Chronic Back Pain
Common Causes for Chronic Back Pain
Acute lower back pain affects 65-85% of the adult population.1 Given the large number of adults impacted by lower back pain, this is
also the most common reason for missed work and doctor's visits. The
majority of patients will get relief within 8-10 weeks without treatment
from a doctor.
- Back Strain
- Back Sprain
- Degenerative Arthritis of the Back Flare Up
- Mechanical Irritation of a Nerve Root
- Discogenic Tear
- Bony Fracture or Contusion
The good news is that 90% of acute back pain caused by disc herniations
will resolve in 2-3 months regardless of treatment.2 However, if you fall within the 10% of patients where the acute back pain
hasn't resolved within this time frame you may need to consider spine
surgery if you experience any of the following.
- Progressive Neurologic Weakness
- Neurologic Injury to Bowel or Bladder Function
- Surgically Correctable Pain Unamenable to all Conservative Treatments
- Surgical Instability or Nerve Compression
Symptoms and Types of Chronic Lower Back Pain Include:
Lumbar Spondylosis: This conditions is often used to describe degenerative arthritis (osteoarthritis)
of the spine. As we age, spinal discs lose moisture and shrink, bone spurs
develop and bones become weaker.
Lumbar Stenosis: Disc degeneration ligament thickening leading to Facet hypertrophy (or
narrowing of the Canal). This eventually leads to a compromise of the
nerve roots exiting the canal and cutting off their vascular supply.
Lumbar Disc Herniation: This is basically a mechanical disc impingement that caused patients to
experience a burning or tingling numbness in the legs typically associated
with a static position vs. movement. This nerve pain typically radiates
down the leg and can go all the way down to the foot and ankle (in a dermatomal
pattern). There may also be sensory, motor and reflex changes associated
to the area impacted by the disc herniation. This radiating nerve pain
can result in Radiculitis which often impacts the Sciatic Nerve and referred
to as "Sciatica."
Discogenic Pain: Is caused from Physical Compression of the nerve root or Chemical Irritation
of the nerve root resulting in nerve damage. Symptoms include weakness,
numbness, and muscle atrophy.
1. Arnold YL Wong, Jaro Karppinen and Dino Samartzis. Low back pain in
older adults: risk factors, management options and future directions.
Scoliosis Spinal Discord. April 18, 2017; 12-14.
2. Andrew J. Schoenfeld and Bradley K. Weiner. Treatment of Lumbar Disc
Herniation: Evidence-based Practice
Int J Med. July 21, 2010; 209-214.