What Are The Causes Of Low Back Pain?
Evaluating low back pain in patients can be extremely difficult. Thankfully, 90% of acute back pain resolves within three months no matter what the treatment. However, if appropriate pain center treatment is employed pain relief may potentially be seen sooner rather than later.
Statistics show that over 30% of the time, medical providers cannot give an accurate low back pain diagnosis with regards to the pain generator. Even with the modern technology in this day and age such as MRI and CT scans and EMG testing, back pain still remains a conundrum in many cases.
The main categories of pain generation include fracture, infection, tumor, trauma, arthritis, soft tissue, or neuropathic.
1) Trauma or Fracture - Vertebra Compression Fractures occur as a result of axial loads on the spine. The number 1 cause is osteoporosis, number 2 is a trauma event like an auto accident or a fall. These fractures are usually seen on plain radiographs, and also extremely easy to see on an MRI. Traumatic injuries also can result in soft tissue sprains/strains with damaged ligaments, tendons, or spinal musculature.
2) Infection - There are 2 regions of infection around the spinal column. One is the vertebra itself, which is called vertebral osteomyelitis. Another is infection in the intervertebral disc, which is called discitis. Infections occur post-surgical, post-procedure, and also in immunocompromised patients such as diabetics.
3) Tumor - There are various tumors that affect the spine and cause low back pain. Most commonly, the spine has a tumor from metastasis of a tumor elsewhere, such as the breast or lung. There are some tumors that occur primarily in the spine, such as multiple myeloma.
4) Arthritis - Just as degenerative arthritis occurs in the knee and hip, it also occurs in the spinal column. The spinal joints are called facet joints, and they are similar in size to a thumbnail. The facet joints are located on each side of each level of the spine. For example the facet joint at L3-L4 is located between the 3rd lumbar and 4th lumbar vertebrae. When arthritis occurs in facet joints, it is called facet syndrome or simply facet arthritis.
5) Soft tissue - The spinal soft tissue areas of the spine entail: Spinal ligaments, intervertebral disc, and also the paraspinal muscles with tendons. Patients involved in a trauma can experience spinal ligament injury with resultant pain. Para-spinal musculature strain is extremely common. Often times the para-spinal mucles will react to other injuries such as fractures, ligament sprains, etc by going into spasm. This is called muscle guarding. Pain from the intervertebral disc itself is a result of disc injury. This may be chronic, termed degenerative disc disease (DDD), or may be more acute. The outside part of the intervertebral disc has pain generating fibers. This area of the disc is called the annulus and an annular tear can cause significant pain in the low back.
6) Neuropathic - This refers to pain emanating from an intervertebral disc herniation that is impinging on a nerve root. The pinched nerve sparks up inflammation and causes pain to radiate down the leg, called sciatica.
Examining a person with lower back pain involves thoroughness and determination with a specific algorhithm. If done right, it will give patients the optimal chance of pain relief success by leading to an appropriate treatment plan that may include an AZ Chiropractic or Spine Decompression Therapy.

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