If you have low back pain, you are not alone. At any given time, about 25% of people in the United States report having low back pain within the past 3 months. In most cases, low back pain is mild and disappears on its own. For some people, back pain can linger, leading to a decrease in quality of life or even to disability.

In fact, low back pain is considered an international health problem with enormous economic and social costs. In the United States, the treatment cost of back pain is estimated to be $86 billion per year or 9% of the country's total health expenditure.

Symptoms

The symptoms differ among individuals and can vary over time. The symptoms of low back pain might be dull, burning, or sharp. Pain might be at a single point or over a broad area. It might be accompanied by muscle spasms or stiffness. Sometimes, it might spread into one or both legs.

There are 3 different types of low back pain:

Most people who have an episode of acute pain will have at least one recurrence.

Often, low back pain occurs due to overuse, strain, or injury. It could be caused by too much bending, twisting, lifting—or even too much sitting. But just as often, the actual cause of low back pain isn't known, and symptoms usually resolve on their own.

Certain conditions can contribute to low back pain. These include

Evaluation

Generally a physical therapist will perform a complete evaluation that includes:

For most cases of low back pain, imaging tests such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are not helpful for diagnosing the cause. However, if the physician or physical therapist suspects that your low back pain might be caused by a serious health condition, they will refer you to other health care professionals for evaluation.

Treatment

Not all low back pain is the same, so your treatment should be tailored to for your specific symptoms and condition. Once the examination is complete, a physical therapist will evaluate the results, identify the factors that have contributed to your specific back problem, and design an individualized treatment plan for your specific back problem. Treatments may include:

Prevention

It may not be possible to prevent low back pain. We cannot avoid the normal wear and tear on our spines that go along with aging. But there are things we can do to reduce the impact of back problems. Exercise, proper lifting, maintaining a healthy weight, and proper posture are all measures that help promote a healthy lower back.

Recent research (Fritz, Childs, Flynn, 2005) in physical therapy (Fritz, Childs, Flynn, 2005) shows that certain subgroups treated within 16 days of injury can have significantly improved response and are less likely to have low back pain become chronic condition. In many cases it might be better when experiencing acute pain to go in early for therapy rather than wait to see if it becomes chronic.

The good news is that in many cases acute low back pain is gone after a few weeks. For those injuries that extend into months and become chronic, management through mutli-disciplinary approach with an orthopedic doctor, physical therapy, and other health care providers often can have significant impact on the quality of life.

Fritz, J.M., Childs, J.D., and Flynn, T.W. (2005). Pragmatic application of clinical prediction rule in primary care to identify patients with low back pain with a good prognosis following a brief spinal manipulation intervention. BMC Family Practice 2005,6:29.