Low Back Pain
It seems as though the most common problem in our day-to-day lives is lower back pain, which accounts for a majority of the patients that come into my office. There is an array of people that come into my office on a day-to-day basis, ranging from young athletes to mothers and fathers, and all the way up to grandparents. No matter their age, size, or occupation, they all share the same common problem of lower back pain. In this article I am not only going to go over the signs and symptoms, but also the types, causes, treatment of, and preventative measures of low back pain.
We have all felt lower back pain, the sharp, stabbing, dull, constant, jagged, shooting, achy pain. When I sit down with patients I have often times noticed that they are ignoring the signs due to their busy life styles. It is the commonality of the pain that keeps people from going in and seeing someone about it. Usually the questions that I ask put their pain into perspective as to how severe it could be. These questions cover when they started feeling the pain, what makes it hurt worse, as well as, the consistency and impairment of the pain, to name a few.
This is followed with a physical examination, which is done to find the signs of pain. In my office it consists of vital signs (blood pressure, pulse, temperature, respiration's, height and weight), posture evaluation and observation, palpation, range of motion, orthopedic examination, and lastly a comprehensive neurological examination. The results of the testing tells me what, and if any further testing needs to be done such as x-rays or an MRI, as well as, what the root of the pain is. When all the testing is complete I correlate the subjective (history) and objective (physical exam/imaging, etc.) information to determine a diagnosis. There are different causes of lower back pain and I must look at each of them and rule them out before I make my final decision.
There are many different causes and problems that are related to lower back pain. One of the more common problems I see in my office is muscle strain or a ligament sprain that is the result of sport or an activity that causes a sharp pain that is worse with movement. Another common cause I see are herniated discs, which I see in truck drivers, weight lifters, and heavy set patients; it is caused by improper lifting, sharp twisting motions, seated posture for long time periods, and many more. Others that are among the more common are joint dysfunction, arthritis, and Facet syndrome, which is usually seen with patients with a "miluakee tumor" and pregnant women. However, among the common problems are the more technical problems. Those in this category are piriformis syndrome, central canal stenosis, spondylolosthesis, ankylosing spondylitis, reiters syndrome, multiple myeloma, metastatic carcinoma (watch for prostate metastatis), infectious spondylitis, abdominal aneurysm, painful periods, referral from internal organs (bladder, kidney, colon, small intestine, liver, pancreas, stomach, uterus, ovaries, etc.) to name a few.