Lower Back Pain Defined: It’s as easy as 1, 2, 3…
Over the next month, I’ll discuss the 3 most common back pain diagnoses, their causes, their symptoms, and what it takes to treat them. Stay tuned for assessments and exercises that can clue you in to what is going on with your body and what you need to do to make permanent changes.
Three main causes of lower back pain
Back pain can be very troubling. It is often mysterious, showing up without any traumatic incident, and fluctuating unpredictably. Fortunately, most back pain is not serious and can heal without major intervention such as injections or surgery. In this post, I will list the 3 main causes of back pain to help you predict what kind you have, and then shift focus to concentrating on the first, and most common diagnosis, Disc Herniation with Sciatica.
Back pain typically has 3 causes:
- Disc Herniation, or disc bulge. Referred to by non-medical professionals as “slipped disc”
- SI Joint Dysfunction, or problems in the pelvis
- Stenosis, or arthritis of the spine
All 3 of these causes are important to define and understand when trying to determine your specific problem, because they can all look a little bit like each other. Sciatica is very common and has pretty specific symptoms, so it’s best that I define it first so you can “rule it in” or “rule it out” when trying to figure out where your pain is coming from.
A disc herniation, or disc bulge, is typically caused by bending, lifting, and/or twisting, with or without weight. It can also crop up due to long term sitting or standing with bad posture. The number one sign of a disc bulge is pain radiating into the buttocks and down the leg. This symptom is termed sciatica, named for the infringement of the disc material onto the sciatic nerve, which runs down both sides of the body from the low back, through the buttock, and down the backside of the thigh and calf. Sciatic pain can be accompanied by weakness, numbness, and tingling and usually occurs down only one side of the body at a time. It often gets worse with bending forward and sitting, and better with standing up and walking.
Most of the time, sciatic symptoms improve and dissipate over a period of one to three months, but sometimes they last longer. Conservative management of a disc bulge is successful the majority of the time. This consists of physical therapy to address inflammation, spine alignment, disc compression, muscle spasm, nerve tension, weakness, and body mechanics. If, and that’s a big IF, you have loss of bowel or bladder control or weakness so severe that your leg is “giving out”, then it would be wise to consult a physician for possible anti-inflammatory pharmaceuticals, in the form of oral medication or a steroid injection. In very rare cases, you may need a surgical consult, the most common surgical procedures being a laminectomy, discectomy, and/or fusion. Surgery is truly your last resort and should only be considered if conservative management has failed, or if the bulge is so severe that weakness progresses at a rapid rate.
If you have any of the symptoms I discussed in this post, we would be happy to take care of you at MoveMend. Please call us at 206-641-7733 or schedule your first appointment online here.
Free Low Back Pain Workshop
If you have any of the symptoms I discussed in this post and are looking for more information about your back pain, please call 206-641-7733 to register for our FREE Low Back Pain Workshop on Wednesday, March 29th from 5:30-6:30pm. If you are ready to schedule an evaluation, you can call us or schedule your first appointment online here.
Written by Dr. Ryan Simmons
Director of Physical Therapy at MoveMend
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