Low Back Pain

Low back pain is a common musculoskeletal disorder affecting 80% of people at some point in their lives. It is the most common cause of disability, a leading contributor to missed work, and the second most common neurological ailment.

Low back pain is a common musculoskeletal disorder affecting 80% of people at some point in their lives. It is the most common cause of disability, a leading contributor to missed work, and the second most common neurological ailment.
(See reference 1).

What causes low back pain?

The vast majority of low back pain episodes are the result of benign musculoskeletal problems, and are referred to as non-specific low back pain. This type may be due to muscle, ligament or joint sprains or strains. However, there are also many non-musculoskeletal causes of low back pain that may or may not require medical care. For this reason, if you are experiencing back pain that is not going away on its own, a visit to your healthcare provider is very important.

How can low back pain be treated?

Depending on the cause, most cases of lower back pain will resolve on their own in 1-3 months; however, some cases of low back pain may not resolve themselves if ignored (See reference 2). Up to 30% of those with low back pain will not recover in one year (See reference 3).

For many people with low back pain, there are treatments that can shorten the recovery time and reduce the likelihood that the pain will come back:

What does the research say?

A 2010 review found that spine manipulation achieves equal or superior improvement in pain and function than all other commonly used treatments (See reference 4).

What do medical doctors say?

In 2007 the American College of Physicians and the American Pain Society jointly recommended that spine manipulation be considered for people who do not improve on their own (See reference 5).

Other non-surgical treatments

Rehabilitative exercises and specific activity recommendations

Engaging in physical activity within the limits of your pain can speed recovery if done correctly. Specific stretching and strengthening can help to restore motion and strength to your lower back can be very helpful in relieving pain and preventing future episodes of low back pain.

Acupuncture – Acupuncture can offer significant relief of chronic low back pain (See reference 6).

What about medications or surgery?

Medication – According to the American Pain Society/American College of Physicians clinical practice guideline, medications with good evidence of short-term effectiveness for low back pain are NSAIDs, skeletal muscle relaxants (for acute low back pain), Evidence is insufficient to identify one medication as offering a clear overall net advantage because of complex tradeoffs between benefits and harms (See reference 8).

Surgery – Surgery is sometimes necessary for some people; however, surgery and overtreatment should be avoided and used as a final resort (See reference 9).

References

1. National Institute of Health. “Lower Back Pain Fact Sheet. nih.gov”. Retrieved 2012-03-16. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm

2. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J. 2003;12(2):149-65.

3. Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, York J, Das A, McAuley JH. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 2008 Jul 7;337:a171.

4. Dagenais, S; Gay, RE; Tricco, AC; Free