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Diagnosing Lower Back Pain

Back pain will inhibit millions of Americans this year, and for some, the pain can be excruciating. Back pain can be caused by a large number of injuries or conditions, thus making a proper diagnosis both difficult and critical. Back pain that occurs with other symptoms like fever and chills, severe abdominal pain or bladder and bowel problems can be an indication of a serious medical condition, and should be evaluated by your doctor immediately.

Lower back pain is classified into one of three categories, based on a description of how the pain is distributed throughout the body. These three categories are axial lower back pain (also known as mechanical or simple back pain), radicular lower back pain (also known as sciatica) and lower back pain with referred pain. We will now briefly examine the most common causes and treatments for each of these categories.

The most common type of lower back pain is axial. This pain is confined to the lower back area and does not radiate into the surrounding portions of the body. There are many causes of axial lower back pain, such as a degenerated disc or damage to the muscles, ligaments or tendons. However, in most cases, the treatment of axial lower back pain is not dependant on the cause.

The usual treatment is rest, exercises or physical therapy, the use of hot and/or cold compresses and various common pain medications. The exceptions to this would be for chronic pain or pain that is so severe that it wakes you up at night. In these cases, one should see their doctor.

Radicular lower back pain is caused by compression of the lower spinal nerve, leading to pain that radiates down the thighs and legs. The most common nerve affected is the sciatic nerve, which runs down the back of the thigh and calf into the food. Sciatica may cause greater pain in the leg than in the back. This nerve compression can be caused by a herniated disc, a narrowing of the passage through which the nerve travels the spine, diabetes or nerve root injuries.

Usually sciatica is treated with physical therapy and medication for a period of six to eight weeks. If the pain persists, surgery may be done to relieve the compression.

Lower back pain with referred pain which spreads to other areas of the body can be caused by the same conditions which cause axial lower back pain, and the treatment is similar. It needs to be carefully differentiated from radicular lower back pain, in which the pain spreads in very specific paths along certain nerves.

Most instances of back pain can be treated successfully with a combination of rest, physical therapy, hot and cold packs and pain medication. Only with severe or persistent pain should a more drastic treatment, such as surgery, be considered.