Why does my lower back hurt?
Sometimes the cause of lower back pain is obvious, other times it just seems to come on slowly over time. Back pain is either mechanical or anatomic. Knowing the difference and diagnosing the difference means the difference between a quick recovery and a long term disaster.
95% of all back pain is due to mechanical causes. Our office focuses on this area of back pain. Tissues are injured including muscles, tendons, ligaments and joints. Examples of mechanical back pain include:
Lower back pain starts when joints, ligaments, and muscles get injured causing a cascade of inflammation and loss of normal ability to move. Sometimes, this means you can bend over and it feels as if your back is about to go “out”. Often, patients with this type of back problem have to limit their activities and are not able to play with their kids or grandkids, can’t play sports, or do things they would normally do with their family.
Once mechanical back pain starts, the body starts the healing process with inflammation. This extra fluid in the area carries away painful chemicals and brings in protein and necessary building blocks for repair. However, excessive inflammation can cause pain in and of itself and needs to be controlled.
Degenerative joint disease, osteoarthritis, wear and tear arthritis – all synonyms – cause back pain which is usually worse in the morning and it gets better with activity. This type of trauma can be caused over time with many micro-traumas or can be brought to the forefront with a large trauma such as a lifting injury, slip and fall, or car accident. Eventually, this type of damage to the joint surfaces leads to bone spurs and pain. Trauma can cause this process to develop and making sure that the joint surfaces are aligned properly is key to ensuring proper healing and prevention of long-term chronic pain.
Once injured, most take some time off to allow healing. However, many do not get back to their routine soon enough and some never return. This lack of muscular movement causes weakness to develop, further complicating lower back pain. A proper and early return to activity level near or close to normal is important. However, premature return to activity can cause further injury. It is key to get activity level right. The doctor will guide you through this very carefully.
The discs of the spine can herniated with trauma or can develop bulging from degenerative disc disease. This type of disc pathology can then lead to sensitive nerve tissue compression and pain. While trauma is often not preventable, degenerative disc disease is modifiable and sometimes even reversible. Repetitive stress and micro-trauma lead to minor tears in the wall of the disc leading to a weakening over time. This weakening can allow the disc to herniated or bulge. Symptoms associated with this problem include pain, tingling/numbness, and sometimes muscle weakness.
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