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Low back pain (LBP) is a common complaint—second only to cold and flu as a reason why patients seek care from their family doctor. It may be a limited musculoskeletal symptom or caused by a variety of diseases and disorders that affect or extend from the lumbar spine. Low back pain is sometimes accompanied by sciatica, which is pain that involves the sciatic nerve and is felt in the lower back, the buttocks, the backs and sides of the thighs, and possibly the calves. More serious causes of LBP may be accompanied by fever, night pain that awakens a person from sleep, loss of bladder or bowel control, numbness, burning urination, swelling or sharp pain.
Low back pain is a symptom that affects 80% of the general United States population at some point in life with sufficient severity to cause absence from work. As mentioned, it is the second most common reason for visits to primary care doctors, and is estimated to cost the American economy $75 billion every year. One third of the nation's disability related costs are associated with LBP, a condition primarily affecting individuals between the ages of 45–60.
The most common cause of low back pain is lumbar strain. The structures of the normal lumbar region of the spine include the lumbar vertebrae, discs between each vertebrae, ligaments, muscles and muscle tendons, the
spinal cord within the vertebrae and nerves extending out-ward from the spine through vertebral foramina (openings in the bone). The lumbar vertebrae are distinct from the cervical (neck area) and thoracic (upper back) vertebrae, being generally thicker for greater weight bearing support, and resting atop the sacrum, the triangular shaped bone between the buttocks. The discs between each vertebrae of the spine cushion and absorb the shock that might otherwise be transmitted through the spine. Occasionally, the discs may "rupture" or herniate outward through their fibrous sheath, or covering, putting pressure on the nerves. Nerve pressure as sciatica (affecting the sciatic nerve) may be causative or additive to LBP. Nerve pain from other local organs may also be causative, in which case diagnosis and treatment is more involved, usually much more serious, and may indicate a life threatening condition.
Risks for low back pain are increased with fracture and osteoporosis, narrowing of the spinal canal within the vertebrae (stenosis), spinal curvatures, fibromyalgia, osteo- and rheumatoid arthritis, pregnancy, smoking, stress, age greater than 30, or disease or illness of the organs of the lower abdomen.
In addition to dividing low back pain into three categories based on duration of symptoms—acute, sub-acute or chronic—low back pain may be described as:
Author Info: Kathleen Wright, Katherine Nelson N.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Alternative Medicine, 2005This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.
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