Low Back Pain: Causes, Symptoms, Diagnosis And Treatment

Low Back Pain: Causes, Symptoms, Diagnosis And Treatment

What is Low Back Pain?

Lower back pain is a condition that affects all human beings at one point of their lives. It mainly occurs in the lumbar region, which is the area below the ribcage. The discomfort associated with this medical condition is often intense. It may end on its own, or may require specialized treatment, more so if it persists.

What Causes of Low Back Pain?

This condition is usually caused by various conditions. Problems occurring in the spinal nerves, muscles, discs, tendons and bones often result in lower back pain. The condition may be caused by the irritation of large nerve roots, which run from the back down to the legs. Smaller nerves, which are spread throughout the lumbar region may sometimes get overworked, thus causing intense pain in the region. Whenever muscles that are located on the lower back get strained during intense activities, you are likely to experience pain. In rare cases, damage to the joints and ligaments, or the regeneration of the intervertebral disc causes slight pains in the lower back region.

Every so often, the occurrence of the condition depends with age. Younger adults aged between 30 to 50 years have a higher chance of experiencing the condition due to the degeneration of the intervertebral disc, or from back muscle strains. Those who are 60 years and above often experience discomfort due to the degeneration of the joints, or from compression fractures. This occurs due to their advanced age. Over-activity has been proven to be a major cause of this medical condition. When you overwork yourself, your muscles tend to get sore. This results from overstretched or injured ligament fibers.

Spinal Stenosis is another major cause of low back pain. This condition comes about when space that surrounds the spinal cord gets smaller. This exerts excess pressure on the spinal nerves and the cord itself. In the event that the intervertebral discs collapse, osteoarthritis often starts developing. When this occurs, the human body responds by allowing a new born to grow in the facet joints to offer extra support to the vertebrae. This bone causes discomfort with time, which explains why you might start experiencing low back pain.

What is Low Back Pain Symptoms?

Most patients report varying symptoms. The intensity of the pain experienced also differs from one patient to another. Some patients complain about a piercing, stabbing sensation while others experience a dull cramp. This variation is influenced by the causal factor of the back pain. Generally, individuals who are affected by this disorder complain about back pains, which worsen whenever they bend or lift up objects. These activities strain muscles fund on the back.

There are some who complain about a sharp discomfort, more so when they sit down. Standing or walking for prolonged periods worsens the pain in some cases. Normally, the soreness may recede or disappear altogether, only to return a few days later. The pain is often experienced on the lumbar region but may extend to the buttocks. Sometimes, there is numbness or tingling sensations.


The first step that physicians take when diagnosing low back pain is discussing the symptoms with patients. Thereafter, they evaluate a patient’s medical history before the back is examined. The examination process involves massaging the back to pinpoint areas where the pain is more intense. In severe cases, physicians often measure the level of nerve function in the leg region. This may involve testing reflexes, more so at the knees and ankles. A patient’s level of reflex greatly determines the extent to which he or she is affected by the condition.

Low back pain is sometimes diagnosed by imaging tests. X-ray imaging, magnetic resonance imaging, computerized axial topography scans, bone scans and bone density scans can be used to diagnose the condition. X-ray imaging is used to determine whether the cause of back pains is broken bones or any bone deformity. Magnetic resonance imaging is used to highlight the condition of intricate muscle and nerve tissues. It establishes the presence of medical conditions like herniated disks, or tissue infection.

CAT scans come in handy in the event that a physician thinks you have a bone disorder. Bone scans are recommended if your physician needs to have a better understanding of the bone structure in your lower back region. Data garnered from the scan will tell the exact cause of the discomfort that you are experiencing. Bone scans are also used to pinpoint the presence of bone cancer, which sometimes causes lower back pain.

Treatment Options

The main challenge that faces physicians is how to treat low back pain in an effective manner. The intervention used on each individual case greatly depends on his or her medical history, and the severity of the condition. In as much as lower back pain is a largely self-remedying condition, there is need for medical intervention if the pain recurs. The treatment offered may either be surgical or nonsurgical.

1. Surgical Treatment

This intervention is often considered after the failure of nonsurgical interventions. The latter should be tried for at least six months before surgical treatment is considered. Besides this, surgery ought to be an option only after the exact source of pain has been pinpointed. There are several surgical procedures used in the treatment of lower back pain. These include spinal fusion and disk replacement.

Spinal fusion involves fusing together the vertebrae to enhance healing. Movements between segments of the vertebrae is painful. Fusing the components together eliminates such movements, and the pain that comes along. The procedure is used on patients who have extensive degeneration of the disks. Spinal fusion has been proven to be quite effective in the elimination of lower back pain.

Disk replacement is a surgical intervention, which entails the removal of the disk so that it can be replaced by an artificial one. This procedure is often carried out to maintain flexibility and restore normal motion, which is usually hampered by back pain. Disk replacement is carried out through the abdomen.

2. Nonsurgical Treatment

This involves the use of therapies to alleviate pain. Medications have been offered for years to relieve back pain. Anti-inflammatory medications such as brufen can eliminate pain and inflammation. Aspirin, codeine and steroids have similarly been used successfully to treat the condition. However, the three medications have different side effects.

Owing to the fact that severe back pain is incapacitating, a combination of medical and therapeutic interventions is preferred. Physical therapy, which entails the use of inactive modalities such as massages, electric simulations and ultrasound, is often combined with exercises to increase lower back strength. Chiropractic therapy, traction and the use of braces have all been found to have the ability of substantially reducing lower back pain.

Prevention of Lower Back Pain

It is quite difficult to prevent lower back pain due to the typical wear and tear that occurs on the back. Certain practices can however be used to minimize the occurrence of the condition. Regular exercises, including swimming and jogging keep back muscles strong and agile. This makes them more resistance to wear and tear. Another effective way of preventing back pain is lifting items using the legs as the center of support, not the back. When picking heavy items, avoid bending your back. Maintaining a manageable body weight also goes a long way in preventing lower back pain. Standing and sitting using the right posture is helpful too.

Most people tend to ignore discomfort in the lower back region because they think the condition is not serious. With time however, it might cause further problems. You need to understand where is low back pain mostly occurs so that you can seek medical attention promptly. Living a healthy lifestyle, and avoiding strenuous activities helps avert back inflammation. You also need to consult your physician regularly so that conditions, which cause low-back pain can be detected early.

Research at NYDNRehab

Conference: the 12th World Congress of the International Society of Physical and Rehabilitation Medicine (ISPRM 2018) At: Paris, France https://www.researchgate.net/publication/326293480_DRY_NEEDLING_UNDER_ULTRASOUND_GUIDANCE_DECREASE_NEUROPATHIC_COMPONENT_AND_INCREASE_LEVEL_OF_MOTION_IN_PATIENT_WITH_LOW_BACK_PAIN

In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

Buy now 3D Gait
Payment Success
Request Telehealth Request Telehealth Request in office visit Book now