Acute low back pain is experienced by almost everyone at some time in his or her adult life. Back problems rank as one of the most common reasons for seeking evaluation by a physician or health care person. For persons under the age of 45, low back problems continue to be one of the most frequent causes of disability. Fortunately, 90% of low back problems go away within one month’s time of onset.

Acute low back pain is likely to occur after either acute or repetitive injury/strain that causes degenerative changes to the disc space. It is estimated that 60–80% of the adult population have experienced low back pain. People who work at jobs that involve repetitive bending, or prolonged stooping, sitting, or vibrational stress appear to have more frequent episodes of low back pain. However, job dissatisfaction, previous low back problems, or personal problems all have been found to be contributing factors in low back pain disability.

Acute low back pain is defined as restriction of normal activities due to back-related problems, which lasts less than 3 months. Back symptoms include back pain and/or leg pain (sciatica). Similar pain that becomes chronic (lasting more than 3 months), is associated with other physical illness, or occurs in persons less than 18 years of age may be quite different and require different treatment. Again, the good news about low back pain is that 9 out of 10 persons have resolution of their symptoms over a 4 to 6 week time period.

Some specific causes of acute low back pain are believed to involve the following:

1) Muscle or soft tissue strain — This involves a stretch-type injury of the musculature that controls the postural support of the spine.
2) Intervertebral disc injury — This involves a strain type injury to a lumbar disc, which may involve either the disc structure, adjacent ligaments, and/or associated facet joints.
3) Annular tear of the intervertebral disc — This involves specific injury to the ligament structure of the disc (similar to a ligament tear of the knee joint).
4) Disc herniation — This is a rupture of the substance that makes up a portion of the intervertebral disc, often associated with annular tears of the disc; as a result, disc material can cause compression and irritation of local nerve structures.
5) Aggravation of underlying degenerative conditions of the spine — This is injury to underlying arthritic changes to the lumbar spine.
6) Discogenic low back pain — This condition is believed to involve persistent pain generation due to premature aging of a disc space often due to several factors (genetics, environmental and work stresses, injury).
7) Spinal stenosis — This condition usually occurs in individuals over the age of 50, often in persons who have experienced years of chronic low back pain, and often involves gradually worsening leg pain and symptoms of leg fatigue and activity intolerance.

Christiaan Janssens
CRO

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