Lower back pain is probably the single most common symptom in man, more common even than a headache.
At any one time 15% of adults in the world have lower back pain, and between 50 – 80% of people will experience lower back pain at some time in their life. About one third of people who experience lower back pain are symptomatic enough to seek medical attention. In fact, lower back pain is the second most frequent reason for visiting a doctor, and the fifth commonest reason for hospital admissions.
Lower back pain then is not only a very common complaint, but is often responsible for a decreased quality of life for the patient and a substantial economic burden for society.
There are many reasons why lower back pain is so common in humans. When compared to our four-legged animal friends, humans vertically load their spines resulting in far greater loads on the lower back and consequent earlier joint and disc degeneration.
As a result of not standing on our ‘front legs’, humans are able to carry heavy objects, sometimes too heavy and with techniques that are unsafe for our lower backs. The blood supply to the spinal disc is poor and by the time we reach 30 years of age is almost non-existent.
This makes the disc susceptible to injury and very slow to heal from injury. In addition, various other factors are common risk factors for lower back pain, including a sedentary lifestyle, having a big belly, lifting heavy objects and being generally unfit. Even cigarette smoking is an indirect risk factor for lower back pain!
Most cases of lower back pain involve benign pathology – in other words, although the patient may have marked pain, the cause of the problem is not life-threatening. This lower back pain is called ‘mechanical back pain’. There are however some causes of lower back pain that are potentially life-threatening, ranging from a cancer in the vertebral column to an aneurysm of the aorta and numerous other illnesses. This lower back pain is called ‘pathological back pain’.
But all is not doom and gloom. Lower back pain can be successfully managed. Firstly, an accurate diagnosis of the cause of the pain must be made, and the ‘pathological’ causes of back pain identified or excluded. Then a carefully supervised rehabilitation program that aims to strengthen the back and restore the normal range of movement in the back and hips should be followed.
This program should be conducted by a suitably qualified professional like a biokineticist. In addition, lower back pain management must include education on back health, weight loss if needed, the judicious use of appropriate medication and the exclusion of the underlying risk factors for the pain. With this management strategy, lower back pain sufferers can return to a normal active lifestyle with much reduced, if not completely resolved, pain.
Dr Mike Marshall