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Lumbar Pain

The lumbar region is the source of most of the lower back problems worldwide. In fact 8 out of 10 adults will experience lower back pain at some point in their lives. According to the National Strength and Conditioning Association about 5 million Americans suffer from acute or chronic back pain. This condition accounts for over 90 million lost production days a year in the United States alone. Just imagine what it is worldwide!

The vertebrae of the lumbar region are larger than those of the cervical and thoracic areas. These vertebrae are responsible for supporting the body's weight. Extremely powerful lumbar muscles attach to this part of the spine.

The facet joints connect the vertebrae above and below one another and their shape restricts rotational movement of the lumbar spine. Flexion to the side, and extension and flexion of the lower back are all controlled by the lumbar facet joints. Amazingly enough, they are non-weight bearing and acting in a passive manner unless the spine is extended or arched backward. The slight curve of the lower back is produced by the shape of these vertebrae and this curve is different for each individual.

· Poor overall posture
· Slumped over, flexion of the lower back
· Poor back posture
· Stress and daily work habits
· Riding in a vehicle for hours on end without a break, especially in a vibrating vehicle which is very hard on the lower back
· Lack of flexibility in the hip joint which causes the back to compensate by flexing/bending forward
· Deterioration of general physical fitness
· Overweight
· Lack of endurance in the extensor muscles of the lower back
· If fit, then incorrect lifting techniques being utilized
· Rounded back when lifting or bending forward during a lift
· Failure to flex at the hip and substituting the lower back to make up for the lack of flexibility in the hip joint

Treatment of low back pain usually begins with a few basic steps. Before beginning any back pain treatment program, be sure you know your diagnosis and discuss the treatment plan with your doctor. There are some conditions that cause back pain and require immediate treatment. For most cases of back pain, the first treatments are as follows:

Rest - The first step in the treatment of low back pain is to rest the spine. Because most cases of back pain are due to muscle strain, it is important to avoid further irritation to the spine and the muscles that surround the spinal column. Bed rest is fine, so long as this only lasts two to three days. Prolonged bed rest can actually lead to more persistent back pain. Once the acute back pain eases, avoid lifting, twisting, and physical exertion.

Anti-Inflammatory Medications - Anti-inflammatory medications, or NSAIDs, are helpful in treatment of both back pain and the associated inflammation. There are both over-the-counter and prescription NSAIDs, and both work well in the treatment of back pain. Side-effects of NSAIDs include problems with gastrointestinal bleeding, and these medications should be avoided in patients with stomach ulcers.

Heat Application - Application of heat packs help ease much of the discomfort associated with muscle spasm causing lower back pain. Patients can use a heating pad, hot water bottles, or even a hot bath to help ease the muscle discomfort that often causes lower back pain.

Exercise - Strengthening of back muscles is probably the most important step in treatment of most causes of back pain. By increasing strength and flexibility of back muscles, weight is better distributed, and less force is placed on the spine.

These simple measures often lead to resolution of the symptoms of lower back pain. If not, you should certainly be under the direct care of a physician to aid in the treatment of your condition. There are further steps in the treatment of lower back pain that can be considered:

Narcotic Pain Medication - Narcotic pain medications are excellent at relieving pain, but these can be dangerous, addictive medications. These medications include Percocet, Vicoden, Oxycontin, and others. Using narcotic medications must be under close supervision, and only for a limited period of time. Prolonged use of narcotic medication can be dangerous.

Muscle Relaxers - Muscle relaxing medications can be very helpful in the treatment of some types of back pain. Muscle relaxers are sold under the trade names of Flexeril, Soma, Valium, and others. These medications help to relieve muscle spasm, but may also make patients quite drowsy.

Physical Therapy - Back exercises, as listed above, are the focus of physical therapy. However, there are other modalities that can be used in the treatment of back pain if the exercises alone do not help. Modalities include aquatherapy, ultrasound, electrical stimulation, and others.

Epidural Steroid Injections - Epidural steroid injections are an option for back pain treatment and inflammation around the spinal nerves. An epidural steroid injection is performed using an x-ray to guide the medication to the area adjacent to the inflamed spinal nerve.