Chronic low back pain is pain that lasts for 12 weeks or longer, even after an initial injury or the underlying cause of acute lower back pain has been treated. About 20 percent of those with acute low back pain develop chronic low back pain with persistent symptoms after one year.

In some cases, the treatment successfully relieves chronic back pain, in other cases the pain persists despite medical and surgical treatment.
Chronic back pain is pain that persists after an injury or surgery whose cause is difficult to determine.

 

ACUTE PAIN

Acute pain can become chronic pain for several reasons. Chronic low back pain can result from injury, illness or stress on various body structures. The type of pain can be very different and can be felt as bone pain, nerve pain or muscle aches. Less than one percent of people who develop acute low back pain have a serious cause, such as cancer or infection, to explain their pain. For example, non-radiating lower back pain is often due to muscle tension and cramping.

Acute mechanical back pain may also be referred to as acute low back pain, lumbago, idiopathic lower back pain, lumbosacral loading or sprain or lumbar syndrome. Sometimes a specific trauma in the back or a strenuous activity can cause the pain. Traumatic injury can also cause the spine to be over-compressed, which in turn can cause a disc to rupture or break and put pressure on one of the nerves that root on the spinal cord.
When the spinal nerves are squeezed and irritated, back pain and sciatica can occur.

 

SCIATICA

Sciatica is usually the result of a pinched nerve when a protruding disc puts pressure on a spinal nerve.
In sciatica, the pain often extends to below the popliteal fossa. Pain radiating to the buttocks and leg may be due to sciatica, a condition in which a protruding disc compresses the sciatic nerve, which extends across the spine to its exit point in the pelvis and is transported to the nerve fibers.
In the most extreme cases, the patient is weakened in addition to numbness and pain, suggesting that a quick assessment is needed.

 

TRANSMITTED PAIN

Transmitted pain occurs when a problem at one point in the body causes pain in another. For example, a pinched nerve in the neck can cause pain in the arm or in the hand.

 

SPINAL STENOSIS

A spinal stenosis is a narrowing of the spine that puts pressure on the spinal cord and nerves, causing pain or numbness as you walk, leading to leg weakness and sensory loss over time.
Spine fractures are often very difficult pain problems, suggesting possible osteoporosis (a bone disease characterized by progressive loss of bone density and strength, which makes bones fragile and unbreakable).

Patients with spinal fractures suffer from cramps and very high levels of pain.
In patients with back pain, where the cause is difficult to determine, especially in elderly patients with osteoporosis, a fracture of the sacrum (the bone between the two hip bones) may be the cause of the pain.

 

CAUSES AND TREATMENT

Once the causes have been determined through a medical examination, the treatment may focus on relieving back pain and improving mood and function.

MEDICAL TREATMENT

Nsaids should be used with caution as they can cause stomach and bowel problems and in some people increase the risk of heart attack and stroke.
When back pain causes lumbar radiculopathy, eg.For example, leg pain (eg sciatica), your doctor may prescribe an anticonvulsant (eg gabapentin, pregabalin) in low doses that can significantly relieve leg pain without the use of anesthetics.
A muscle relaxant prescription may be given to reduce painful muscle cramps associated with lower back strain.
The most common side effects include excessive bruising and bleeding, as well as stomach irritation. Prolonged use may cause kidney and liver problems.
However, they calm or soothe the central nervous system and may be useful to facilitate sleep, and second, to lessen the emotional or muscular tension associated with severe pain.
Narcotics (also called opioids) are powerful analgesics and relieve the symptoms of acute low back pain.
The symptoms of acute lower back pain are usually benign and self-limiting.

 

PHYSICAL ACTIVITY AS MEDICINE

There is strong evidence that people who continue their activities without bed rest after experiencing low back pain seem to have better back flexibility than those who rested in bed for one week.

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