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What Causes Low Back Pain?


Why Pain?

Pain is the language your body uses to notify your brain about the presence of a threat to your body. In the actual sense of it, pain is really not a bad thing in itself. However, not responding to this "SOS" message might lead to a critical situation. Interestingly, the degree of pain isn't directly proportional to the level of damage, so just because the pain you feel is severe doesn't mean the damage is a lot and feeling mild pain doesn't mean there isn't any damage.

So what causes of low back pain?

What does this kind of pain mean? Where exactly are the signals coming from? How do you respond to them? Is there anything to be worried about? What kind of treatments can give relief from low back pain? How can physiotherapy or visiting a physiotherapist help?
Firstly, let's look at the back. What structures actually make up the back?

What makes up the back?

Bones
There are 33 small bones called vertebrae that make up what is called the vertebral column. The vertebral column starts from the neck, just below the skull (head) to the pelvic girdle. The vertebrae in the neck area are called the cervical vertebrae and they are seven in number. Next are the thoracic vertebrae, which constitute the upper back and are 12 in number. There are five lumbar vertebrae in the lower back. Finally, you have the triangular shaped sacrum (sacral vertebrae) made up of 5 bones fused together and the coccyx (tail bone) made up of 4 vertebrae at the end of the vertebral column.

Discs
The intervetebral discs are ligament-like structures that are located between every two vertebrae all the way down the vertebral column. So the vertebrae don't just sit directly on easy other but are separated by shock absorbers or cushions called inter vertebral discs. Movement in your backbone is "cushioned" by these discs.

Spinal Cord
"The cord from which all nerves in the body originate" is refered to as the spinal cord. The spinal cord is actually encased and protected by the vertebral column.

Muscles
Muscles are part of the supporting structures of the vertebral column. These muscles are responsible for all your back movements and support your back in assuming various postures such as sitting, standing, running and so on.
Other structures in the back are the spinal nerve roots, ligaments and facet joints.
So now that you have an idea of what makes up your back, having an idea of what causes back pain will be much clearer and easier to comprehend.

What is Low Back Pain?
Low back pain is one of the top five reasons why people see a doctor. According to S.Kinkade, low back pain is "pain that occurs posteriorly in the region between the lower rib margin and the proximal thighs". (Proximal - upper)

Common causes of low back pain


  • Arthritis of the vertebral facet joints also called spondylosis is a cause of low back pain. Spondylosis is more common in older people as degenerative changes take place occur with use and age.
  • Disc Prolapse or disc bulge is another cause of low back pain. This can occur as a result of increased pressure in the intervetebral discs. Actions such as lifting heavy loads increase the disc pressure. Nerve root compression resulting from a disc prolapse can produce severe discomfort.
  • Degeneration of the intervetebral disc negatively affects its shock absorbing properties. A degenerated disc is reduces the intervetebral disc space which can also lead to arthritis.
  • Increase in body fat affects the spine or back biomechanics. Obesity puts excess strain on structures of the back. It's important to note that your deep abdominal muscles also serve the function of supporting the back. So having a "pot belly" alters the lordotic curve (lordosis) or the "small of your back" by exaggerating the curve.
  • In the workplace setting, standing or sitting for more than two hours at a time, can cause a strain on your back. Driving for long hours and  lifting heavy loads are also causes of low back pain.


What is Specific Low Back Pain?
When low back pain is specific, it simply means that the cause of the pain is specific or there is an underlying pathology. Common causes of specific back pain are cancer, fracture, spinal stenosis or disc bulge.

Non Specific Low Back Pain
Most people that complain of low back pain present with the non specific type. Non specific back pain is any type of back pain in the lower back (lumbar region) that doesn't have a specific cause or serious underlying pathology (disease).

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