Low back pain is the largest cause of disability worldwide, and the World Health Organization reports that 619 million people worldwide were affected by it in 2020. As our population grows and ages, that number is expected to increase by more than 30% in the next 25 years. Most of those cases (90%) presented as non-specific low back pain, meaning they cannot be attributed to some underlying disease or tissue damage. Most people will experience low back pain at some point throughout their lives, so understanding its causes and treatments can benefit just about everyone.
Common causes of low back pain seen by chiropractors
Low back pain can arise from a variety of causes, some related to the spine and its surrounding musculature, tendons, ligaments, and nerves, and some from the organs that are near the spine. As a chiropractor, most of my focus lies on the structural side of things.
The low back's nerves exit the spine and run down into the glutes, hips, legs, and feet. When there is some injury to the lumbar spine or the structures surrounding it, we often see radiating pain down the leg as a symptom. Radiating pain down the legs can be a temporary, solvable problem for a chiropractor, but can also be the result of some more dangerous visceral pathologies. A thorough exam and healthy history can help us determine the underlying cause to safely and effectively treat our patients.
We frequently see people who come in with localized low back pain and say they "threw out their back". This is a common phrase, but people often confuse the true nature of their complaint with other terms like a "pinched nerve" or "sciatica". Our previous blog focused specifically on sciatica and its causes and treatments.
A patient who says they threw out their back and has localized low back pain typically has a strained muscle. This is an injury that arises from overuse of a specific muscle or muscle group in a way that causes damage to the muscle itself, like lifting something too heavy or with poor form. Patients often feel soreness in the muscle, and will likely feel tightness in the low back as well. The muscle is repairing itself after suffering this damage, which causes local inflammation. This results in heat, redness, and swelling in the area. This swelling and tension can in some cases, put pressure on the nerves that exit the lumbar spine, and cause radiating pain as well.
Low back pain can also be caused by one vertebra moving forward or backward in relation to the one above or below it. When this occurs, it is called spondylolisthesis. Anterolisthesis (meaning one vertebra moves forward on the one below it) is the most common, and is graded on a scale of 0-4, with a grade 4 describing the vertebra fully moving off the one below it. Spondylolisthesis can occur as a result of trauma, degeneration, or some pathology that affects the bones.
The higher the grade of anterolisthesis, the more pressure gets put on the nerves, and the more pain patients feel. Grades 1 and 2 can often be treated conservatively, depending on the underlying cause. Grades 3 and 4 often require surgical correction and more invasive management.
Disc pathology is another common cause of low back pain. The discs are the shock absorbers between the bones, and when they are put under some unusual stress, they can change their shape in a way that causes pain. There are varying stages to disc pathologies, but the important thing to understand here is that it occurs as a result of some abnormal stress on the disc, and is another cause of low back pain and radiating pain down the legs.
There are a number of other causes of low back pain, but those listed so far are some of the most commonly seen in a chiropractors office, and are conditions we can often help patients manage. In all cases of low back pain it is important to evaluate the pros and cons of each treatment option and discuss any concerns with your provider about how to proceed.
Treating low back pain
Treating low back pain begins with understanding the cause of the pain itself. A thorough examination and health history for each patient is vital to understanding the underlying causes of pain and the path forward. Chiropractors are skilled in diagnosing and treating many ailments and have several treatment options that vary depending on the cause.
Spinal manipulation has been shown to be an effective option for management of low back pain, especially when combined with therapeutic exercises. Manipulation helps restore proper motion to the joints of the spine, and the exercises help preserve that motion and stabilize the joints. Spinal mobility has been shown to be a predictor of overall quality of life, and this is exactly where chiropractors are most effective.
A proper assessment can also help to determine which muscle groups need strengthening to help stabilize the spine and prevent low back pain going forward, which is a main goal of chiropractic treatment.
Whether it's a disc problem, a strained muscle, or something else, it's important that you feel educated and empowered to improve your condition, and we want to help you with that! Give us a call (913) 400-2014, or visit our website today to schedule and get you on the path to a healthier, pain free life!