The 16 year old girl, who lay in front of me, was writhing on her bed in pain. I tried my best to calm her. These groans and grimaces of pain were nothing new to me. Estelle, that was the name of the girl, was suffering from lower back pain. ‘Why is this happening to me?’ she croaked, her face contorted with pain. There was no one-word answer to her question!
Lower back pain causes, as experts have found out, can be many and varied. That is why it is important to investigate the causes pertinent to a particular case before one starts looking for relief or solutions.
The back is an intricate structure including muscles, bones, ligaments, disks and tendons. The segments of an individual’s spine are interspersed with cartilage-like pads called discs that act as cushions. Problems with any of these component parts can give rise to back problem. Some people have no specific reason for their back pain. Back pain, more often than not, occurs from strained muscles and ligament, from heavy or improper lifting or after some awkward motion. At times a muscle spasm can induce back pain.
In some cases structural problems may cause back pain, such as:
• Bulging or ruptured discs – The vertebrae in your spine is interspersed with cushion like disks. Sometime the soft material inside the disc may be displaced or may rupture and create pressure on a nerve. Having said so, many people with bulging or herniated disks do not undergo any pain.
• Sciatica – If a herniated or bulging disc creates pressure on the main nerve that travels down your leg, it can lead to sciatica. This involves sharp, shooting pain through the buttock and back of the leg.
• Arthritis – Hips, hands, knees and lower back are the joints most likely to be affected by osteoarthritis. In some cases arthritis in the spine can cause the space around the spinal cord to narrow down. This condition is called spinal stenosis.
• Skeletal irregularities – If your spine curves in an abnormal way, it can lead to back pain. Exaggeration of the natural curves in your spine can make your upper back look abnormally rounded or make your lower back arch excessively. If your spine curves to the side, it
can lead to a condition called Scoliosis and may induce back pain.
• Osteoporosis-Brittle and porous bones can lead to compression fractures of your spine’s vertebrae.
In rare cases back pain may be caused by
• Cauda equina syndrome – This is a serious neurological problem involving a bundle of nerve roots serving your lower back and legs. This condition can enervate the legs, turn the saddle or groin area numb and result in loss of bowel or bladder control.
• Cancer in the spine-A tumor on the spine can create pressure on a nerve, inducing back pain.
• Infection of the spine – If a fever and a tender, warm area associate back pain, an infection could be the likely cause.
Lower back pain symptoms are determined by the cause. For instance, in case of back sprain or strain, the symptoms generally include:
• Spasms in muscle, stiffness and cramping.
• Pain in the buttocks and the back. The pain may onset gradually or quickly. This pain occurs mostly in episodes. Certain movements can worsen the pain and resting can better the condition.
The worst pain usually lasts for a duration of 48 to 72 hours and the pain may mitigate over days or weeks. During this time, the back is more prone to injury.
In case of nerve root pressure, the symptoms are inclusive of the following:
Leg Pain: If the pain spreads below the knee, it is more likely to be induced by pressure on a nerve than a muscle problem. More often than not, it’s a pain that starts in the buttock and extends down the back of the leg as far as the ankle of the foot.
Nerve related problems like weakness, numbness or tingling in one leg or in the lower leg, foot or both legs may occur. The tingling sensation may start in the buttock and spread to the ankle or foot. Both legs can turn weak or numb, and there may be loss of bladder and/or bowel control – both symptoms of Cauda equina syndrome. The latter is a condition which requires immediate medical supervision.
Arthritis of the spine usually causes pain that worsens in the hip and the back region. It onsets gradually, worsens over time, and the duration ranges from 3 to 6 months. It is generally worse in the morning or post long hours of inactivity. Arthritis pain improves when one moves around.
Symptoms of the disease that affect the spine are determined by the diseases. This may be inclusive of the following:
• Pain that is worse in that part of the spine where there is a compression fracture, tumor, or infection.
• Pain that sets in gradually, is static and may be dull or a sharp ache. Taking rest does not help matters and may turn the situation worse. The duration of the pain can be 2 to 3 weeks.
• The spine becomes sensitive to touch and pressure.
• Pain that does not allow you to sleep or wakes you from it.
Is prolonged computer use always responsible for lower back and arm pain? Not always. A study conducted by the department of Epidemiology and Health Promotion, Municipal Health Service, Amsterdam has confirmed in the negative. A school based questionnaire survey was given in the years 2002 and 2003 to 3485 adolescents aged between 12 to 16 years who attended secondary schools in Amsterdam, Netherlands. The study revealed that that musculoskeletal pain is common among adolescents and is linked with depression and stress and not with computer use and physical activity.
Can lower back pain cause constipation? The truth is that even minor cases of constipation can cause back pain. The blockage of waste material in the lower intestine induces constipation. Pressure can be created on the lower back due to this blockage. The pain will worsen if the blockage is not done away with. This is because waste material will continue to be produced by the body even if is not being passed. At the same time, back pain from a sudden jerk, lifting or other straining activities can induce a bout of constipation. This is because a spasm in the muscles in the lower back can hinder the autonomic nerves responsible for peristalsis of bowel movements.
Not all problems related to constipation and back pain are the same. The symptoms can vary from occasional constipation to a chronic one, even blockage. In case of occasional irregularity, the constipation can get cleared on its own in a day. More severe cases may have you spending days without having bowel movements. If the bowels do move, dry and hard stools are produced. When your bowels don’t move easily, the first thing that you do is to strain. This straining produces pressure that induces back pain. Severe, chronic constipation can continue for days. It can call for medical supervision and even hospitalization.
The best way to eliminate back pain and constipation is to drink plenty of water. You can also increase your dietary fiber intake by incorporating a lot of fresh vegetables and fruits in your daily diet. You can also lie down on the floor with your legs on a chair. This removes pressure and weight from your back and offers your muscles and nerves the time to recover. Since proper exercise activates bowel movements, regular exercise can also go a long way in offering you relief from back pain and constipation.
Can lower back pain cause pelvic pain? Certain conditions in the lower back can induce direct or associated pain in the pelvic region. The most common cause of pelvic and lower back pain is muscular injury. Pain throughout the pelvic region can be caused by a pulled, strained or sprained muscle or ligament. Pain in the front and back of the lower body can be induced by pinched nerves leading to the pelvis and pelvic organs. Some forms of central spinal stenosis may manifest symptoms in the pelvic region as well as in many other parts of the body.
Incontinence, general pelvic numbness or pain in the anus or genitals can be the likely symptoms of cauda equina syndrome. The condition requires immediate medical guidance since damage to many lower body systems and neurological structures may generate long lasting effects.
Health problems in the pelvic area can also induce direct or associated pain in the lower back, buttocks and legs. These symptoms bear resemblance to those of sciatic nerve pain and can be difficult to identify. Make sure you apprise your doctor of any new or changing pains.
All said and done, it is best to consult a medical practitioner in case you suffer from back pain.