More than 80 percent of adults will experience lower back pain at some point in their lives.1 It is the single most common cause of disability worldwide 2 and the second most common cause of adult disability in the United States. 3
Most cases of lower back pain have abenign clinical course which resolves with conservative care such as rest, activity modification, anti-inflammatories, heat or ice therapy, and physical therapy. Some, however, will develop chronic low back pain or pain that lasts for 3 months or longer.
Common Causes of Chronic Lower Back Pain
Arthritis. Osteoarthritis of the spine is a condition where there is degeneration of the joints, discs, and bones in the spine as people age. Arthritis can lead to bone spurs which result in the narrowing of the space around the spinal nerves and spinal cord, a condition called spinal stenosis.
Facet joint dysfunction: This occurs when the facet joints, the small joints that connect the individual bones in the spinal column, get inflamed or when the cartilage in the joints becomes injured or worn out. They can also get out of normal alignment, a condition called spondylolisthesis.
Bulging or Ruptured Disc: The discs are soft, gel-filled structures that act as a cushion or shock absorbers between the vertebral bones in your spine. When these discs become injured, they can bulge out and can put pressure on neighboring nerves causing pain. As people age, discs lose their hydration and wear down leading to degeneration. Degenerative discs can develop tears and collapse which causes low back pain, muscle spasm, or spinal stenosis.
Other less common causes of low back pain include spinal cord problems, scoliosis, fracture, and non-spine sources like tumors and kidney stones. It is important that your physician perform a comprehensive evaluation of your medical history and physical examination to give you an appropriate diagnosis for your back pain.
Patients who have failed standard treatments or are seeking alternatives to spine surgery for back pain should consider Regenerative therapies. These advanced treatments involve the use of your own cells to help your body heal faster. They avoid the risks and long-term complications associated with surgery and reduce pain to help you maintain an active lifestyle. Read about these regenerative treatment solutions here.
Sauver, JL et al. Why patients visit their doctors: Assessing the most prevalent conditions in a defined American population. Mayo Clinic Proceedings, Volume 88, Issue 1, 56–67.
Hoy D, March L, Brooks P, et al The global burden of low back pain: estimates from the Global Burden of Disease 2010 study Annals of the Rheumatic Diseases Published Online First: 24 March 2014. doi: 10.1136/annrheumdis-2013-204428
From the Centers for Disease Control and Prevention, Prevalence of disabilities and associated health conditions among adults—United States, 1999. JAMA 2001;285 (12) 1571- 1572
The human spine is composed of 24 individual bones called the vertebrae. In between these bones are the intervertebral discs, which are gel filled structures that act as shock absorbers. They consist of a tough outer layer called the annulus fibrosus that protects the disc’s gel-like interior, the nucleus pulposus. In thelower back, the discsare a little more than a third of an inch (10 millimeters) thick and about 1.5 inches (four centimeters) in diameter.[i]
A bulging disc or herniated disc occurs when the outer layer of the disc weakens and tears. This can cause the inner gel to bulge out to the spinal canal and affect the nearby nerves causing back pain, leg pain or muscle spasm. The disc tear can also cause leakage of materials into the spinal canal that can cause inflammation and pain.
Herniated discs most often occur in the lower back but can occur anywhere in the spine, including the neck and the midback. The location of the herniated disc often determines where the patient will feel symptoms of pain, tingling, numbness or weakness. Bulging discs in the lumbar spine can result in pain in the low back, buttocks, thighs, legs and feet. On the other hand, if your herniated disc is in the cervical spine, pain can be felt in the neck, shoulders, arms and hands.
What Causes a Herniated Disc?
Disc herniation can occur due to injury or age-related wear and tear.As people age, the disc nucleus pulposus loses hydration, wears down and leads to degeneration.Other factors may increase the risk of developing a herniated disc. These include:
Repetitive lifting, pulling, pushing, bending and twisting
Increased height (tall people)
Smoking (decreases blood supply to the disk leading to degeneration)
A thorough medical history and physical examination can lead to the diagnoses of disc herniation.An MRI of the spine is an imaging modality that reveals herniated discs and other structural abnormalities of the spine.
The treatment for most cases of mild to moderate herniated discs involves conservative measures which include the following:
Activity modification: Avoid repetitive twisting, bending or lifting.Do not sit or stand for extended periods of time.
Physical therapy to strengthen your trunk, arm and leg muscles that support the spine.
Medications: Anti-inflammatory medications such as ibuprofen or naproxen, muscle relaxers, or pain killers
Ice packs or heating pads
Alternative therapies such as acupuncture, massage or gentle chiropractic manual therapies to manage pain.
When conservative measures fail to provide symptomatic relief, a board-certified spine specialist can offer injection treatments that do not require hospitalization and provide a more rapid recovery than surgery.
Epidural corticosteroid injection is a treatment that delivers steroid, a powerful anti-inflammatory medication, directly to the source of pain.This is performed using fluoroscopic (x-ray) guidance. This treatment can provide immediate relief of pain.The number of treatments is limited as repetitive steroid use could result to tissue damage, hormonal irregularities, osteoporosis and decreased immune response.
