Low Back Pain: What’s the Cause?

Approximately 75 to 85 percent of adults will be affected by low back pain (LBP) during their lifetime. Americans spend at least $50 billion each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work. Because of this LBP epidemic, it is important to know the likely causes of low back pain.

In a research study done in Annals of Internal Medicine, it was determined that 85% of patients who present to primary care physicians have low back pain that cannot be reliably attributed to a specific disease or spinal abnormality. These cases are classified as nonspecific low back pain or mechanical low back pain. In a minority of patients low back pain is caused by a specific disorder: cancer (0.7%), compression fractures (4%), spinal infection (0.01%), ankylosing spondylitis (2%), spinal stenosis (3%), symptomatic disc herniation’s (4%), cauda equine syndrome (0.04%).

The study further found that lumbar spine imaging (x-ray, MRI and CT) did not improve pain, function, anxiety levels, or quality of life. For LBP routine imaging of the spine should not be performed unless there is suspicion of serious underlying conditions (red flags).

Mechanical low back pain is a general term that refers to any type of back pain caused by muscles of the spine or the spinal joints. When the back is injured with a specific traumatic incident or cumulative repetitive stress, the surrounding ligaments, muscles and joints may become irritated and inflamed. Symptoms may range from a muscle ache to shooting or stabbing pain that may radiate to the knees, thighs or buttocks. There is often tightness, limited flexibility, and/or range of motion of the spine. Mechanical low back pain is typically aggravated by; bending, lifting, twisting, prolonged sitting or standing.

Low back pain is the number one disorder seen in outpatient physical therapy clinics and by chiropractors. In future articles, I will describe common evidence based treatments that have been proven successful for the treatment of mechanical low back pain.

Dr. Mishock is one of a few licensed physical therapist and chiropractors in the state of Pennsylvania. He and his physical therapy staff would welcome the opportunity to help you decrease pain, improve your function and return you to the highest quality of life possible. We are here to “serve you” with offices in Gilbertsville, Skippack, Phoenixville, Barto, Limerick, and Stowe(Pottstown)! Please call 610-327-2600 or email mishockpt@comcast.net to see how physical therapy or chiropractic can help.

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