Low Back Pain

What is lumbago or low back pain?

Low back pain is one of the most frequently experienced health issues across the globe. It affects 7.5% of the world’s population, including 80% of Americans, who experience various forms of back pain in their lifetime. Low back pain is categorized as acute, subacute, or chronic. Fortunately, in most cases, back pain improves or resolves with proper care and treatment. 

What are the risk factors for low back pain?

• Sedentary lifestyle
• Poor physical activity
• Obesity
• Smoking and drinking
• Pregnancy 

What is etiology?

• Strains and sprains
• Herniated discs 
• Disc degeneration
• Spondylolisthesis
• Osteoporosis
• Infection in spine
• Abnormal shape of the spine
• Inflammatory back pain
• Sacroiliac joint pain
• Posture-related back pain such as bending, standing, or sitting

How is low back pain diagnosed?

• Complete medical and physical history
• Blood test to rule out inflammatory markers, infection, cancer, or/and arthritis
• Bone scan to detect and monitor fractures, bone disorders, and infection
• Diagnostic imaging including Magnetic Resonance Imaging (MRI), may be ordered if a problem is detected with the bone (vertebrae), soft tissue (spinal cord), nerves, and/or disks 

• X-ray to rule out abnormalities in the low back such as wearing of cartilages and bones; and narrowing of vertebrae
• Computerized Tomography (CT) helios to rule out any soft tissue injuries such as disc rupture, spinal stenosis, or tumors

What are the treatment options for low back pain?

Step 1

Self-care management 

• Hot and cold packs
• Exercise to strengthen the core or abdominal muscles 
• Re-integration of normal activities as soon as possible to ease pain and avoidance of strict bed rest

Step 2

Alternative techniques

• Transcutaneous Electrical Nerve Stimulation (TENS): a wearable, battery-powered medical device which places electrodes on the skin over the painful area that generates electrical impulses designed to block or modify the perception of pain   
• Physical therapy: a method to support the low back, improve mobility and flexibility, and promote proper positioning and posture; often used in combination with other interventions 
• Spinal manipulation and spinal mobilization: use of hands to mobilize, adjust, massage, or stimulate the spine and the surrounding tissues; manipulation involves a rapid movement over which the individual has no control; mobilization involves slower adjustment movements

Step 3 

Injections 

Trigger point injections include a series of injections of PRP, local anesthetic, and/or corticosteroid drug into the trigger point(s) to lessen or relieve pain 

Peptide injections help in diminishing degenerative processes in the early stages of the lumbar disease and relieving pain

Epidural steroid injections into the lumbar area of the back are given to treat low back pain and sciatica associated with inflammation