No area presents more of a problem to doctors than the back. Second only to head pain, disabling low back pain strikes 80 per cent of us during our lifetimes, causes millions of lost work days and accounts for a steady stream of presentations to general practitioners.
In spite of endless research into its diagnosis, causes and treatment, doctors seem no nearer to understanding back pain than they ever were. Today, misdiagnosis or unproven and aggressive treatment with drugs and surgery contributes more to the problems of back pain sufferers than they do to the solutions.
There are many possible causes of back pain, and low back pain in particular, ranging from posture, stress, damage from exercise or lifting, pharmaceutical drugs, and being overweight. Although a large proportion of back pain appears to come on spontaneously, often it's the result of insults and traumas to the body over a period of months or years. Occasionally, the pain is caused by functional problems: slipped, ruptured or herniated discs, pinched or otherwise compromised nerve roots, or fused or deteriorating vertebrae. For a significant number, the cause of back pain is never found.
Here is a comprehensive list of the most recognised causes:
- Previous history of low back pain
- Radiating leg pain
- Signs of nerve root involvement
- Vascular problems
- Reduced straight leg raising
- Reduced trunk muscle strength and endurance
- Poor physical fitness
- Heavy smoking
- Low job satisfaction
- Psychological distress, especially depressive symptoms
- Heavy physical work at home or in job
- Birth (or surgical procedure) under epidural anaesthesia