Introduction- Low back supports weight of upper body and provides mobility for everyday motions such as bending and twisting. Muscles in low back are responsible for flexing and rotating hips while walking, as well as supporting spinal column. Nerves in low back supply sensation and power muscles in pelvis, legs, and feet.
– Are you have acute low back pain?
– Are you Knowing how it happened?
– If no? Then it’s important to know about your body to?

It results from injury to muscles, ligaments, joints, or discs. body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain.
Sometime there is a significant overlap of nerve supply to many of discs, muscles, ligaments, and other spinal structures, and it can be difficult for brain to accurately sense which is cause of pain.
For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in same area. Muscles and ligaments heal rapidly, while a torn disc may or may not.

NOTE: time course of pain helps determine the exact cause.

Are You Sometime suffers with Acute Low Back Pain? Then………..Check it..
Muscle Strain and Ligament Sprain?
1. Understand the common Medical terminologies?
2. Know the Sensitivity and capacity of muscle & ligament?

Muscle Strain and Ligament Sprain-
1. A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.
2. Strains occur when a muscle is stretched too far and tears, damaging muscle itself.
3. Sprains happen when over-stretching and tearing affects ligaments, which connect bones together. it does not matter whether muscle or ligament is damaged, as symptoms and treatment are same.

Common causes of sprain and strain include:
– Lifting a heavy object, or twisting the spine while lifting
– Sudden movements that place too much stress on the low back, such as a fall
– Poor posture over time
– Sports injuries, especially in sports that involve twisting or large forces of impact
While sprains and strains do not sound serious and do not typically cause long-lasting pain, acute pain can quite severe.

Causes of Chronic Lower Back Pain:-
Pain considered chronic once, lasts for more than three months and exceeds body’s natural healing process. Chronic pain in low back often involves a disc problem, joint problem, and/or an irritated nerve root. Common causes include:
Lumbar herniated disc.- Jelly-like center of lumbar disc can break through tough outer layer and irritate nearby nerve root. herniated portion of disc is full of proteins cause inflammation when reach nerve root, and inflammation, as well as nerve compression, cause nerve root pain. Disc wall also richly supplied by nerve fibers, and tear through wall cause severe pain.

Degenerative disc disease.- At birth, intervertebral discs are full of water & at their healthiest. As people age over time, discs lose hydration and wear down. As disc loses hydration, it cannot resist forces as well, and transfers force to disc wall that may develop tears & cause pain or weakening that can lead to herniation. Disc can also collapse and contribute to stenosis.

Facet joint dysfunction- There are 2 facet joints behind each disc at each motion segment in lumbar spine. These joints have cartilage between bones and surrounded by capsular ligament, which richly innervated by nerves. These joints can painful by themselves, or conjunction with disc pain.

Sacroiliac joint dysfunction- Sacroiliac joint connects sacrum at bottom of spine to each side of pelvis. Its strong, low-motion joint primarily absorbs shock & tension between the upper body and the lower body. sacroiliac joint become painful if becomes inflamed (sacroiliitis) , if there is too much / too little motion of joint.

Spinal stenosis- Condition causes pain through narrowing of spinal canal where nerve roots located, narrowing can be central, foraminal, / both, can be at single level or multiple levels in lower back.

Spondylolisthesis- Condition occurs when 1 vertebra slips over the adjacent 1. There are 5 types spondylolisthesis but most common are secondary to defect or fracture of pars (between facet joints) or mechanical instability of facet joints (degenerative). Pain can cause by instability (back) / compression of nerves (leg).

Osteoarthritis- Condition from wear & tear of disc, facet joints- causes pain, inflammation, instability, stenosis to variable degree, can occur at a single level /multiple levels of lower spine. Spinal osteoarthritis is associated with aging & slowly progressive. also referred spondylosis/ degenerative joint disease.

Deformity – Curvature of spine include scoliosis / kyphosis. deformity may be associated with lower back pain if leads to breakdown of discs, facet joints, sacroiliac joints / stenosis.

Trauma – Acute fractures or dislocations of spine can lead pain. Lower back pain that develops after trauma, such as a motor vehicle accident or fall, should be medically evaluated.

Compression fracture – A fracture occurs in cylindrical vertebra, in which bone essentially caves on itself, can cause sudden pain. This type fracture, most common due to weak bones, such as from osteoporosis, and more common in older people.

Dr. Kanchan Kholiya (PT), Assistant Professor, Department of Physiotherapy, Career Point University, Kota

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