Low back pain is the most common cause for medical consultation worldwide. Low back pain may be acute or chronic, with the latter being defined as pain that lasts greater than 3 months. One study has indicated that 85% of adults will experience incapacitating back pain at some point in their lives.
Low back pain is frequently reported as the most frequent cause of disability; it reduces quality of life by hindering work responsibilities and limiting many other life activities. Back pain is most commonly attributed to degenerative disease though many other pathologic states may be the cause. Some of these include trauma, renal stones, pancreatitis, aneurysm, cancer, inflammatory arthritis, scoliosis, infection, metabolic syndromes, and developmental malformations.
Degenerative changes of the spine frequently occur at the disk space between the vertebral bodies or between the posterior elements of the vertebra. The disks are like shock absorbers for the spine; they distribute forces equally and transfer them to the muscles, tendons, and ligaments along the spine. The posterior elements server as anchors for muscles and maintain bilateral joints at each level for movement of the spine.
The spinal cord and spinal nerves protected by the spine can become compressed by degenerative changes leading to pain. Disk tears and inflammatory changes of the bones and surrounding soft tissues are commonly associated with pain.
“There are many treatments for back pain ranging from conservative care to minimally invasive interventions and even open surgery.”
Knowing all the potential causes of back pain is essential to tailoring an effective treatment plan and alleviating pain. Some medical reports only describe glaring abnormalities when in fact those may or may not represent pain generators. If spine imaging has been performed a second opinion from a fellowship trained specialist may be considered prior to any intervention as a second opinion may help identify occult causes of pain.