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Low Back Pain (lumbago) - Diagnosis


Complications
Prognosis
Images


Risk factors|
 risk factor is something that increases your chances of having back pain. Having more risk factors means you have a higher chance of having back pain.
Anyone can develop back pain, even children and teens. Research has yet to prove what contributes to back pain. However, these factors might put you at greater risk of developing back pain:
Age. Back pain is more common as you get older, starting around age 30 or 40.
Lack of exercise. Weak, unused muscles in your back might lead to back pain.
Excess weight. Carrying too much weight puts extra stress on your back.
Diseases. Some types of arthritis and cancer can contribute to back pain.
Improper lifting. Using your back instead of your legs can lead to back pain.
Psychological conditions. People prone to depression and anxiety appear to have a greater risk of back pain.
Smoking. This can keep your body from delivering enough nutrients to the disks in your back.
Risk factors you can change with lifestyle changes
Doing a job or other activity that requires long periods of sitting, heavy lifting, bending or twisting, repetitive motions, or constant vibration, such as using a jackhammer or driving certain types of heavy equipment
Smoking. People who smoke are more likely than people who don't smoke to have low back pain.
Being overweight. Excess body weight, especially around the waist, may put strain on your back, although this has not been proved. But being overweight often also means being in poor physical condition, with weaker muscles and less flexibility. These can lead to low back pain.
Having poor posture. Slumping or slouching on its own may not cause low back pain. But after the back has been strained or injured, bad posture can make pain worse. "Good posture" generally means your ears, shoulders, and hips are in a straight line. If this posture causes pain, you may have another condition such as a problem with a disc or bones in your back.
Being under stress. Stress and other emotional factors are believed to play a major role in low back pain, particularly chronic low back pain. Many people unconsciously tighten their back muscles when they are under stress.


Diagnosis|
The causes of low back pain can be complex, and there are many structures in the spine that can cause pain. Doctors will ask patients to describe the location, severity and type of pain, in addition to the history of the pain: when the patient started to feel it, and any activities or positions that make the pain better or worse.
Classification
A diagnosis will typically classify the patient’s condition as one of three types of pain.
Axial low back pain.  This is the most common type of back pain, is confined to the lower back and does not travel into the buttocks or legs. The pain can be sharp or dull, and can be severe enough to limit everyday activities, such as standing and walking. It usually worsens with certain activities (such as sports) or physical positions (such as sitting for long periods) and is relieved by rest. Most low axial back pain is acute – meaning it is short-lived and heals within six to 12 weeks – but can last longer and become chronic.
Lumbar radiculopathy (sciatica). It’s the second most common type of pain caused by a lower back problem. Caused by conditions that compress the nerve roots of the sciatic nerve, the pain is more severe in the leg than in the back. Symptoms are pain, numbness and/or weakness that is felt in the lower back (if at all) and on only on one side of the lower body, affecting the buttock, leg, foot, or the entire length of the leg.
Low back pain with referred pain. This is pain in the lower back that also radiates to the groin, buttock and upper thigh, but rarely below the knee. Patients describe the pain as dull and achy with varying intensities. Low back pain with referred pain is similar to axial pain and is managed with similar treatments.
Tests
If there is reason to suspect a specific condition may be causing your back pain, your doctor may order one or more tests:
X-ray. These images show the alignment of your bones and whether you have arthritis or broken bones. These images alone won't show problems with your spinal cord, muscles, nerves or disks.
MRI or CT scans. These scans can generate images that may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
Blood tests. These can help determine whether you have an infection or other condition that might be causing your pain.
Myelogram. Allows identification of problems within the spine, spinal cord and nerve roots. An injection of contrast dye illuminates the spine prior to an x-ray or CT scan
Bone scan. In rare cases, your doctor may use a bone scan to look for bone tumors or compression fractures caused by osteoporosis.

Nerve studies (electromyography, or EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).

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