Key facts
- In 2020, low back pain (LBP) affected 619 million people globally and it is estimated that the number of cases will increase to 843 million cases by 2050, driven largely by population expansion and ageing (1).
- LBP is the single leading cause of disability worldwide and the condition for which the greatest number of people may benefit from rehabilitation.
- LBP can be experienced at any age, and most people experience LBP at least once in their life.
- Prevalence increases with age up to 80 years, while the highest number of LBP cases occurs at the age of 50–55 years. LBP is more prevalent in women (2).
- Non-specific LBP is the most common presentation of LBP (about 90% of cases).
What is lower back pain?
Low back pain (LBP) describes pain between the lower edge of the ribs and the buttock. It can last for a short time (acute), a little longer (sub-acute) or a long time (chronic). It can affect anyone.
LBP makes it hard to move and can affect quality of life and mental well-being. It can limit work activities and engagement with family and friends.
LBP can be specific or non-specific. Specific LBP is pain that is caused by a certain disease or structural problem in the spine, or when the pain radiates from another part of the body.
Non-specific LBP is when it isn’t possible to identify a specific disease or structural reason to explain the pain. LBP is non-specific in about 90% of cases.
In all types and at all stages of LBP, rehabilitation is essential to reassure people and help them make sense of their pain, help them return to activities they enjoy and identify strategies to support recovery and improve function. Specialized care pathways may be needed for specific LBP.
An estimated 619 million people live with LBP and it is the leading cause of disability worldwide. LBP is a major public health issue. LBP is often associated with loss of work productivity and thus produces huge economic burden on individuals and on societies.
Scope of the problem
Low back pain (LBP) has the highest prevalence globally among musculoskeletal conditions and is the leading cause of disability worldwide. It is the condition where the greatest number of people may benefit from rehabilitation.
People at any age can experience LBP, including children and adolescents. Most people experience LBP at some point in their lives. The peak in the number of cases occurs at 50–55 years, and women experience LBP more frequently than men. The prevalence and disability impact of LBP are greatest among older people aged 80–85 years. Recurrent LBP episodes are more common with ageing.
Chronic LBP is a major cause of work loss and participation restriction and reduced quality of life around the world. Considering the high prevalence, LBP contributes to a huge economic burden on societies. It should be considered a global public health problem that requires an appropriate response.
Signs and symptoms
Low back pain can be a dull ache or sharp pain. It can also cause pain to radiate into other areas of the body, especially the legs.
LBP can restrict a person’s movement, which can affect their work, school and community engagement. It can also cause problems with sleep, low mood and distress.
LPB can be acute (lasting under 6 weeks), sub-acute (6–12 weeks) or chronic (over 12 weeks).
In most cases of acute LBP, symptoms go away on their own and most people will recover well. However, for some people the symptoms will continue and turn into chronic pain.
People with LBP may also experience spine-related leg pain (sometimes called sciatica or radicular pain). This is often described as a dull sensation or a sharp, electric shock feeling. Numbness or tingling and weakness in some muscles may be experienced with the leg pain.
When associated with LBP, radicular signs and symptoms are often due to involvement of a spinal nerve root. Some people may experience radicular symptoms without LBP, when a nerve is compressed or injured distal to the spinal column.
All these experiences affect well-being and quality of life and often lead to loss of work and retirement wealth, particularly in those who experience chronic symptoms.
Lower back pain causes
There are many common causes of lower back pain, including underlying chronic conditions.
Muscle sprains or strains
The muscles and ligaments in the back can stretch or tear due to excess activity. Sudden movements can also cause sprains or strains.
Symptoms include pain and stiffness in the lower back as well as muscle spasms.
Herniated disc
The discs in the back are prone to injury, and this risk increases with age.
The outside of the discs can tear or herniate.
A herniated disc is also known as a slipped or ruptured disc. It occurs when the cartilage surrounding a disc pushes against the spinal cord or nerve roots. The cushion that sits between the spinal vertebrae extends outside its usual position. This can result in the nerve root becoming compressed as it exits the spinal cord and vertebrae.
Possible causes include trauma and degenerative changes over time. Without treatment, pain from a herniated disc will typically last up to 6 weeks.
Sciatica
The sciatic nerve connects the spine to the legs.
If a herniated disc presses on the sciatic nerve, sciatica can occur. Sciatica can cause leg or foot pain that usually feels like burning, or pins and needles.
Spinal stenosis
Spinal stenosis causes the spaces in your spine to narrow, putting pressure on the spinal cord and spinal nerves.
Spinal stenosis is commonly associated with the degeneration of the discs between the vertebrae. The result is compression of the nerve roots or spinal cord by bony spurs or soft tissues, such as discs.
Pressure on the spinal nerves causes symptoms such as:
- Numbness
- Weakness
- Cramping
You might feel these symptoms anywhere in the body. Many people with spinal stenosis notice their symptoms worsen when they stand or walk.
Unusual spine curvatures
Conditions that cause unusual curvatures in the spine include:
- Scoliosis
- Lordosis
- Kyphosis
These conditions are often present at birth and are usually first diagnosed during childhood or adolescence.
The unusual curvature can cause pain and poor posture because it places pressure on the:
- Muscles
- Tendons
- Ligaments
- Vertebrae
However, some people may not have any symptoms.
