Acute Lower back Problems

The human spine (or backbone) is made up of small bones called vertebrae. The vertebrae are stacked on top of each other to form a column. Between each vertebra is a cushion known as a disc. The vertebrae are held together by ligaments, and muscles are attached to the vertebrae by bands of tissue called tendons. Openings in each vertebra line up to form a long hollow canal. The spinal cord runs through this canal from the base of the brain. Nerves from the spinal cord branch out and leave the spine through the spaces between the vertebrae.

The lower part of the back holds most of the body's weight. Even a minor problem with the bones, muscles, ligaments, or tendons in this area can cause pain when a person stand, bends, or moves around. Less often, a problem with a disc can pinch or irritate a nerve from the spinal cord, causing pain that runs down the leg, below the knee called sciatica.

If you have a low back problem, you may have symptoms that include:

Pain or discomfort in the lower part of the back.

Pain or numbness that moves down the leg (sciatica).

Low back symptoms can keep you from doing your normal daily activities or doing things that you enjoy. A low back problem may come on suddenly or gradually. It is acute if it lasts a short while, usually a few days to several weeks. An episode that lasts longer than 3 months is not acute. If you have been bothered by your lower back, you are not alone. Eight out of ten adults will have a low back problem at some time in their life. And most will have more than one episode of acute low back problems. In between episodes, most people return to their normal activities with little or no symptoms.

Causes of Low Back Problems

Even with today's technology, the exact reason or cause of low back problems can be found in very few people. Most times, the symptoms are blamed on poor muscle tone in the back, muscle tension or spasm, back sprains, ligament or muscle tears, joint problems. Sometimes nerves from the spinal cord (see Figure 1) can be irritated by "slipped" discs causing buttock or leg pain. This may also cause numbness, tingling, or weakness in the legs. People who are in poor physical condition or do work that includes heavy labor or long periods of sitting or standing are at greater risk for low back problems. These people also get better more slowly. Emotional stress or long periods of inactivity may make back symptoms seem worse. Low back problems are often painful. But the good news is that very few people turn out to have a major problem with the bones or joints or the back or a dangerous medical conditions.

Things To Do About Low Back Problems

Seeing a health care provider

Many people who develop mild low back discomfort may not need to see a health care provider right away. Often, within a few days, the symptoms go away without any treatment. A visit to your health care provider is good idea if:

Your symptoms are severe.

The pain is keeping you from doing things that you do every day.

The problem does not go away within a few days.

If you also have problems controlling your bowel or bladder, if you feel numb in the groin or rectal area, or if there is extreme leg weakness, call your health care provider right away. Your health care provider will check to see if you have a medical illness causing your back problem (chances are you will not). Your health care provider can also help you get some relief from your symptoms. Your health care provider will:

Ask about your symptoms and what they keep you from doing.

Ask about your medical history.

Give you a physical exam.

Getting Relief

Your health care provider will help you get relief from your pain, discomfort, or other symptoms. A number of medicines and other treatments help with low back symptoms. The good news is that most people start feeling better soon.

Proven treatments
Medicine often helps relieve low back symptoms. The type of medicine that your health care provider recommends depends on your symptoms and how uncomfortable you are.

If your symptoms are mild to moderate, you may get the relief you need from an over-the-counter (non-prescription) medicine such as acetaminophen, aspirin, or ibuprofen. These medicines usually have fewer side effects than prescription medicines and are less expensive.

If your symptoms are severe, your health care provider may recommend a prescription medicine.

For most people, medicine works well to control pain and discomfort. But any medicine can have side effects. For example, some people cannot take aspirin or ibuprofen because it can cause stomach irritation and even ulcers. Many medicines prescribed for low back pain can make people feel drowsy. These medicines should not be taken if you need to drive or use heavy equipment. Talk to your health care provider about the benefits and risks of any medicine recommended. If you develop side effects (such as nausea, vomiting, rash, dizziness), stop taking the medicine, and tell your health care provider right away.

Your health care provider may recommend one or more of the following to be used alone or along with medicine to help relieve your symptoms.

Heat or cold applied to the back. Within the first 48 hours after your back symptoms start, you may want apply a cold pack (or a bag of ice) to the painful area for 5 to 10 minutes at a time, If your symptoms last longer than 48 hours, you may find that a heating pad or hot shower or bath helps relieve your symptoms.

Spinal manipulation. This treatment (using the hands to apply force to the back to "adjust" the spine) can be helpful for some people in the first month of low back symptoms. It should only be done by a professional with experience in manipulation. You should go back to your health care provider if your symptoms have not responded to spinal manipulation within 4 weeks.

Keep in mind that everyone is different. You will have to find what works best to relieve your own back symptoms.

Other treatments
A number of other treatments are sometimes used for low back symptoms. While these treatments may give relief for a short time, none have been found to speed recovery or keep acute back problems from returning. They may also be expensive. Such treatments include:

Traction.

TENS (transcutaneous electrical nerve stimulation).

Massage.

Biofeedback.

Acupuncture.

Injections into the back.

Back corsets.

Ultrasound.

Physical activity

Your health care provider will want to know about the physical demands of your life (your job or daily activities). Until you feel better, your health care provider may need to recommend some changes in your activities. You will want to talk to your health care provider about your own personal situation. In general, when pain is severe, you should avoid:

Heavy lifting.

Lifting when twisting, bending forward, and reaching.

Sitting for long periods of time.

The most important goal is for you to return to your normal activities as soon as it is safe. Your health care provider and (if you work) your employer can help you decide how much you are able to do safely at work. Your schedule can be gradually increased as your back improves.

Bed Rest
If your symptoms are sever, your health care provider may recommend a short period of bed rest. However, bed rest should be limited to 2 or 3 days. Lying down for longer periods may weaken muscles and bones and actually slow your recovery. If you feel that you must lie down, be sure to get up every few hours and walk around-even if it hurts. Feeling a little discomfort as you return to normal activity is common and does not mean that you are hurting yourself.

http://www.pueblo.gsa.gov/cic_text/health/backpain/backpain.htm