Understanding Low Back Pain and the Lumbar Spine

Low back pain is a leading cause of disability worldwide, affecting nearly 619 million people globally in 2020, with that number projected to rise to over 843 million by 2050, according to the Lancet Rheumatology (Wu et al., 2023). Most low back pain originates in the lumbar spine, the lower portion of the back that bears most of the body's weight and absorbs the forces of movement and posture. When this region becomes dysfunctional, it often results in pain, stiffness, or restricted mobility. Chiropractic care offers a non-invasive, evidence-informed approach to managing and relieving low back pain by targeting its mechanical causes, restoring joint function, and supporting long-term spinal health.

To understand low back pain better lets take a look at the anatomical structures of the low back. The lumbar spine consists of five vertebrae (L1–L5) located between the thoracic spine and the sacrum. These vertebrae are separated by intervertebral discs composed of a tough outer annulus fibrosus and a gel-like inner nucleus pulposus. These discs act as shock absorbers and allow for flexibility in the spine. Surrounding the lumbar spine are ligaments, tendons, and muscles (particularly the erector spinae, multifidus, and quadratus lumborum) that help stabilize the trunk and control motion. The lumbar spine also houses the cauda equina, a bundle of spinal nerves responsible for lower body function.

Because of its mechanical demands and range of motion, the lumbar spine is especially prone to injury and degenerative changes. Dysfunction in this area can irritate spinal nerves, compress discs, or strain soft tissue structures.

Common Causes of Low Back Pain:

There are numerous mechanical, degenerative, and postural causes of low back pain, many of which chiropractic care can address:

  1. Lumbar facet joint dysfunction: Facet joints are small joints at the back of the spine that guide motion. When these joints become irritated or inflamed, they can cause localized pain or referred discomfort. Research has shown that facet joint syndrome is responsible for up to 45% of chronic low back pain cases (Cohen & Raja, 2007).
  2. Disc degeneration and herniation: Age-related disc changes or disc injuries can lead to reduced disc height, bulging, or herniation. This can place pressure on nearby nerves and lead to symptoms such as radiculopathy (sciatica). A study published in The Spine Journal noted that lumbar disc herniation is a leading cause of low back pain in individuals under 50 years old (Jensen et al., 1994).
  3. Muscle strain and ligament sprain: Acute injuries from lifting, twisting, or overuse often lead to muscular strain or ligamentous sprain. These are among the most common causes of acute low back pain and typically respond well to manual therapies (Airaksinen et al., 2006)
  4. Postural imbalances and sedentary behavior: Prolonged sitting, especially with poor posture, can lead to abnormal loading on the lumbar discs and postural fatigue in supporting musculature. Research in Applied Ergonomics has linked sedentary work environments to increased prevalence of low back pain (Lis et al., 2007).
  5. Sacroiliac joint dysfunction: The sacroiliac (SI) joints connect the sacrum to the pelvis. Dysfunction in these joints can mimic lumbar spine pain. According to studies, SI joint dysfunction is responsible for 15–30% of low back pain cases (Forseen & Corey, 2011).

Chiropractic Care for Low Back Pain:

Chiropractic care focuses on diagnosing and treating mechanical disorders of the musculoskeletal system, particularly those involving the spine. Spinal manipulation, also known as a chiropractic adjustment, is one of the primary interventions used to improve joint mobility and reduce pain. Your chiropractor may also utilize soft tissue therapies, exerceis education, dietary counseling, and ergonimic/lifestyle advice to help you see better results and get out of pain more quickly. This multifaceted approach not only addresses pain at its source but also improves spinal biomechanics and functional capacity. 

Given the high global burden of low back pain and the growing interest in non-pharmacologic treatment options, chiropractic care continues to emerge as a reliable, low risk, and evidence supported choice.

Modern Care Chiropractic offers patient-centered, science-informed treatment plans that help patients find relief from low back pain and regain their quality of life

 

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References:

  1. Wu, A., et al. (2023). Global Burden of Disease Study on Low Back Pain. The Lancet Rheumatology.
  2. Cohen, S.P., & Raja, S.N. (2007). Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology.
  3. Jensen, M.C., et al. (1994). Magnetic resonance imaging of the lumbar spine in people without back pain. The New England Journal of Medicine.
  4. Airaksinen, O., et al. (2006). Chapter 4: European guidelines for the management of chronic nonspecific low back pain. European Spine Journal.
  5. Lis, A.M., et al. (2007). Association between sitting and occupational LBP: A review. Applied Ergonomics.
  6. Forseen, S.E., & Corey, A.S. (2011). Diagnostic imaging of back pain. Physical Medicine and Rehabilitation Clinics of North America.
  7. Paige, N.M., et al. (2017). Association of Spinal Manipulative Therapy with Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA.
  8. Qaseem, A., et al. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline. Annals of Internal Medicine.