Lower back pain can be from a lumbar sprain to rupture of a disc.

Your back is an intricate structure, giving you the power to stand, walk, run, sit and lift. The ligaments of the lower back connect the vertebral bones, supporting and stabilizing this area. An unconditioned back is prone to strain when muscles and ligaments are overworked. Back muscle strain occurs when a sudden, forceful movement injures a ligament, which has become stiff or weak from poor conditioning or overuse.
Acute lower back pain is a common medical problem afflicting two-thirds of Americans during some part of their lives. Each year nearly 6 million Americans suffer from back or spinal problems, making back pain the most commonly reported health condition in the United States.

The back is made up of bones, muscles and other tissues extending from the neck to the pelvis. The spinal column supports the body’s trunk and protects the spinal cord – the vast highway of nerves that help control the body’s sensations and nerves. Bones in your back include 30 pieces stacked up called vertebrae. This is your spine, and vertebrae protect the spinal cord. Nerves from the spinal cord branch off to organs and muscles throughout the body. The spaces between the vertebrae are made up of round spongy pads of cartilage. These are the intervertebral discs that act as shock absorbers when you walk or run. Ligaments and tendons hold the vertebrae in place and attach muscles to the spinal column.

Lower back pain can be anything from a lumbar sprain to an actual rupture of a disc. However, most cases of lower back pain come from muscle or ligament strain as a result of lifting, bending or overstretching. As a result of the injury, your back muscles spasm, causing the muscles to “lock” and develop pain.

Acute back pain usually means you have pain for a few days to a few weeks. Chronic pain lasts for three months or more. Chronic pain or pain with unusual symptoms could mean a tumor, herniated disc, osteoporosis, osteoarthritis or other serious diseases.

Prognosis

In more than 95 percent of cases, the underlying cause is not serious. Using over-the-counter pain relievers such as ibuprofen, aspirin or naproxen for a few days usually help you feel better. Through exercise and healthy habits, you can keep your back healthy and strong and even avoid pain in the future. Two people may be diagnosed with a herniated disc between the fourth and fifth lumbar vertebrae – one a 24-year-old football player hurt when tackled and the other a 55-year-old librarian who felt terrible sharp pain after bending over to pick up a piece of paper. There are many factors leading to back pain, from lifestyle to hereditary characteristics. Several combinations of factors contribute to varying degrees. Six main factors underlying back pain include:

* Age.

* Underlying disease process.

* Poor posture.

* Excess weight.

* Sedentary lifestyle.

* Stress.

Age

Many older adults suffer from arthritis that involves one or multiple vertebrae (back bones) partially due to disc degeneration. Intervertebral discs provide cushioning and flexibility between vertebrae and lose some of their fluid. However, it’s not known why some older people with a lot of back problems are more prone to pain than others.

Posture

The relationship between our backbones and their respective ligaments and tendons determines posture. Good posture is established by conscious effort, habit and heredity. Constant energy exerted by muscles around the spine help balance the vertebrae against gravity all the time, even when we sleep. Consciousness of how we hold our bodies when walking and sitting significantly helps to minimize strain against gravity and motion. Your mother was right when she said, “Don’t slouch!” and “Stand up straight!” Whether due to bad habits or a hereditary condition, when posture is poor, back problems often result.

Underlying disease

Diseases may affect vertebral bones. Arthritis and cancer (especially when a tumor spreads to the spine) can impinge on the spinal cord and nerve roots, causing pain or other symptoms.

Excess weight

There is a natural curve of the lower spine or lumbar region (the third curve in the “S”). However, abdominal fat tends to pull the lumbar spine forward and downward resulting in “lordosis.” The heavier we get in the mid-section, the greater weight we carry in the already vulnerable lower back. Unlike the thoracic spine, where ribs add protection – like the ribbed ceiling of a Gothic cathedral – the cervical or neck region and lower back are more vulnerable to stress and strain. The cervical spine tends to be injured when we come to a sudden stop, such as acceleration/deceleration injuries (whiplash). The lower back, over time, becomes vulnerable even to the usual, everyday demands of bending and walking.

Sedentary lifestyles

When out of shape, our muscles, including those that support the spine, atrophy or weaken from lack of use. Strong abdominal muscles provide additional protection to the lower back.

Stressful life

There are two types of stress: good stress and bad stress. When the reactions to the demands of every day life are extreme, our body reacts by tightening muscles. Our jaw muscles contract, our fists may clench and the back muscles tighten as though gearing up to flee. Unfortunately, all the extra muscle effort leaves less energy for our back to work smoothly doing the delicate balance of protecting the spine while permitting the flexibility and range of motion we tend to take for granted. The back’s ready-or-not-stressful state is a set-up for injury, as stiff back muscles cannot work efficiently.

Source: The News, 14/9/2008

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