Evaluating low back pain in patients can be extremely difficult. Thankfully, ninety percent of acute low back pain resolves within 3 months no matter the type of treatment. However, if appropriate pain center treatment is instituted pain relief can potentially be achieved sooner rather than later.

Statistics show that over 30% of the time, medical providers cannot give an accurate low back pain diagnosis with regards to the pain generator. Even with the modern technology in this day and age such as MRI and CT scans and EMG testing, back pain still remains a conundrum in many cases.

The main pain generation categories include infection, tumor, arthritis, soft tissue, trauma, neuropathic, or fracture.

1) Fracture or Trauma – Vertebral Compression Fractures are seen as a result of an axial load on the spinal column. The number 1 cause is osteoporosis, number 2 is a trauma event like an auto accident or a fall. These fractures are typically seen on plain x-rays, and also very easy to see on an MRI. Traumatic injuries also can result in soft tissue sprains/strains with damaged ligaments, tendons, or spinal musculature.

2) Infection – There are 2 regions of infection around the spinal column. One is the vertebra itself, which is called vertebral osteomyelitis. Another cause is infection in the intervertebral disk, which is termed diskitis. Infections are seen post-surgery, post-procedures, and in immunocompromised individuals like diabetics.

3) Tumor – There are multiple tumors that affecting the spine and resulting in lower back pain. Most common, the spine ends up with a tumor from a metastasis from a tumor somewhere else, like the lung or breast. There are some tumors that occur primarily in the spine, such as multiple myeloma.

4) Arthritis – Just as degenerative arthritis occurs in the knee and hip, it also occurs in the spinal column. The spinal joints are called facet joints, and they are similar in size to a thumbnail. The facet joints are located on each side of each level of the spine. For instance the L3-L4 facet joint is the one located between the third lumbar and fourth lumbar vertebra. When arthritis occurs in facet joints, it is called facet syndrome or simply facet arthritis.

5) Soft tissue – The spinal soft tissue areas of the spine entail: Spinal ligaments, intervertebral disc, and also the paraspinal muscles with tendons. Trauma patients may experience spinal ligament injury with resulting pain. Paraspinal muscle strain is very common. Often times the para-spinal mucles will react to other injuries such as fractures, ligament sprains, etc by going into spasm. This is called muscle guarding. Pain from the intervertebral disc itself is a result of disc injury. This may be chronic, termed degenerative disc disease (DDD), or may be more acute. The outside part of the intervertebral disc has pain generating fibers. This region of the disk is termed the annulus and a tear in it may cause a lot of pain in the low back.

6) Neuropathic – This refers to pain emanating from an intervertebral disc herniation that is impinging on a nerve root. The pinched nerve causes pain to radiate down the leg (sciatica) from the inflammation that is sparked up.

Examining a person with lower back pain involves thoroughness and determination with a specific algorhithm. If done correctly, it will give patients the best chance of success by leading to an appropriate treatment regimen that may include a Phoenix Chiropractor or Phoenix Physical Therapy.

The Causes Of Low Back Pain
What is causing my lower back pain?

Yesterday morning my lower back started hurting. I have not injured myself at all, so that is not the cause. Today there is localized heat around the painful area which leads me to think of an infection. I have no fever or any other health problems, I have always been healthy with the exception of the occassional cold/flu. What are some of the causes of lower back pain with heat?
added info – I drink water all day long, approximately 6 16oz glasses throughout the day. I do drink iced tea, but no soda or coffee.

First, yes dehydration is a major cause of back pain, but it does not lead to localized heat around a painful area. But, continue to drink lots of water because this will help you fight whatever you have.

Btw, have you tried Motrin? If you have-did it help? If yes, it is probably muscular in nature. If it did not, think infection.

It could be several things.
1) You could have something that is causing inflammation. Maybe you moved or slept wrong. Inflammation of any sort will cause heat around the area.

2) An infection will definitely cause heat, but usually you will see other signs also. This could be the running of a fever or swollen lymph nodes.
However, an infection of the spine is not something you want to wait a week to get taken care of. It can cause serious irrepairable damage in that time. Spinal infections can cause a lot of damage quickly. If the pain is localized around the spine, I would get it checked out right away.

With both of these, I would personally go to a chiropractor first. They will be able to differentiate between a infection and normal inflammation. He can also correct many of the conditions that cause inflammation. If it is an infection, he should refer you out to the proper medical professional in order to get antibiotics.

REMEMBER- IF it continues to get worse, GET IT LOOKED AT ASAP.
(Muscle strains and inflammation will go away, infections get worse)

Good luck with this.

Chiropractic Adjustment For Lower Back Pain Demonstration by Austin Chiropractic Care

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