Title: Lower left back pain
1Lower left back pain
Low Back pain is a pain in the lower back area
that can relate to problems with the lumbar
region of the spine, the discs between the
vertebrae, the ligaments around the spine and
discs, the spinal cord and nerves, muscles of the
low back, internal organs of the pelvis and
abdomen, or the skin covering the lumbar area. It
is common and nearly inescapable phenomenon.
Nearly 60 of adults will experience an episode
of severe back pain at some point in their
lifetime. Left sided lower back pain is actually
more common than right-sided lower back
pain. Symptoms of lower back pain include a dull
or aching pain often punctuated by periods of
rapid increase in intensity. The pain can travel
down the hip and into the leg. Some will note a
numb of cold sensation in the leg or foot while
others describe a hot-poker type sensation. The
reality is that lower back pain is often
multifactorial in cause.
2Causes and treatment options
A variety of problems can result in lower left
back pain. Treatment of low back pain is
optimally directed toward a diagnosed or
suspected speci?c cause. Some cases are common
strains and overuse type injuries while others
are serious and potentially life threatening. It
is a good idea to visit your doctor who can fully
examine you and evaluate for a potentially more
serious cause.
Lower Back Strain A group of muscles and
ligaments run the length of the spine and provide
support and movement of the spinal column.
Stretching too far or overdoing a physical
activity can strain these tissues. Small tears
can even occur in the tissue causing further
pain. Back strain can also occur as a consequence
of falling, excessive bending or twisting or
lifting heavy objects. Obesity and lack of core
body strength contribute to low back strain. Many
describe the pain of a low back strain as
sti?ness and soreness that worsens with movement,
coughing, laughing and sneezing. It can a?ect one
ore both sides of the back. Treatment of a low
back strain starts by applying ice for 20 minutes
several times a day. OTC anti-in?ammatory
medications such as ibuprofen, naproxen and
Tylenol can provide relief of pain. Follow the
package instructions and take these medications
with food. Visiting a physical therapist can
often help when a back strain is not improving as
expected. Your doctor can recommend a series of
visits with a physical therapist to help you
recover.
3Pregnancy
Low back pain, particularly on the left side, is
common in pregnancy and occurs for several
reasons. As the baby grows in size, the uterus
can compress pain sensi- tive structures
including nerves and Ureters. It is not uncommon
for pregnant patients to complain of pain
traveling down the buttock and leg due to
compression of the sciatic nerve. Hormonal
changes result in soften- ing of ligaments and
this creates additional strain on the pelvic and
low back ligaments. The additional weight of the
growing baby and mother serve to compound the
problem.
To minimize the e?ects of low back during
pregnancy, follow these helpful tips. First, work
to maintain good posture. This will help
strengthen the core muscles and keep the center
of gravity where it belongs. Change positions
frequently and stand with weight balanced over
the feet as opposed to one leg. Avoid wearing
shoes with anything but a minimal heel. Adopt a
side lying position whenever in bed or resting.
Add a pillow between the knees to help ensure
proper spine alignment to minimize strain on the
lower back. Maintain physical activity during
pregnancy. In severe cases, a visit to a physical
therapist may help.
4Herniated Disc and Sciatica
Discs are structures that provide the cushioning
between the bones of our spine. Over time they
wear out, shrink, bulge and even rupture. When
this happens the disc material of is forced out
of its normal position and results in compression
of an adjacent nerve. Nerves are very sensitive
to pressure and intense pain is often the result
of a bulging or herniated disc. When a disc in
the lower back compresses the sciatic nerve the
condition that results is called sciatica. The
pain is usually one-sided and felt down the
buttock, hip and all the way down to the lower
leg or foot. Numbness and severe pain can be
debilitating. Treatment of low back pain from a
herniated disc starts with a conservative
approach using physical therapy, OTC pain
relievers and modifying daily activities to limit
pain. If a person already has numbness or loss of
strength, a more rapid course of treatment is
recommended and may include corticosteroid
injections and advanced imaging such as MRI. For
most patients, the pain associated with a lumbar
herniated disc will resolve with time. The main
goals of initial treatment are to relieve pain
and return the patient back to their normal level
of daily functioning. Additional therapies can
include massage therapy or chiropractic
care. Surgery is generally a last resort but may
be required if numbness and loss of strength are
not quickly restored by conservative therapy.
5Kidney Infection
Kidney infections can cause serious low back pain
on one or both sides. The infection generally
starts in the bladder and travels up to the
kidneys creating swelling, in?ammation and pain.
Fever and nausea can also go along with a kidney
infection. The pain can be dull or intense and is
located in the ?ank area along the spine and
above the hip. The pain is worse with movement or
palpation of the area. Kidney infections require
a visit to a doctor for antibiotic treatment. At
times, hospitalization is needed for intravenous
antibiotic therapy. Be sure to ?nish all the
antibiotic medication and recheck with your
doctor if all symptoms have not
resolved. Occasionally, kidney infections can
reoccur and become chronic. This is usually the
result of an underlying medical condition or
anatomic problem with the urinary tract. In this
case your doctor may refer you to a urinary
surgeon or kidney specialist.
