OSNA's Expert Q & A - Lower Back Pain
Q: How common is lower back pain?
A: 60-90% of adults will have pain in their low back (lumbar spine) sometime in their life. Lower back pain is the 2nd most common reason to see a Primary Care Physician.
Q: How long does lower back pain usually last?
A: 40-50% of patients with low back pain will improve within one week, although over 60% will have at least one relapse within one year.
Q: What causes lower back pain?
A: Lower back pain can come from nerves, muscles, ligaments, or joints.
Q: How can I tell the cause of my pain?
A: A physician will perform a physical examination (both neurological and functional) and, if necessary order imaging studies (x-ray, MRI, CT scan). Occasionally EMG nerve conduction studies are needed to determine the cause of pain.
Q: What are the most common lumbar spine injuries?
A: Soft tissue sprain/strain injuries, Sacroiliac Joint Dysfunction, Disc herniation, and Compression fractures are the most common lumbar spine injuries.
Q: What are the symptoms of soft tissue sprain/strain?
A: The patient will experience muscle aches with associated spasm and guarding in the region of injury. Muscle soreness can be delayed 24-48 hours from time of injury.
Q: What are the symptoms of Sacroiliac Joint Dysfunction?
A: The patient will experience back, buttock, leg, or groin pain with tenderness over the joint, abnormal joint motion patterns, and increased discomfort with a change in positions.
Q: What are the symptoms of disc herniation?
A: Back pain radiating into the legs, weakness, numbness, paresthesias or pain secondary to chemical or mechanical stimuli to the disc or nerve root. Exacerbation of pain with motion, sitting, sneezing, coughing, Valsalva maneuvers (bearing down), and neural tension
Q: What are the symptoms of a compression fracture?
A: Sudden onset of constant pain exacerbated by Valsalva maneuvers (bearing down), turning in bed, coughing, or incidental trauma such as stepping off a curb
Q: What are the steps to rehabilitating lower back pain?
A: There are three phases to rehabilitating lower back pain: Acute, Recovery, and Maintenance. The Acute Phase includes relieving pain, modalities (ultra sound, electrical stimulation, etc.) and patient education. The Recovery Phase includes increasing flexibility, strength, working on body mechanics, and instituting an exercise plan. The Maintenance Phase includes working on proper cardiovascular conditioning, work-specific training, and ergonomic issues at home and work.
Q: Will lower back pain result in surgery?
A: For most patients, surgery is not the best option.Q: What are some alternative healthcare options for lower back pain?
Q: What is your advice for someone with lower back pain?
A: If your pain is lasting more than two weeks, consult with a physician for a full evaluation.
