Low Back Pain

Why Low Back Pain…?

·        Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back.

·        Pain can vary from a dull constant ache to a sudden sharp feeling.

·         Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks).

·         The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain.

·        Lower back pain can be caused by a variety of problems with any parts of the complex, interconnected network of spinal muscles, nerves, bones, discs or tendons in the lumbar spine.

 

What is the Aetiology…?

·        Younger adults (30 to 60 year olds) are more likely to experience back pain from the disc space itself (e.g. lumbar disc herniation or degenerative disc disease) or from a back-muscle strain or other soft tissue strain.

·        Older adults (over 60) are more likely to suffer from pain related to joint degeneration (such as osteoarthritis or spinal stenosis) or from a compression fracture.

 

What are the Causes:

·        A herniated disc as seen on MRI, one possible cause of low back pain.

·        Low back pain is not a specific disease but rather a complaint that may be caused by a large number of underlying problems of varying levels of seriousness.

·        The majority of LBP does not have a clear cause but is believed to be the result of non-serious muscle or skeletal issues such as sprains or strains.

 

 

 

 

General causes:

·        Obesity, weight gain during pregnancy, stress, poor physical condition, poor posture and poor sleeping position may also contribute to low back pain.

·        Physical causes may include osteoarthritis, degeneration of the discs between the vertebrae or a spinal disc herniation, broken vertebrae (such as from osteoporosis) or, rarely, an infection or tumor of the spine.

 

Causes in Women:

·        Women may have acute low back pain from medical conditions affecting the female reproductive system, including pelvic inflammatory disease, endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids.

·         Nearly half of all pregnant women report pain in the lower back or sacral area during pregnancy, due to changes in their posture and center of gravity causing muscle and ligament strain.

 

How can low back pain be classified…?

Low back pain can be broadly classified as:

·        Musculoskeletal - mechanical including muscle strain, muscle spasm, herniated discs, compressed nerve roots, degenerative discs or joint disease, and broken vertebra, osteoarthritis, herniated nucleus pulposus, herniated disk, spinal stenosis or compression fracture.

·        Inflammatory - HLA-B27 associated arthritis including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, inflammatory bowel disease, etc.

·        Referred pain from internal organs (gallbladder disease, kidney stones, kidney infections, and aortic aneurysm, among others).

·        Malignancy - bone metastasis from lung, breast, prostate, thyroid, among others.

·        Infectious – osteomyelitis, abscess, etc.

 

 

 

 

What is the pathology…?

·        The lumbar (or lower back) region is made up of five vertebrae (L1-L5), sometimes involving the sacrum too.

·         In between these vertebrae are fibrocartilaginous discs, which act as cushions, preventing the vertebrae from rubbing together while at the same time protecting the spinal cord.

·        An intervertebral disc has a gelatinous core surrounded by a fibrous ring.

·        When in its normal, uninjured state, most of the disc is not served by either the circulatory or nervous systems – blood and nerves only run to the outside of the disc.

·        Specialized cells that can survive without direct blood supply are in the inside of the disc.

·        Over time, the discs lose flexibility and the ability to absorb physical forces.

·        This decreased ability to handle physical forces increases stresses on other parts of the spine, causing the ligaments of the spine to thicken and bony growths to develop on the vertebrae.

·        As a result, there is less space through which the spinal cord and nerve roots may pass.

·        When a disc degenerates as a result of injury or disease, the makeup of a disc changes: blood vessels and nerves may grow into its interior and/or herniated disc material can push directly on a nerve root.

·        Any of these changes may result in back pain.

 

What are the Diagnostic Tests and Scans:

Most low back pain is caused by muscle and joint problems, this cause must be separated from neurological problems, spinal tumors, fracture of the spine, and infections, among others.

·        X-ray. Provides information on the bones in the spine; used to test for spinal instability, tumors and fractures.

·        CT scan. Captures cross-section images of the vertebrae and spinal discs; can be used to check for herniated disc or spinal stenosis.

·        Myelogram. Allows identification of problems within the spine, spinal cord and nerve roots. An injection of contrast dye illuminates the spine prior to an x-ray or CT scan.

·        MRI scan. Displays detailed cross-section of the components of the spine. Useful to assess issues with lumbar discs and nerve roots, as well as ruling out causes of lower back pain like spinal infections or tumors.

 

 

What are the Preventive measures…?

·        Exercise appears to be useful for preventing low back pain. Exercise is also probably effective in preventing recurrences in those with pain that has lasted more than six weeks.

·        Medium-firm mattresses are more beneficial for chronic pain than firm mattresses.

·        Rest. Ceasing activity for a few days allows injured tissue and even nerve roots to begin to heal, which in turn will help relieve lower back pain.

·        However, more than a few days of rest can lead to a weakening of the muscles, and weak muscles have to struggle to adequately support the spine.

 

How Homeopathy is the best treatment of choice…?

·        Complete case study and analysis of the physical and mental states and thereof administration of the right homeopathy medication can bestow complete cure.

·        Alongside with the removal of the triggering factors and life style modifications, which varies from individual to individual, the treatment time can also be minimized.

·        Homeopathy is the ultimate solution to the problem of low back pain with no side effects.