Low Back Pain

Low back pain (LBP) is pain localized to the lumbar spine region, with or without leg pain, arising from musculoskeletal, neurological, or visceral structures, and is a leading cause of disability worldwide.

Definition

Epidemiology

Affects up to 80% of adults at some point in their lives
Most common in adults aged 30–60 years
Slight male predominance in certain occupational groups
Leading cause of work-related disability and absenteeism
Prevalence is increasing with sedentary lifestyle and obesity
Higher incidence in individuals with heavy lifting or prolonged sitting
Recurrence rate is high, with 60–70% experiencing multiple episodes

Etiology

Mechanical: muscle strain, ligament sprain, intervertebral disc degeneration, facet joint arthropathy
Radicular/nerve-related: herniated disc, spinal stenosis, spondylolisthesis
Inflammatory: ankylosing spondylitis or other spondyloarthropathies
Osteoporotic vertebral fracture
Visceral referred pain: kidney, pancreas, abdominal aorta
Postural or occupational factors
Psychosocial contributors: stress, depression, fear-avoidance behavior

Pathophysiology

Acute injury leads to muscle spasm and inflammation
Disc degeneration or herniation may compress nerve roots
Inflammation triggers nociceptor activation and pain perception
Chronic pain may involve central sensitization and altered pain processing
Facet joint arthritis or ligament degeneration contributes to mechanical instability
Inflammatory spondyloarthropathy causes enthesitis and joint inflammation
Psychosocial stress can amplify perception of pain