Low back pain

Abstract

Low back pain is an important public health problem. It is a relatively frequent clinical condition among active population. Chronic or acute low back pain is among the most frequent diagnosis that make people miss their work. Back pain is found also among the elderly. The exceptionally complex anatomical structure of the lumbar segment makes it prone to injuries and overstrain, as the main causes of pain symptoms. From the biomechanical point of view it is the spinal segment which is responsible for large amplitude motions (flexion and extension, lateral banding and axial rotation), which means that this segment is subject to great force i.e. strain (axial weight and lifting). All these factors may lead to injuries. Pain can be caused by changes and loss of integrity of all anatomical structures of the lumbar segment (vertebra, fasset joint, sacro-iliacal joint, muscles or ligaments). More often, the main spine problem is intervertebral disc disease (disc herniation), with compression effect on spinal nerve roots and medula. In these case, the leading symptom is sciatica (radiculopathy). Along with the above mentioned spinal conditions, there is also need to consider other possible problems associated with back pain (tumors, infections, trauma, kidney diseases). The treatment of back pain/radiculopathy is almost always conservative and in the majority of patients it leads to complete recovery. If back pain starts to be chronic, this requires neuroradiologic analysis, with surgical treatment being also an option.