Understanding Chronic Lower Back Pain
Understanding Chronic Lower Back Pain
Published: April 24, 2023
Lower back pain is a common problem, experienced by as many as 39% of adults in the U.S. Prevalence goes up with age, and while not all of this back pain is chronic, many people suffer from it.
What is Chronic Lower Back Pain?
Chronic lower back pain is pain in the lower back, from any cause, that lasts 12 weeks or longer and continues after the underlying cause or initial injury has been treated.
The intensity of pain is not important, only the length of time for which it is experienced, and it can range from a dull ache to sharp, shooting pain.
Common Causes
There are a number of causes of lower back pain, not all of which cause chronic pain. Common causes of chronic pain include:
- Herniated disk. A herniated disk is also called a bulging or ruptured disk, and is one of the most common causes of lower back pain. Your discs are soft pads that rest between the vertebrae and prevent them from rubbing directly on each other. Overall wear and tear, or an injury, can cause the ring to bulge outwards, pressing against the spinal cord and/or nearby nerves and releasing chemical irritants. In addition to lower back pain, this can cause sciatica, which is pain, numbness, and weakness in one or both legs.
- Facet joint disease. Your facet joints are the joints that allow your spine to flex and extend, while preventing the vertebrae from slipping over each other. Facet joint disease is associated with a degenerative condition called spondylosis, but can also be caused by arthritis in the spine. This results in inflammation and erosion of cartilage in these joints, leading to pain.
- Lumbar spinal stenosis. This happens when your spinal canal narrows in the lower back, compressing the nerves leading to the legs. This is typically a disease of aging, affecting people over 60, but can sometimes happen due to a developmental defect. Spinal stenosis may also cause bulging of the disks. Not everyone with spinal stenosis experiences symptoms, but it can cause back pain as well as sciatica.
- Spondylolisthesis. This long word means that a vertebra has slipped forward, which causes lower back pain that is worse when standing or walking and relieved when sitting or bending forward. It can also cause sciatica.
Again, these diseases and conditions may not cause symptoms and may cause pain which can be mild and tolerable or severe and debilitating. Treatment is warranted if the pain interferes with your daily life.
Treatments of Lower Back Pain
First of all, bed rest is no longer recommended to treat lower back pain. Prolonged immobilization can, in fact, make back pain worse. Instead, treatments might include:
- Prescription or over-the-counter pain relievers.
- Muscle relaxants if muscle tension is contributing to your back pain.
- Anti-inflammatory drugs.
- Cold and hot packs.
- Physical therapy to strengthen the muscles that support the back. This takes strain off of the spine and its joints, improving posture and mobility and often helping decreasing pain.
- Instruction in how to move your body properly and lift correctly so you do not increase pain.
- Massage of the spine and nearby tissues.
- Transcutaneous electrical nerve stimulation (TENS). This sends mild electrical pulses to the nerves from pads placed on the skin. TENS devices do not work for everyone, but can be very effective.
- Surgery. Surgery is a last resort for when other treatments have not relieved the pain. The type of surgery depends on the cause of your back pain, which might include disc replacement surgery in which a disc is replaced with a synthetic prosthetic, spinal fusion to join two or more vertebrae to stabilize them, etc.
Chronic lower back pain can be treated and you can get your life back. If you need help with your back pain, fill out the form below to arrange an initial appointment. The team at Texas Pain Experts is here to help.