Having lower back pain?

Dr Douglas Street, Contributor

Lower back pain (LBP) is one of the most common reasons for a doctor's visit. It is estimated that about 90 per cent of persons will have it at some point or another, but it's usually mild or short-lived.

Lower back pain may be acute (lasting under a month), or chronic (longer than a month), and the causes are many. Injury is the most common cause of LBP. The injury may have been recent or long term. It may have caused damage to any or all the structures that make up the back - the bones, the nervous system, muscles, ligaments, or intervertebral discs (the cartilage between the bones).

The treatment and prognosis (long-term expectation) are dependent on the severity of the injury. Investigations such as X-ray, CT scan, or MRI scan may be done to assess the extent of the injury. Treatment may involve rest (complete rest no more than one day), pain-reliever(s), a muscle relaxant, physiotherapy, chiropractic treatment, acupuncture, and guided activity. A back support and proper lifting techniques may reduce the possibility of further injury.

Sometimes the nerves in the back may be responsible for LBP. This is often due to injury or complications of arthritis. The inner portion of the discs is soft and severe compressive force (such as from a fall, a motor vehicle accident, or lifting) can cause it to rupture and protrude outwards and on to the nerves that serve from the back to legs. Sym-ptoms including shooting pain, numbness, weakness, stiffness, tingling, or burning may then be felt anywhere along this area.

Arthritis can also weaken the joints causing the bones of the back to shift out of place putting pressure on the surrounding structures, including the nerves. It may also cause narrowing of the passage through which the nerves pass.

Other causes of LBP include infection, tumour, pregnancy, fibromyalgia, and anxiety/depression. Disorders of the abdomen and pelvis may also cause an aneurysm, some kidney diseases (such as stones, a tumour, or an infection), ovarian tumours, period pain, and appendicitis.

The doctor should be seen if there is unexplained weight loss, persistent fever, a weakened immune system, a history of cancer, nerve-related symptoms, weak bones, duration longer than six weeks, and new onset of LBP in age greater than 70.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.