Cell-based therapies can treat disc degeneration and tears that are traditionally managed with medications or surgery. These treatments have been shown to increase disc hydration and disc cell proliferation, decrease inflammation, increase disc support tissue and assist in tissue healing. These therapies involve obtaining the patient’s own healthy cells and delivering them to the injured disc where they can jump start the body’s own regenerative healing processes.
Platelet Rich Plasma uses platelets in the blood that release growth factors and proteins to promote tissue repair, while the plasma carries the hormones, electrolytes and nutrients required to nourish cells during the healing process.
Cell Based Therapies use cells derived from the patient’s own bone marrow. Bone marrow contain adult stem cells that have the unique ability to develop into the specific kind of cells, including anulus and nucleus pulposus cells. They also contain many other healing cells and molecules that direct other cells in the area to form new blood vessels, awaken stem cells and produce collagen or other proteins essential for creating healthy new tissue.
Patients considering regenerative treatments such as these cell therapies need to know that the U.S. Food and Drug Administration (FDA) does not currently allow the use of stem cells derived from birth tissue products such as amniotic fluid or umbilical cord blood to treat orthopedic conditions. These donor products do not contain live stem cells and have not been tested for safety or efficacy.
Candidates for Cell-Based Therapies for Herniated Discs
The success of cell-based treatments for herniated discs is dependent upon the severity of your condition and your overall health. Cell-based treatments are not suitable for those who have active cancer, infection, history of blood disease, or are pregnant.
Cell-based therapies are giving new hope for long-lasting pain relief to many patients with injured discs. It is important that you take an active role in your healing and recovery with good nutrition and a commitment to overall fitness to achieve the best outcome.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group together have successfully treated thousands of patients with interventional spine proceduresand cell-based treatments for more than three decades. They are published authors and cell therapy researchers. Their facility in Carlsbad contains the most advanced Regenerative Medicine technology in San Diego and offers same- day treatments with the highest level of safety and efficacy.
Lower back pain is very common among Americans. In fact, an estimated 80 percent of people living in the United States will experience lower back pain at some time in their lives. While there are some ways to prevent it, eventually, everyone will have to face the possibility of developing the condition. Here are the most common risk factors for developing lower back disc pain.
Unfortunately, more people are spending more time sitting than any other time in history. Prolonged sitting without a stretching break can lead to strain of the ligaments and discs in your lower back leading to tissue injury. An interesting research study performed in India showed that farmers rich enough to own a tractor were three times more likely to develop disc degeneration and lower back pain than the farmers who plowed their fields with an ox and plow. You are most likely sitting as you read this. Go ahead, stand up and give your back a break.
There’s a reason why mom told you to sit up straight when you were a kid. Not only does poor posture look bad, but it also puts a strain on your back which can lead to back pain. If bad posture is a habit for you, here’s a simple trick you can do to help. Instead of sitting back in your chair at work or the dinner table, sit at the edge instead. It’s much harder to slouch in this position. The natural arch in your lower back is designed to protect it. Try to maintain this healthy arch for as long as possible.
De-conditioning of the Lower Back Muscles
The muscles of the spine are designed to protect the joints, ligaments and discs of your lower back. Prolonged sitting, poor posture and de-conditioning all combine to increase the risk of lower back pain. Almost all forms of exercise will maintain the strength and endurance of these muscles, but exercises that focus on these muscles are more effective. One research study showed that patients who did not restore the health of their muscles after back surgery for a herniated disc were eight times more likely to develop lower back pain in the future. Other studies have shown that adequate lower back muscle endurance may prevent lower back pain from ever happening in the first place.
Increased age is a risk factor for developing lower back pain. One of the most common causes of chronic lower back pain is disc degeneration. This is not a disease, but something that almost everyone will develop in their life. Studies suggest that up to 80 percent of people aged 50 years and over will have some disc degeneration, even if they have never experienced lower back pain. Disc degeneration decreases the stability of the spine leaving you susceptible to developing a lower back strain or pain.
The work that you do at home or on the job may put you at risk for lower back pain. People who perform constant bending or lifting, such as nurses, are at higher risk as are people who stand on their feet for extended periods of time. As mentioned above, prolonged sitting at work also increases the risk of lower back pain.
Nearly 50 percent of all pregnant women experience lower back pain. Most think that this is solely due to the extra weight of the baby, but there are other reasons that pregnant women experience this pain. One involves the hormone, relaxin, which causes the ligaments in the pelvis to loosen the joints in preparation for birth. One of these joints, the sacroiliac joint, may become more easily strained leading to lower back pain.
Excess weight is not associated with an increased risk of lower back pain. However, people who are overweight or obese have a more difficult time recovering from the injury because it interferes with therapy. Most patients requiring treatment will receive physical therapy, chiropractic care or massage. Occasionally injections to the spine or surgery are required. Patients who maintain a normal weight or are more physically fit respond better to all of these forms of treatment
Many causes of lower back pain are preventable. As with most health conditions, maintaining an ideal body weight, maximizing strength and listening to your body when it’s had enough may be enough to keep you out of trouble.
Regenerative Medicine offers gentle and effective treatments for patients with lower back pain. They facilitate the body’s natural ability to heal itself. Contact us to see if you’re a good candidate for this breakthrough therapy. We want to help you make a change in your life, today.