A healthy spine supports the body, allows you to move freely and protects the spinal cord and its bundle of nerves. It is comprised of a series of interconnecting vertebrae, joints, discs and supporting soft tissue. Between each vertebrae, the disc, or soft cushioning tissue, acts as a shock absorber when you bend or move.
Your vertebrae and discs are aligned in three natural curves. Normally, these curves are kept in balance by strong flexible muscles. But when an injury, the normal aging process or misuse occurs, spinal problems can result.
Causes
 A number of conditions may cause low back pain. Poor posture leads to abnormal pressure on your spine. Over time this and the natural aging process can cause discs to wear out and dry out. Worn out or injured discs can cause a number of problems resulting in back pain. Discs can tear, bulge or rupture (shown at right) thus losing their shock- absorbing ability. This wear and tear can lead to significant pain and stiffness.
With age, arthritis can develop and sometimes cause bone spurs. These can cause nerve irritation and extremity pain.
The most common causes of low back pain are overuse, poor conditioning of the muscles and poor body mechanics. These often contribute to injuries such as sprains and strains.
Diagnosis
To diagnose a back problem, you doctor will first perform a thorough medical evaluation. This will include taking a detailed medical history to learn about your back pain, other possible symptoms and any injuries you may have sustained. Your doctor will also perform a physical examination. Your posture while sitting, standing, lying down and moving will be checked. The doctor may also perform range of motion tests and a neurologic examination to check for any reflex change, loss of sensation or loss of strength.
To gain more detailed information, you may undergo testing. This may include X-rays; a CT scan, which produces a detailed picture of bones and soft tissue; an EMG, which uses electrical impulses to check for muscle and nerve damage; an MRI (magnetic resonance imaging), which produces detailed images of soft tissue; and other tests.
Treatment
Most low back pain is not serious and can be treated safely and effectively by non-surgical methods. Depending on your condition, you may be referred to a physiatrist, a physician who specializes in physical medicine and rehabilitation, for non-surgical treatment.
You may be asked to modify your activities for a short time period. It is likely however, that proper exercise will be encouraged because studies show that activity contributes to recovery. Pain medication may be prescribed to help relieve pain.
Once improvement is shown, a rehabilitation program may be prescribed to build muscle strength. You will also be instructed on posture, proper lifting and preventing further injuries. For more information about non-surgical treatment of back problems, select: Spinal Physiatry.
Some conditions do not respond to non-surgical treatment. Surgical procedures may be indicated to relieve irritation or compression of the spinal nerves. The surgeon may remove part of the bony vertebrae (laminectomy/laminotomy), part of the damaged disc (discectomy) or both. For patients with instability, a fusion may be performed. For more information about these procedures, select Spinal Surgery for the Lower Back.
Prevention
Follow these recommendations for maintaining better back health and preventing injury:
- establish a regular exercise program to keep muscles strong
- maintain a healthy weight to avoid additional strain on your back
- laearn and use proper technique when lifting
- use proper posture
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