Most low back pain is triggered by some combination of overuse, muscle strain, and injury to the muscles, ligaments, and discs that support the spine. Many experts believe that over time muscle strain can lead to an overall imbalance in the spinal structure. This leads to a constant tension on the muscles, ligaments, bones, and discs, making the back more prone to injury or reinjury.



The causes of pain in the low back, or lumbosacral region, tend to add on to one another. For example, after straining muscles, you are likely to walk or move in different ways to avoid pain or to use muscles that aren't sore. That can cause you to strain other muscles that don't usually move that way.

Low back pain affects a reported 5.6 percent of U.S. adults each day,1 and 18 percent report having had back pain in the previous month.The lifetime prevalence of low back pain is estimated to be at least 60 to 70 percent.3,4  Although most patients self-treat back pain and only 25 to 30 percent seek medical care,5,6 back pain is one of the most common reasons for visits to family physicians. Family physicians treat more patients with back pain than any other subspecialist, and about as many as orthopedists and neurosurgeons combined.

Treatment of Lower Back Pain

Rest

Bed rest? Experts suggest only 1 to 2 days at most. You should resume activities as soon as possible.

Exercise

Exercise may be an effective way to speed recovery from low back pain and help strengthen muscles. This is particularly important for persons with skeletal irregularities.

Medicines

Taking a painkiller that you would normally take for a headache (eg paracetamol or ibuprofen) is usually enough to relieve simple back pain and can help you keep active. It is best to get into a routine and take this at the same time every day. Always follow the instructions on the patient information leaflet that comes with the medicine and speak to your pharmacist.

The decision to have or not to have spinal surgery includes weighing the risks and benefits involved. You will make the final decision, so ask your spine surgeon questions about anything you do not understand. Since medical care is tailored to each person's needs and differences, not all information presented here will apply to your treatment or its outcome. Seek the advice of your physician and other members of the health care team for specific information about your medical condition.

Physical therapy for back pain in the form of exercise and stretching can irritate trigger points and make them worse, as thousands of patients can attest. Exercising in an attempt to strengthen the abdominal muscles can be especially risky when unsuspected abdominal trigger points are the hidden source of your back pain. Exercise and stretching are valuable and effective forms of therapy but can actually worsen back problems for many people unless their trigger points are first deactivated.

Low back pain is a common, impairing and disabling condition, often long-term, with an estimated lifetime prevalence of 70 percent to 85 percent,� the authors write as background information in the article. 'It is the second most common pain for which physician treatment is sought and a major reason for absenteeism and disability.� Acupuncture is increasingly used as an alternative therapy, but its value as a treatment for low back pain is still controversial.