Lower back pain

Low Back Pain Basics

Low back pain is epidemic in our society. It is the second most common reason Americans see a doctor. It is estimated that 85% of Americans will have a disabling low back injury sometime in their lives. This doesn’t mean that they will have a little soreness and ache, but they will not be able to carry out their necessary activities of daily living. This translates to a significant loss of income and productivity.

The lower back consists of a very complex structure of connected elements including:

  • Tendons and muscles and other soft tissues
  • Highly sensitive nerves and nerve roots that travel from the lower back down into the legs and feet
  • Small and complex joints
  • Spinal discs with their gelatinous inner cores.

How do these low back occur? Well, obviously trauma plays a part; falls, car accidents, sports injuries, lifting injuries, and the like. But the majority of injuries are not traumatic.

The most common reason women patients give for the cause of their low back pain is the stress of pregnancy and childbirth. The majority of the rest of low back injuries are cumulative in nature. This means that daily activities we do such as repetitive bending, lifting, twisting, and turning over the course of days, weeks, months, and years weaken the back, and set the stage for injury.

Research has shown that repetitive bending weakens the discs and is a precursor to disc herniation. You can only bend over so many times before injury occurs. Instability results, and left untreated, the low back problem becomes chronic. That’s why a person can perform a simple action such as bending over to put on his or her shoes feel a distinct “pop” and feel sharp pain.

What factors are involved in instability? Primarily, ligament laxity, previous injury weakening the supportive muscles such as the multifidus muscle, and muscle fatigue.

How do you treat low back pain? One of the most effective means is a multidisciplinary approach including: spinal manipulation, physical therapy, rehab therapy, and massage therapy. Alignment of the spine coupled with functional strengthening and stabilizing has a synergistic effect that has better results than only one approach by itself. Unfortunately, sometimes surgery becomes a consideration, but studies are showing that the multidisciplinary approach can often have as good or better results.



Ullrich Jr. MD, P. (2012, January 1). Lower Back Pain Symptoms, Diagnosis, and Treatment. Retrieved October 9, 2014.


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