The Agency for Health Care Policy and Research

The human spine (or backbone) is made up of small bones called vertebrae. The vertebrae are stacked on top of each other to form a column. Between each vertebrae is a cushion known as a disc. The vertebrae are held together by ligaments, and muscles are attached to the vertebrae by bands of tissue called tendons.

Openings in each vertebrae line up to form a long hollow canal. The spinal cord runs through this canal from the base of the brain. Nerves from the spinal cord branch out and leave the spine through the spaces between the vertebrae.

The lower part of the back holds most of the bodys weight. Even a minor problem with the bones, muscles, ligaments, or tendons in this area can cause pain when a person stands, bends, or moves around. Less often, a problem with a disc can pinch or irritate a nerve from the spinal cord, causing pain that runs down the leg, below the knee called sciatica.

Purpose
This booklet is about acute low back problems in adults. If you have a low back problem, you may have symptoms that include:

Pain or discomfort in the lower part of the back. Pain or numbness that moves down the leg (sciatica).

Low back symptoms can keep you from doing your normal daily activities or doing things that you enjoy.

A low back problem may come on suddenly or gradually. It is acute if it lasts a short while, usually a few days to several weeks. An episode that lasts longer than 3 months is not acute.

If you have been bothered by your lower back, you are not alone. Eight out of ten adults will have a low back problem at some time in their life. And most will have more than one episode of acute low back problems. In between episodes, most people return to their normal activities with little or no symptoms.

This booklet will tell you more about acute low back problems, what to do, and what to expect when you see a health care provider.

Causes of Low Back Problems
Even with todays technology, the exact reason or cause of low back problems can be found in very few people. Most times, the symptoms are blamed on poor muscle tone in the back, muscle tension or spasm, back sprains, ligament or muscle tears, joint problems. Sometimes nerves from the spinal cord (see Figure 1) can be irritated by slipped discs causing buttock or leg pain. This may also cause numbness, tingling, or weakness in the legs.

People who are in poor physical condition or do work that includes heavy labor or long periods of sitting or standing are at greater risk for low back problems.

These people also get better more slowly. Emotional stress or long periods of inactivity may make back symptoms seem worse.

Low back problems are often painful. But the good news is that very few people turn out to have a major problem with the bones or joints of the back or a dangerous medical condition.

 

Muscles of the Back & Spine    

 

  Fig 1a

 

   Fig 1b

Things To Do About Low Back Problems

Seeing a health care provider
Many people who develop mild low back discomfort may not need to see a health care provider right away. Often, within a few days, the symptoms go away without any treatment.

A visit to your health care provider is a good idea if:

• Your symptoms are severe. The pain is keeping you from doing things that you do every day. The problem does not go away within a few days.
• If you also have problems controlling your bowel or bladder, if you feel numb in the groin or rectal area, or if there is extreme leg weakness, call your health care provider right away.

Your health care provider will check to see if you have a medical illness causing your back problem (chances are you will not). Your health care provider can also help you get some relief from your symptoms.

Your health care provider will:

• Ask about your symptoms and what they keep you from doing.
• Ask about your medical history.
• Give you a physical exam.

Talking about your symptoms
Your health care provider will want to know about your back problem. Here are some examples of the kinds of questions he or she may ask you. You can write down the answers in the space below each question:

When did your back symptoms start? __________________________ __________________________________________________________ __________________________________________________________

Which of your daily activities are you not able to do because of your back symptoms? __________________________________________________________ __________________________________________________________ __________________________________________________________

Is there anything you do that makes the symptoms better or worse? __________________________________________________________ __________________________________________________________ __________________________________________________________

Have you noticed any problem with your legs? ____________________ __________________________________________________________ __________________________________________________________

Around the time your symptoms began, did you have a fever or symptoms of pain or burning when urinating? __________________________________________________________ __________________________________________________________ __________________________________________________________

Talking about your medical history
Be sure to tell your health care provider about your general health and about illnesses you have had in the past. Here are some questions your health care provider may ask you about your medical history. You can write your answers in the space below each question:

Have you had a problem with your back in the past? If so, when? __________________________________________________________ __________________________________________________________ __________________________________________________________

What medical illnesses have you had (for example, cancer, arthritis, or diseases of the immune system)?
__________________________________________________________ __________________________________________________________ __________________________________________________________

Which medicines do you take regularly? ________________________ __________________________________________________________ __________________________________________________________

Have you ever used intravenous (IV) drugs? _____________________ __________________________________________________________ __________________________________________________________

Have you recently lost weight without trying? _____________________ __________________________________________________________

You should also tell your health care provider about anything you may be doing for your symptoms: medicines you are taking, creamsor ointments you are using, and other home remedies.

Having a physical exam
Your health care provider will examine your back. Even after a careful physical examination, it may not be possible for your health care provider to tell you the exact cause of your low back problem. But you most likely will find out that your symptoms are not being caused by a dangerous medical condition. Very few people (about 1 in 200) have low back symptoms caused by such conditions. You probably wont need special tests (page 11) if you have had low back symptoms for only a few weeks.

Material Provided by "The Agency for Health Care Policy and Research"
Understanding Acute Low Back Problems. Publication No. 95-0644.
http://text.nlm.nih.gov