6Kidney Stones
Kidney stones can cause rapid onset of excruci-
ating left- or rightsided pain. Some call kidney
stones "childbirth for men" as the pain can be
that severe, though women are also at risk. The
pain can radiate around the ?ank into the lower
abdomen and down to the groin. A sensation of
urgency to urinate is common for those su?er- ing
from a kidney stone. Blood may appear in the
urine as a consequence of the stone moving in the
urinary tract passageways.
Pain control is the ?rst priority in treating
kidney stones. A combination of
anti-in?ammatories and narcotic pain medication
is often required. Hydration is key drinking
plenty of water and avoiding dehydration can help
pass a kidney stone and prevent new ones from
forming. Large stones may get caught up and not
pass on their own. In this instance a variety of
medical pro- cedures can be used to help pass the
stone. A medical specialist (Urologist) will
decide the best course of treatment. Options
include surgical removal of the stone by going
through the urethra or use of sound waves
(lithotripsy) or a laser to break up
7Spinal Stenosis
This condition results when the spinal canal
begins to narrow and encroach on the spinal cord.
This process occurs in older individuals and is a
result of arthritis, disc herniation and bone
spur formation. Common symptoms include back
pain, numbness, weakness or loss of strength in
one or both legs.
Initial treatment for spinal stenosis is similar
to that of herniated disc management. Pain
control can be accomplished by using
non-steroidal medications, muscle relaxers,
antidepressants and narcotic medications.
Physical therapy can help maintain strength and
mobility as well as improving balance. A trial of
steroid injections can provide long lasting
relief for many, but occasionally surgery is
required. Your doctor may refer you to a spine
surgeon if conservative treatments are not
working, the pain is incapacitating or if you are
experiencing loss of strength and weakness. The
surgical procedure focuses on removing the
pressure exerted on the spinal cord.
8Other causes
A variety of other medical conditions commonly
cause lower back pain on the left side and seeing
your doctor is the best way to sort out the
cause. Examples include ovarian cysts and ?broid
tumors, gastrointestinal problems such as
irritable bowel, peptic ulcer disease or
in?ammation of the pancreas (actute and chronic
pancreatitis). Conditions that result in
imbalance or deterioration of muscles can result
in abnormal mechanical forces being placed on the
spine and surrounding tissues.
9Prevention
Steps to lower the risk of developing low back
pain consist of following Exercise regular
exercise helps build strength as well as keeping
your body weight down. Experts say that
low-impact aerobic activities are best
activities that do not strain or jerk the back.
Before starting any exercise program, talk to a
health care professional. Core-strengthening
exercises exercises that work the abdominal and
back muscles, help strengthen muscles which
protect your back. Flexibility exercises aimed
at improving ?exibility in your hips and upper
legs may help too. Smoking a signi?cantly
higher percentage of smokers have back pain
incidences compared to non-smokers of the same
age, height and weight. Body weight the fatter
you are the greater your risk of developing back
pain. The di?erence in back pain risk between
obese and normal-weight individuals is
considerable. Posture when standing make sure
you have a neutral pelvic position. Stand
upright, head facing forward, back straight, and
balance your weight evenly on both feet keep
your legs straight. Posture when sitting a good
seat should have good back support, arm rests and
a swivel base (for working). When sitting try to
keep your knees and hips level and keep your feet
?at on the ?oor if you cant, use a footstool.
You should ideally be able to sit upright with
support in the small of your back. If you are
using a keyboard, make sure your elbows are at
right-angles and that your forearms are
horizontal.
10Prevention
Lifting things the secret for protecting your
back when lifting things is to think legs not
back. In other words, use your legs to do the
lifting, more than your back. Keep your back as
straight as you can, keep your feet apart with
one leg slightly forward so you can maintain
balance, bend only at the knees, hold the weight
close to your body, and straighten the legs while
changing the position of your back as little as
possible. Bending your back initially is
unavoidable, when you bend your back try not to
stoop or squat, tighten your stomach muscles so
that your pelvis is pulled in. Most important, do
not straighten your legs before lifting
otherwise you will be using your back for most of
the work. Do not lift and twist at the same time.
If something is particularly heavy, see if you
can lift it with someone else. While you are
lifting keep looking straight ahead, not up nor
down, so that the back of your neck is like a
continuous straight line from your spine. Moving
things remember that it is better for your back
to push things across the ?oor, rather than
pulling them. Shoes ?at shoes place less of a
strain on the back. Driving it is important to
have proper support for your back. Make sure the
wing mirrors are properly positioned so you do
not need to twist. The pedals should be squarely
in front of your feet. If you are on a long
journey, have plenty of breaks get out of the
car and walk around. Your bed you should have a
mattress that keeps you spine straight, while at
the same time sup- porting the weight of your
shoulders and buttocks. Use a pillow, but not one
that forces your neck into a steep angle.