Acute back pain
What is Acute Low Back Pain?
- Any back pain that has been present for less than 2 to 3 weeks could be termed as acute low back pain. Research states that almost everyone will experience low back pain at some point in their lives. This pain can vary from mild to severe. It can be short-lived or long-lasting. However it happens, low back pain can make many everyday activities difficult to do.
- Your spine is made up of small bones, called vertebrae, which are stacked on top of one another. Muscles, ligaments, nerves, and intervertebral discs also make up your spine.
- Back pain is different from one person to the next. The pain can have a slow onset or come on suddenly. The pain may be intermittent or constant. In most cases, back pain resolves on its own within a few weeks.
What Causes Acute low back pain?
- There are many causes of low back pain. It sometimes happens after a specific movement such as lifting or bending. Getting older also plays a role in many back conditions.
- As we age our spines age with us, causing degenerative changes. These changes can start in our 30s, or even younger, and can make us prone to back pain, especially if we overdo our activities.
- These changes, however, do not keep most people from leading productive and mostly pain-free lives.
Over-activity leading to Muscle and ligament strain
- One of the more common causes of low back pain is muscle soreness from over-activity. Muscles and ligament fibres can be overstretched or injured.
- This is often brought about by the first football or golf game of the season, or too much gardening in one day. We are all familiar with this "stiffness" and soreness in the low back (and other areas of the body) that usually goes away within a few days.
Some people develop low back pain that does not go away within days. This may mean there is an injury to a disc.
Disc tear. Small tears to the outer part of the disc (annulus) sometimes happen with aging. Some people with disc tears have no pain at all. Others can have pain that lasts for weeks, months, or even longer. A small number of people may develop constant pain that lasts for years and is quite disabling. Why some people have pain and others do not is not well understood.
Disc herniation. Another common type of disc injury is a "slipped" or herniated disc. A disc herniates when its jelly-like centre (nucleus) pushes against its outer ring (annulus). If the disc is very worn or injured, the nucleus may squeeze all the way through. When the herniated disc bulges out toward the spinal canal, it puts pressure on the sensitive spinal nerves, causing pain.
Because a herniated disc in the low back often puts pressure on the nerve root leading to the leg and foot, pain may appear in the buttock and down the leg. This is called sciatica. A herniated disc often happens with lifting, pulling, bending, or twisting movements. We must also remeber that many people (one in three) have disc changes like this without any pain.
Please watch the brief video about disc herniation
Disc Degeneration. With age, intevertebral discs begin to wear away and shrink. In some cases, they may collapse completely and cause the facet joints in the vertebrae to rub against one another. Pain and stiffness result. When there is "wear and tear" on the facet joints and discs, this is referred to as spondylosis or osteoarthritis of the spine. It can lead to further back problems, including spinal stenosis.
Degenerative Spondylolisthesis. Changes from aging and general wear and tear make it hard for your joints and ligaments to keep your spine in the proper position. The vertebrae move more than they should, and one vertebra can slide forward on top of another. If too much slippage occurs, the bones may begin to press on the spinal nerves.
Spinal Stenosis. Spinal stenosis is when the space around the spinal cord narrows and puts pressure on the cord and spinal nerves.
When intervertebral discs collapse and osteoarthritis develops, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth (called spurs) can lead to a narrowing of the spinal canal. Osteoarthritis can also cause the ligaments that connect vertebrae to thicken, which can narrow the spinal canal.
What are the symptoms of Acute Low Back Pain?
Back pain varies. It may be sharp or stabbing. It can be dull, achy, or feel like a sudden cramp. The type of pain you have will depend on the underlying cause of your back pain.
Most people find that reclining or lying down will improve low back pain, no matter what the underlying cause.
People with low back pain may experience some of the following:
- Back pain may be worse with bending and lifting.
- Sitting may worsen pain.
- Standing and walking may worsen pain
- Back pain comes and goes, and often follows an up and down course with good days and bad days.
- Pain may extend from the back into the buttock or outer hip area and sometimes down the leg.
- Sciatica is common with a herniated disk. This includes buttock and leg pain, and even numbness, tingling or weakness that goes down to the foot. It is possible to have sciatica without pain in the back.
What are the treatments available?
In general, treatment for low back pain falls into one of three categories:
- Self management with exercises and pain killers
- Manual therapy by physiotherapists and osteopaths
- Sometimes it may require treatment in hospital such as injections into the spine. Very rarely surgery might be considered.
The most important advice with acute back pain is to keep active as much as you can within the limits of pain. Please read more about treatments under dealing with back pain.