Other conditions
Several other conditions can cause lower back pain. They’re usually accompanied by additional symptoms.
They include the following conditions, all associated with musculoskeletal pain:
- Arthritis: Arthritis is inflammation of the joints.
- Fibromyalgia: Fibromyalgia is long-term pain and tenderness in the joints, muscles, and tendons.
- Spondylitis: Spondylitis is an autoimmune disease that causes inflammation. It’s a form of arthritis.
- Spondylosis: Spondylosis is also a form of arthritis. This degenerative disorder may cause the loss of normal spinal structure and function. Although aging is the primary cause, the location and rate of degeneration will vary by individual.
Other health conditions that can cause lower back pain include:
- Kidney and bladder problems, including kidney infections
- Pregnancy
- Endometriosis
- Ovarian cysts
- Uterine fibroids
- Spinal cord misalignment
- Spinal infections
- Cancer, such as cancer of the spinal cord
Diagnosis of lower back pain
A doctor will likely begin by requesting a complete medical history and conducting a thorough physical exam to determine where you’re feeling the pain. The physical exam can also reveal whether the pain affects your range of motion.
In addition, a doctor may check your reflexes and responses to certain sensations. This helps them determine if your lower back pain is affecting your nerves.
Unless your symptoms are concerning or you have neurologic loss, a doctor will probably monitor your condition for a few weeks before sending you for more testing. This is because most lower back pain resolves with simple self-care treatments.
Symptoms that require more testing include:
- Weakness
- Unintentional weight loss
- Fever
- Lack of bowel control
Seek medical attention immediately if you experience any of these symptoms in addition to lower back pain.
Acupuncture for back pain
The good news is chronic low back pain is one of the conditions that research suggests acupuncture may be an effective tool for treating.
One recent review of 22 acupuncture studies showed that it provided short-term relief from chronic back pain. It also showed there was greater improvement in pain for people who got acupuncture compared to those who received a “sham” treatment. Other studies have found, though, that sham acupuncture can be as effective as actual acupuncture. Those studies also found that, compared to standard treatment, both actual acupuncture and sham acupuncture are more effective.
Guidelines from the American Pain Society and American College of Physicians say doctors should consider acupuncture as an alternative therapy for patients with chronic low-back pain that’s not helped by conventional treatment.
How acupuncture appears to help back pain
Acupuncture began in China more than 2,500 years ago. It involves inserting thin needles at certain points on the body. According to traditional Chinese medicine, the body has more than 2,000 of these points. They are connected by pathways or meridians, which create a flow of energy called Qi (pronounced “chee”). Stimulating these points is said to correct the imbalance of qi and improve the flow of energy. Practitioners believe that this helps relieve pain and improve health.
It’s thought the effects come from stimulating the central nervous system. This may trigger the release of chemicals into the muscles, spinal cord, and brain. These chemicals either alter the experience of pain or produce bodily changes that promote a sense of well-being.
Other theories suggest acupuncture works by:
- Speeding the relay of electromagnetic signals. This may begin the flow of pain-killing chemicals such as endorphins. Or it may release immune system cells in the body.
- Triggering the release of natural opioids. These are chemicals in the brain that may lessen pain or promote sleep.
- Changing brain chemistry by altering the release of neurotransmitters and neurohormones. Neurotransmitters either stimulate or dampen nerve impulses. Neurohormones can affect the function or activity of an organ in the body.
Lower back acupuncture points
If you have pain in the lower part of your back, known as the lumbar area, an acupuncturist may target energy points in the following areas:
- Hip points
- Lower back points
- Hand points
- Foot points
- Backs of the knees
- Stomach points
Possible side effects & Risks
Acupuncture from a qualified practitioner is generally very safe, though some Individuals may experience mild, short-term side effects. These may include:
- Pain at the site of insertion
- Bleeding or bruising at the site of insertion
- Nausea
- Dizziness or lightheadedness
- Drowsiness
Serious side effects, such as an infection or punctured lung, are rare.
People with one or more of the following should notify the acupuncturist before receiving acupuncture:
- A bleeding disorder, such as hemophilia
- A metal allergy
- A preexisting infection in the area the acupuncturist will insert needles
A person should also inform their acupuncture practitioner if they are pregnant, as certain acupuncture points are unsafe to treat during pregnancy.
How to prevent lower back pain
There are many ways to prevent lower back pain. Taking these measures may help prevent pain altogether or lessen the severity of your symptoms if you manage to get injured.
Prevention may involve:
- Exercising the muscles in your abdomen and back
- Losing weight if you have overweight
- Lifting items properly by bending at the knees and lifting with your legs
- Maintaining proper posture
You may also want to:
- Sleep on a firm surface
- Sit on supportive chairs that are adjusted to the correct height
- Avoid high-heeled shoes
- Quit smoking if you smoke, since nicotine causes spinal disc degeneration and reduces blood flow
Fuji Wellness has skilled acupuncturists available to treat lower back pain caused by injuries and degenerative conditions. To learn more about how acupuncture and other conventional treatments help relieve pain and improve physical functioning, call 8190-8508-2507 or request an appointment online.
- Address: 132-0031 Matsushima 1-chome, 21-14, Tokyo, Japan
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