rheumatoid arthritis and osteoarthritis
- Poor lifting body mechanics
- Degenerative disc disease
- Whiplash injury
- Sciatica nerve pain (spinal nerve roots L4-S3)
- Herniated intervertebral disc
- Piriformis syndrome
Normal Healing Cycle and Chronic Conditions
The normal healing cycle is made of 4 distinct stages called hemostasis, inflammation, proliferation, and maturation stages. Each stage has distinct mechanisms and progresses to the next phase in a sequential and timely manner. The description of the 4 stages of the healing cycle is given in the following table. (3, 4)
Table 1 Stages of the Normal Healing Cycle
|Number of Stages||Name of Stages||Description of Mechanisms|
|Stage 1||Hemostasis||The mechanisms during this stage of the healing cycle include the vasoconstriction of the blood vessels and the formation of a thrombus or a blood clot to limit the loss of blood at the site of injury.|
|Stage 2||Inflammation||The cardinal signs of inflammation are warmth, loss of function, redness, swelling, and pain. During this stage of the healing cycle, immune and inflammatory cells are recruited to the site of injury. These cells release substances such as cytokines and inflammatory mediators for modulating inflammation.|
|Stage 3||Proliferation||The mechanisms during this stage of the healing cycle include the formation of new blood vessels or angiogenesis, synthesis of collagen and extracellular matrix, and re-epithelization. In chronic conditions, the formation of fascia restrictions, muscle trigger points, muscle spasms, and scar tissue are associated with the persistence of this stage of the healing cycle.|
|Stage 4||Maturation||During this stage, the healing cycle attains completion as the inflammation and proliferation stages are resolved. In chronic conditions, the healing cycle does not reach completion and moves back and forth between proliferation and inflammation.|
Effective and Ineffective Treatments of Low Back Pain
The effective and ineffective treatments of low back pain are listed in the table given below.
|Table 2 Low Back Pain Treatment|
Ineffective Treatments of Low Back Pain
Effective Treatments of Low Back Pain
|Following are the traditional therapeutic pain-relieving strategies that many people opt for in order to treat low back pain. These strategies not only provide temporary pain relief but can also aggravate low back pain and associated symptoms.
||Resolution of the inflammation stage of the healing cycle can be achieved in the following ways.
|Resolution of the proliferation stage of the healing cycle can be achieved in the following ways.
|Lifestyle modification and implementation of healthy habits are also useful for effective treatment and management of low back pain.
Low back pain is a common occurrence among the adult population across the globe. It can be associated with soft tissue lesions, inflammatory conditions, nerve root or cord compression, and malignancy of the spine. Effective treatment strategies for alleviation of low back pain involve the resolution of the healing cycle, proper posture, core stabilization, and proper lifting body mechanics.
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