The lower back (lumbar spine) is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.
The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.
Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain.
Patients complain of pain (dull or achy, contained to the low back); stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; numbness or tingling in the legs; muscle spasms and tightness in the low back, pelvis, and hips; pain that worsens after prolonged sitting or standing; difficulty standing up straight, walking, or going from standing to sitting.
The most common types of low back pain are:
- Mechanical pain which is the most common cause of lower back pain, mechanical pain (axial pain) is pain primarily from the muscles, ligaments, joints (facet joints, sacroiliac joints), or bones in and around the spine. This type of pain tends to be localized to the lower back, buttocks, and sometimes the top of the legs. It is usually influenced by loading the spine and may feel different based on motion (forward/backward/twisting), activity, standing, sitting, or resting.
- Radicular pain which occurs if a spinal nerve root becomes impinged or inflamed. Radicular pain may follow a nerve root pattern or dermatome down into the buttock and/or leg. Its specific sensation is sharp, electric, burning-type pain and can be associated with numbness or weakness. It is typically felt on only one side of the body.
Photobiomodulation is one of the best treatment options for sub-acute and chronic lower back pain with a significant clinical improvement in the majority of patients.