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One of the most common problems seen in a primary care medical practice is low back pain. It accounts for more discomfort, lost work and productivity, and frustration for many patients than any other malady. Some think it is the price we, as humans, pay for walking upright. The lower back is a complex structure made of bone, muscles, connective tissue and nerves that, along with our legs, hold us erect, allow us to bend, run, twist, catch a football, or just lay down and rest. However, once a problem arises, the complexity of its structure makes pain in the lower back difficult to diagnose and treat. The lower back consists of a spinal column from the lumbar region of the mid-back down to the tail bone or coccyx. The spinal column consists of 5 lumbar vertebrae which are cylindrical bony structures with a ring like component behind the cylinder also made of bone. In between the vertebrae are disc shaped cushions filled with a gelatinous central core known as the nucleus pulposis
Alternative Names Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term Symptoms You may feel a variety of symptoms if you've hurt your back. You may have a tingling or burning sensation, a dull achy feeling, or sharp pain. Depending on the cause, you also may have weakness in your legs or feet. Low back pain can vary widely. The pain may be mild, or it can be so severe that you are unable to move. Depending on the cause of your back pain, you may also have pain in your leg, hip, or bottom of your foot. See: Sciatica Signs and tests When you first see your doctor, you will be asked questions about your back pain, including how often it occurs and how severe it is. Your doctor will try to determine the cause of your back pain and whether it is likely to quickly get better with simple measures such as ice, mild painkillers, physical therapy, and proper exercises. Most of the time, back pain will get better using these approaches. Questions w...
Surgeons commonly use radiofrequency (heat) energy to cut small sensory nerves around the facet (spinal) joints that are causing patients' low back pain. The procedure is called a radiofrequency denervation (RFD). The evidence for RFD as a safe and cost-effective treatment method is a bit sketchy. Some say it works well. Others show little or no benefit over sham (pretend) treatment. In this Canadian study, carefully selected patients were treated with RFD at the pain generating spinal structure. What does carefully selected mean? And how do they know which joint is causing the pain? Both of these questions can be answered by the process used to choose patients for this treatment intervention. First, everyone had chronic low back pain that had not responded to other conservative care methods. In fact, they all reported back pain lasting more than two years. The facet joints were identified as the primary cause of back pain by using fluoroscopic-guided nerve blocks. In this procedure, th...
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