Signs Symptoms and Causes of Common Back Pain

Almost everyone will experience some form of back pain in their lifetime. The lower back is the area behind the abdomen from the ribs to the pelvis and is also called the lumbar region.

Back pain is the leading cause of work disruption during the pandemic. Being at home without a comfortable chair to work in can undoubtedly cause low back pain.

1. Definition

Low back pain is a condition when there is pain or discomfort in the lower back, starting from below the costa to the lower crease of the buttocks but without pain radiating to the legs.

If not treated properly, low back pain can reduce lumbar mobility so that there will be limited movement and interfere with activities.

2. Signs and Symptoms

Low back pain can be mild or severe. It can also occur suddenly, or it can be slow, so it comes and goes but gradually gets worse over time.

Depending on the underlying cause of the pain, symptoms can be experienced in different ways, such as: 

• Pain or soreness in the lower back area
• Stinging, burning pain that radiates from the lower back to the back of the thigh, sometimes to the lower leg or foot; may include numbness or tingling (pegel sciatica)
• Muscle spasms and tightness in the lower back, pelvis and hips
• Pain that worsens after prolonged sitting or standing
• Difficulty standing upright, walking, or transferring from standing to sitting

In addition, the symptoms of low back pain also differ according to severity, namely: 

• Acute low back pain: usually comes on suddenly and lasts for a few days or weeks. This condition is considered the body's normal response to injury or tissue damage. The pain gradually subsides as the body heals.
• Subacute low back pain: generally lasts between 6 weeks and 3 months and is usually mechanical in nature (such as muscle strain or joint pain) but prolonged. At this point, a medical examination may be considered, and is recommended if the pain is severe and interferes with activities. 
• Chronic low back pain: lasting more than 3 months, this type of pain is usually severe, does not respond to initial treatment, and requires a thorough medical examination to determine the exact source of the pain. 

3. Causes

Here are some of the causes of low back pain:

The most common cause of low back pain is a torn or pulled muscle or ligament. This can be in the form of a sprain or strain of the lower back can happen suddenly, or it can develop slowly over time due to repetitive movements.

Strains occur when a muscle is stretched too far and tears, damaging the muscle itself. In addition, it can also be due to sprains that occur when overstretching and tearing affects the ligaments, which connect bones together.

Sprains and strains that trigger lower back pain can be caused by a number of factors such as:

• Lifting heavy objects, or twisting the spine while lifting
• Sudden movements that put too much pressure on the lower back, such as falls
• Poor posture over time
• Sports injuries, especially in sports that involve twisting or large impact forces 

In addition, pain is considered chronic once it lasts more than three months and exceeds the body's natural healing process. Chronic pain in the lower back often involves disc problems, joint problems, and/or irritated nerve roots. 

Some of the conditions that cause this are: 

• Lumbar disc hernia 
• Degenerative disc disease 
• Joint dysfunction 
• Spinal stenosis 
• Spondylolisthesis 
• Osteoarthritis
• Deformity 
• Trauma 
• Compress fracture 
• Infection
• Tumors
• Autoimmune disease

4. Treatment

Usually, low back pain will improve with bed rest, medication, braces (lumbar corset), and physiotherapy, only about 1 - 2% require surgery. 

Surgery will be performed especially in conditions of herniation (HNP) or decreased motor and sensory function of the lower limbs. 

When it comes to low back pain, physiotherapy is a treatment that is often recommended for all ages. The goal is to maintain, improve, restore function, and dependence when individuals experience impaired ability to move and function or problems caused by physical damage. 

In conditions of low back pain, the role of physiotherapy is to reduce pain, increase the elasticity of the back muscles, restore functional activities using the modalities possessed.

Often someone who has experienced low back pain will be affected again in the future. This occurs due to weakness of the muscles of the back and abdomen after low back pain. 

The weakness of the lower back muscles is what triggers the onset of pain in the future.

Exercise therapy is certain movements designed to retrain the strength of the back and abdominal muscles, so that their elasticity returns. The movements or exercises are adjusted to the causative factors of low back pain, inappropriate movements can aggravate the complaints and conditions of the patient.