Low Back Pain
Facts, anatomy and perception of pain.
InteliHealth/Harvard Medical Content
Your lower back is a remarkable machine, reliably carrying out a critical and all-but-invisible support role in a host of daily activities, including sitting, standing, walking and lifting. But like any machine, your lower back can malfunction. Indeed, most adults will suffer low back pain at some point in their lives. It's not entirely clear why the lower back is so prone to trouble, but it probably relates to the remarkable stresses placed on it over a lifetime.
Although low back pain is common, each person's experience is as individual as he or she is. For example, low back pain can appear suddenly or gradually and can be severe and debilitating or merely annoying. It may feel like a dull ache or a sharp, stabbing pain. Low back pain can seem focused in a single spot, or it can spread throughout the back and even down the legs. And it can quickly get better completely on its own, or it may stubbornly resist treatment and persist for years.
This diversity occurs, at least in part, because low back pain is not one disease; it's a symptom that has many possible causes. There are some simple, effective treatments for some types of back pain. But the fact is that in most cases the cause of the pain is unknown, there is no single best treatment, and it cannot be determined if the pain is going to get better quickly or last a long time. Happily, nine out of 10 people with new back pain will get completely better on their own within eight weeks or sooner.
Understanding Basic Anatomy
Although the lower back may seem simple enough (especially when it isn't causing any trouble), it has a complex anatomy that allows it to do several basic jobs:
- The lower back protects the spinal cord.
- The lower back serves as an attachment point for many muscles that support the spine.
- The lower back makes it possible to sit, stand, walk and flex your torso in all directions.
Familiarity with the basic anatomy of the back and lower back can be useful in understanding some of the more common causes of low back pain.
Anatomy of a vertebra.
Illustration created by InteliHealth designer Kelly Farrington.
The spine itself consists of a column of cylindrical backbones (vertebrae) separated by flexible, shock-absorbing disks made of cartilage, a type of connective tissue. (These disks, tough capsules encasing jelly-like centers, can themselves become a source of back pain.
) The spinal cord runs down the back of this protective structure. The spinal cord is the communication center that carries messages between the brain and the rest of the body.
The lumbosacral spine is the portion of the spine that sits at the center of the lower back. Nerves to and from the lower half of the body connect with the spinal cord through channels between each vertebra. The bones and joints of the pelvis connect to the lumbosacral spine, and muscles and ligaments surround it.
The role of nearby organs. In addition to knowing the structures of the lower back, it's important to be aware of the nearby organs that can play a role in back pain. The kidneys reside just under the lower ribs in the middle of the back. And the ureters, the drainage tubes that carry urine from the kidneys to the bladder, are located in the lower back. The uterus, ovaries and portions of the intestines are also situated in the area of the lower back. Even the aorta, the body's largest blood vessel, travels through the lower back.
Damage to any of these organs can give rise to back pain.
Experiencing Low Back Pain
When it comes to back pain, people are a lot like snowflakes — no two are exactly the same. In part, this follows from the back's complicated anatomy and the array of possible causes of pain. But even for back pain resulting from the same cause — disk disease, for example — each person's perception may be different.
Factors other than the specific cause of the back problem can influence how the pain feels. Differences in activities, posture and even the quality of sleep can affect how you perceive pain. And psychological factors, such as emotional stress, can increase the sensation of pain or the ability to tolerate what might otherwise be mild symptoms.
For these reasons, if you have low back pain severe enough to interfere with your normal activities or quality of life, you should see a health-care provider for a full evaluation. Also see your health-care provider if you have low back pain that simply makes you worry. Even if the exam doesn't turn up a cause — which, remember, is often the case — learning that your pain isn't a sign of something life threatening is well worth the effort. Your health-care provider also may offer advice on how to treat your back pain, so a visit may be very beneficial.
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