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Lower Back Pain

Lower back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience lower back pain at some point in their lives.

Ironically, the severity of the pain is often unrelated to the extent of physical damage. Muscle spasm from a simple back strain can cause excruciating back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can be completely painless.

The causes of back pain can be very complex, and there are many structures in the lower back that can cause pain. The following parts of spinal anatomy can cause pain:
• The large nerve roots that go to the legs and arms may be irritated
• The smaller nerves that innervate the spine may be irritated
• The large paired back muscles (erector spinae) may be strained
• The bones, ligaments or joints may be injured
• The intervertebral disc may be injured
It is important to note that many types of lower back pain have no known anatomical cause, but the pain is still real and needs to be treated. However, usually lower back pain can be linked to a general cause (such as muscle strain) or a specific and diagnosable condition (such as degenerative disc disease or a herniated disc).

This article provides a review of the most common types of low back pain and related symptoms. The vast majority of lower back pain will get better with time and can be addressed with conservative treatments, such as osteopathic or chiropractic manipulation, physical therapy, pain medications, etc. However, it is important to note that there are a few symptoms that indicate the need for emergency surgery.

Types of lower back pain that indicate a surgical emergency
There are a few symptoms that are possible indications of a serious medical condition requiring surgery, and patients with these symptoms should seek medical attention immediately. These symptoms include:
• Sudden bowel and/or bladder incontinence (cauda equina syndrome)
• Progressive weakness in the legs (cauda equina syndrome)
• Severe, continuous abdominal and back pain
• People with fever and chills, history of cancer with recent weight loss, or who have just suffered a severe trauma should also seek immediate medical attention.

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