What Causes Low Back Pain? How Is It Treated?

Low back pain is one of the most common musculoskeletal problems that negatively affects daily life. It can arise from many different causes, ranging from a simple muscle strain to spinal disorders. Accurate diagnosis and timely treatment are of great importance in low back pain. Orthopedics and Traumatology Specialists at Yeditepe University Hospitals answered frequently asked questions about low back pain.

What Is Low Back Pain?

Low back pain is pain, tenderness, or stiffness felt in the lower part of the back. It most commonly occurs due to muscle or ligament strain, poor posture, or age-related changes.
The lower back is a complex structure that connects the upper part of your body (including your chest and arms) to the lower part (including your pelvis and legs). This important region of the spine allows you to move comfortably. It enables actions such as standing, walking, and lifting by allowing movements like turning, bending, and stooping. The proper functioning of your lower back is essential for almost all movements in your daily life. Low back pain, on the other hand, can hinder your activities, reduce your work capacity and quality of life, and even make it difficult for you to enjoy life.

Which Department Should You Visit for Low Back Pain?

The question "Which doctor should I see for low back pain?" is one of the most frequently encountered questions. Low back pain is one of the most common problems treated by orthopedic specialists. One in five adults experiences significant low back pain at some point in their lives. After the common cold, back problems are the leading cause of work loss in adults under 45 years of age.

How Is Low Back Pain Diagnosed?

Most cases of low back pain can be easily treated before reaching serious proportions. Your orthopedic specialist can make a definitive diagnosis and provide treatment for the majority of back problems. For diagnosing low back pain, your doctor will ask about your complaints regarding your back and whether you have had any previous injuries, and will also examine your spine and legs.
In most back conditions, expensive tests are not necessary for initial evaluation and treatment. If your pain is severe, does not respond to treatment, or you experience widespread pain in your legs, some imaging tests may be used. X-rays are frequently used to identify arthritis and bone diseases.
Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) may be required to visualize soft tissues (lumbar discs, nerves). Rarely, a bone scan may be ordered to assess bone activity. If the spinal problem has caused damage to nerves or muscles, Electromyography (EMG) may be needed.

What Causes Low Back Pain?

Low back pain can develop due to injuries, aging, structural changes, and certain risk factors. Therefore, the causes of low back pain can vary due to many reasons. Some of these include:

Back Strains and Sprains

The back muscles provide you with strength during activities such as standing, walking, and lifting. If your muscles are weak or have been overexerted, strains can occur. The ligaments around the back connect the spinal bones to each other, providing support to the back. As a result of sudden and forceful movements, these ligaments can stretch, stiffen, or weaken, leading to sprains.
These strains and sprains are the most common causes of low back pain. The following factors increase the risk of injury:

Muscle weakness
Improper use
Obesity
Smoking

Aging

Over time, wear and tear occur in the discs. This process is called degenerative disc disease. Arthritic changes in the small joints may also be seen. These changes occur with age in most people. However, when advanced, they can cause stiffness and pain in the lower back. Bone spurs and inflamed joints caused by arthritis can press on nerves, leading to leg pain. In some people, even though these changes are significant, they may not cause pain or functional loss.

Osteoporosis and Fractures

Bones lose strength over time. Especially in postmenopausal women, the lumbar spine can easily fracture or collapse during falls, lifting, or simple daily activities.

Protruded Disc (Herniated Disc)

In childhood and young adulthood, discs contain a gel-like nucleus. This nucleus is surrounded by a tougher structure called the annulus. With age, the structure of the nucleus changes, and discs may crack, collapse, or degenerate. This can lead to back pain.
If the disc contents protrude outward, herniation (slipped disc) occurs. If the protruding disc presses on a nerve, pain may occur in the leg.

What Is the Treatment for Low Back Pain?

Most low back pain is treated after evaluation by an orthopedic specialist by avoiding pain-provoking movements and using medications that reduce pain and inflammation. Short-term rest may be beneficial for treating low back pain; however, research shows that light activity accelerates recovery. It is not necessary to stop all activities, including work, entirely. Your orthopedic specialist will help you regulate your activities.
When the pain subsides, exercises aimed at strengthening the back and abdominal muscles, as well as stretching movements to increase flexibility, are recommended. If you are overweight, losing weight, and if you smoke, quitting, will reduce the recurrence of low back pain. In the long term, the best treatment is to develop preventive programs that help maintain your physical fitness and proper movement habits.

Can Low Back Pain Be Treated Without Surgery?

Low back pain can be treated without surgery using non-surgical methods. Most acute or chronic low back pain cases can be treated without requiring surgery. Surgical treatment, on the other hand, is applied especially to relieve the pressure caused by herniated discs that cause nerve and leg pain and do not respond to other treatments. Advanced arthritis in the spine may also require surgical intervention when it leads to severe nerve compression.

What Should We Do to Prevent Low Back Pain?

As we age, bone mass, muscle and ligament strength, and flexibility decrease. However, this process can be slowed down with the following precautions: