Definition Low back pain refers to pain or discomfort in the lower back. It is often caused by stress.
What is going on in the body? Low back pain typically involves some strain or spasm of the large muscles along the spine that work to support the spine. Stress can make a person more likely to remain tense and create muscle tension, so it is an important risk factor for backache. Many cases of chronic or long-lasting back pain are thought to be at least partly caused by stress.
What are the signs and symptoms of the condition? Generalised lower back pain due to stress occurs mainly in people 20 to 40 years of age. The pain can be in the back, buttocks, and upper thighs. The pain is often dull, difficult to pinpoint, and chronic or long-lasting.
What are the causes and risks of the condition? A general ache along the spine can be due to stretching or tearing of muscles, back trauma, or mechanical stress.
Low back pain may be caused by the fatigue and stiffness that result from staying in a fixed position for a long time. A common example is sitting at a desk at work for long hours. Any of these factors can be made worse by stress.
What can be done to prevent the condition? Low back pain can often be prevented by certain measures. These measures may include exercises to strengthen and stretch supporting back muscles, and weight loss. Techniques for proper lifting and sleeping and body mechanics can also be discussed with a doctor.
How is the condition diagnosed? Back pain may be caused by some serious conditions that should be evaluated by a doctor. For example, a person who has back pain after a fall or an auto accident should seek medical care. A tumour or infection may cause back pain. People with a history of cancer, fever, chills, weight loss, recent infection, pain that is worse when standing, or severe night time pain should also see a doctor promptly. Weakness, radiating pain down the buttocks or legs, loss of bladder or bowel control, or numbness should be evaluated by a doctor.
If no serious cause for low back pain can be found, which is quite common, stress must be considered. It is frustrating for the caregiver and the affected person that a cause is rarely found for low back pain. No one test can determine that stress is the cause for back pain.
What are the long-term effects of the condition? Low back pain due to stress is a common cause of disability and missed work. Those affected may be unable to perform activities they enjoy. Pain can be irritating or even disabling. When low back pain is due to stress, it is not a life-threatening condition and usually gets better eventually.
What are the risks to others? Low back pain is not contagious and poses no risk to others.
What are the treatments for the condition? Once more serious conditions have been ruled out, treatment is usually tailored to the affected person's needs. A doctor can help the person learn how to prevent further injury and how to decrease stress on the lower back. Low-stress stretching and moderate exercise can help relieve backaches caused by stress. During the first 24 hours after the injury, cold compresses for 20 to 30 minutes several times a day are helpful. After the first day, applications of heat for 20 to 30 minutes several times a day may lessen the discomfort.
Pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are often helpful. Bed rest has not been shown to improve this condition, and it may actually make things worse. Activity should be gradually increased as tolerated. A person's attitude toward the back pain is often the most important factor in determining recovery. For example, in work-related back pain, the person's attitude toward work is the most important factor in predicting whether or not a person will return to work. Medications used to treat depression often help those with long-term low back pain as well.
Most lower back pain will get better on its own within four weeks, with or without treatment.
What are the side effects of the treatments? All medications have possible side effects. NSAIDs, for example, may cause allergic reactions, stomach upset, and other side effects. Specific side effects depend on the drugs used.
What happens after treatment for the condition? In cases of back pain caused by stress, treatment stops once symptoms go away. At this point, no further treatment is needed. In some cases, treatment may be needed for years.
How is the condition monitored? The affected person can monitor his or her symptoms at home. These can be reported to the doctor if a person is getting medical treatment. If numbness or weakness develops, medical treatment should be sought.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
