Low back pain is a general term referring to the symptom of pain in the low back region rather than the cause. If you live in a developed nation, you are very lucky if you never get back pain. In fact, look around your office and it's likely someone near you also has back pain. The good news is, almost everyone eventually recovers.
Here are some statistics:
Most of us, 80% of Americans, will experience back pain during our lives.
One-half of all working Americans admit to having back pain symptoms each year.
60-80% will have repeat cases.
Only 10% will ever find the cause and it often goes away within 6 weeks.
Not surprisingly, 54% percent of low back pain cases are in office workers.
Low back pain is the leading cause of disability worldwide.
Back pain is one of the most common reasons for missed work.
Back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
Low back pain results from 50-75% of auto accidents, depending on the angle and speed of the crash.
Many cases of back pain are due to poor form in lifting, bending, and sitting. It may have a sudden onset or slow. Symptoms of back pain vary from sharp or stabbing to dull, achy, or crampy and the type of pain you have will depend on the cause of your back pain. Most people find that reclining or lying down will improve low back pain, no matter the underlying cause, though walking can also help some kinds of back pain. The overwhelming majority of cases are not in need of immediate medical attention, but it is one of the most common complaints that brings patients in to see doctors. Massage, physical therapy, acupuncture, yoga, pilates and chiropractic care are much more effective at relieving low back pain of a soft tissue nature, than doctors who will likely only prescribe pain medication. However, if your back pain is debilitating, you may want to see a doctor to order imaging and rule out spinal injury.
People with low back pain may experience these symptoms:
Back pain may be worse with bending and lifting.
Sitting may worsen pain.
Standing and walking may worsen pain.
Back pain comes and goes, and often follows an up and down course with good days and bad days. Normal back pain should get better overall. Although there may be a reactivation event.
Pain may extend from the back into the buttock or outer hip area, but not down the leg. Pain that goes goes down the leg is usually due to a tightness or restriction in the pelvic area or upper thigh. The most common pattern I see is piriformis syndrome.
Sciatica is common with a herniated disk. This includes buttock and leg pain, and even numbness, tingling or weakness that goes down to the foot. It is possible to have sciatica without back pain.
To see symptoms that go with back pain that need to be quickly evaluated by a doctor, read When to Worry About Low Back Pain. In particular numbness, fever, organ dysfunction, weight loss or other nonmuscular type symptoms are of concern. These are rare compared to the overwhelming majority of simple musculoskeletal injuries.
Solving low back pain is complicated, because of these factors:
There are so many different forces working on the area we call the low back. It's challenging to figure out. There's the erector spinae, psoas, the QLs, occasionally the obliques, illiacus, multifidi, rotatores, the glute family and deep rotators of the hip, the lats, rectus abdomis, adductor group, the hamstrings and more. There's also ligaments and the sacrum, the SI joint, spine issues, fascia everywhere, and nerves, oh my! If your massage therapist just keeps whaling away on your paraspinal muscles to no avail, please change therapists.
Most people are unable to stop the primary cause of the injury, which is excessive sitting in poor form. This leads to poor posture, excessive pelvic tilt and torsion and immobility of the spine and its junctures with other joints.
Once back pain has begun, the body adjusts to the pain by tensing additional muscles and creating new imbalances. Sometimes it feels like your middle section is playing painful tug of war.
Core strength is often an issue and needs to be addressed in tandem.
The entire body posture could be involved, starting from the feet or neck. This is where structural integration can be very helpful.
Muscles in spasm near the spine often have a strong neuromuscular resistance to treatment. That is the nerves just don't want to let go and when they do, they want to go back into spasm soon after.
The pelvis can be involved heavily and it's often a painful and uncomfortable place to work.