Conditions InDepth: Low Back Pain and Sciatica

Low Back Pain

Low back pain is an ache or discomfort in the area of the lower part of the spinal column that may radiate down into one or both legs. The lower spinal column consists of small, stacked bones (the vertebrae) that surround and protect the spinal cord and nerves.

Cross-section of Vertebral Canal with Spinal Cord in the Center

© 2008 Nucleus Medical Art, Inc.

There are many possible causes for low back pain, including:

  • Sprain or strain of muscles or ligaments in the area
  • Herniated disc or ruptured disc – The cushions between the bones of the spine bulge out of place as a result of age-related changes or trauma.
  • Disc degeneration – caused by arthritis or by the wear and tear of living plus aging
  • Lumbar spinal stenosis – bony narrowing of the spinal canal in the low back area
  • Spondylolisthesis – slippage of one bone over another, causing stretching or pinching of nerves
  • Fractures due to trauma or osteoporosis
  • Fibromyalgia – a condition that causes muscle aches and fatigue
  • Ankylosing spondylitis – a disorder that causes spine stiffness and arthritis (believed to be hereditary)
  • In rare cases,
    • Benign or malignant tumors
    • Infections
    • Arterial problems, such as hardening of the arteries

Lumbar Disc Herniation With Pinching of Spinal Nerve

© 2008 Nucleus Medical Art, Inc.

Sciatica

Sciatica is irritation of the sciatic nerve, which passes from the spinal cord to the buttocks down the back of each thigh. The sciatic nerve is composed of several nerve roots that arise from the lower spine on each side of the spinal column. These nerve bundles travel deep in the pelvis to the lower buttocks. From there, the nerve passes along the back of each upper leg and divides at the knee into branches that go to the feet.

Sciatica typically causes pain that shoots down the back of one thigh or buttock. Anything that causes irritation or puts pressure on the sciatic nerve can cause sciatica, including:

  • Herniated disc (ruptured or slipped disc)
  • Disc degeneration
  • Spinal stenosis
  • Spondylolisthesis
  • In rare cases:
    • Benign or malignant tumors
    • Infections

Low back pain is very common, affecting four out of five adults at some point in their lives. Every year, about 15% of the adults in the United States will experience back pain. Most back pain gets better with time; about 5% to 10% of patients will continue to have pain for longer than three months.

What are the risk factors for low back pain and sciatica?
What are the symptoms of low back pain and sciatica?
How are low back pain and sciatica diagnosed?
What are the treatments for low back pain and sciatica?
Are there screening tests for low back pain and sciatica?
How can I reduce my risk of low back pain and sciatica?
What questions should I ask my healthcare provider?
What is it like to live with sciatica?
Where can I get more information about low back pain and sciatica?

Sources:

Conn's Current Therapy 2001 . 53rd edition. W.B. Saunders Company; 2001.

National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/ .

Textbook of Primary Care Medicine . 3rd edition. Mosby, Inc.; 2001.



Last reviewed February 2007 by Barbara Harty-Golder, MD, JD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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