In this blog post, we will take an easy-to-understand and in-depth look at the origins and causes of lower back pain, as well as treatment methods.

Lower back pain, the pain that has become the fate of humans

Since humans began walking upright, lower back pain has become a disease that has followed them like fate. Although standing upright has brought many benefits to humans throughout their evolution, it has also placed new stresses on the spine and lower back. These structural changes increased the strain on the lower back from the moment humans began to stand upright, which soon manifested itself as lower back pain.
Historically, lower back pain has been documented in literature for a long time. Ancient Greek and Egyptian medical literature contains various prescriptions for diagnosing and treating lower back pain. This suggests that lower back pain is not a disease that suddenly appeared in modern times, but a chronic problem that has plagued humans throughout history.
Even in modern times, lower back pain is a very common disease, and its prevalence can be confirmed by various statistical data. It is estimated that approximately 80% of adults experience lower back pain at least once in their lifetime. Lower back pain has a significant impact on the working population, especially young people who are in their prime working years. The main reason for sick leave is generally upper respiratory tract infections such as the common cold, but lower back pain is also identified as a cause of sick leave at a similar level. According to actual statistics, the average number of days per year that daily activities are restricted due to lower back pain is approximately 23.5, of which approximately 8 days result in a direct loss of labor. This is a problem that cannot be taken lightly, not only in terms of the individual’s quality of life, but also in terms of social and economic aspects.

Low back pain is both a symptom and a disease

Low back pain is not just a symptom of pain, but also a disease in its own right. Its manifestations vary greatly, ranging from temporary discomfort to chronic pain that lasts for long periods of time, and in some cases, even modern medical technology cannot completely resolve it. Low back pain is a complex and multifaceted condition.
There are many causes of low back pain. One of the most widely known factors is age. The frequency of low back pain increases with age, and the intensity and duration of pain also tend to increase. Low back pain mainly occurs in people in their 30s to 50s, but it can also appear in more severe forms in older people due to aging. In addition to age, occupational factors also play an important role. The risk of low back pain increases significantly in people who frequently lift heavy objects or engage in repetitive tasks that strain the lower back. In addition to physical factors, these occupational stresses can interact with psychological factors to create more complex symptoms.
Mental health is also closely related to low back pain. Psychiatric disorders such as depression and anxiety disorders can be important factors in causing or exacerbating low back pain. Conversely, chronic low back pain can undermine a patient’s mental stability and, in severe cases, lead to mental illness. These interactions show that low back pain is more than just physical pain.
Psychosocial factors cannot be overlooked either. In some patients, an unconscious compensatory mechanism may cause them to exaggerate the pain they actually feel in order to attract attention or sympathy from others. As such, low back pain can develop and worsen not only due to physiological and structural factors, but also due to various background factors, such as the individual’s social and cultural environment and psychological state. Therefore, a holistic approach is necessary for the diagnosis and treatment of low back pain, and it is not effective to explain it with a single cause or treat it with a simple method.

Conservative treatment and surgical approaches

The treatment methods for low back pain are as diverse as its causes. In general, simple low back pain often improves naturally within four weeks without special medical intervention. For patients with mild low back pain, conservative treatment is primarily used to relieve symptoms.
Typical examples of conservative treatment include bed rest, heat therapy using hot packs or hot compresses, and administration of nonsteroidal anti-inflammatory drugs (NSAIDs).
These are all temporary pain relief measures and supplementary treatments to aid the natural healing process. However, more important than conservative treatment is finding a fundamental solution, and the key to this is building a strong back. In other words, strengthening the back muscles and surrounding support structures is necessary to prevent and manage lower back pain. The most effective way to do this is through regular exercise.
However, in actual clinical practice, patients who are prescribed exercise often do not follow the instructions properly. They refuse to exercise or stop after a short time, thinking that their back pain is special and different from other people’s. However, exercise therapy for back pain must be continued consistently for at least six months to achieve meaningful results. Temporary attempts are unlikely to lead to muscle strengthening, posture correction, or body shape improvement.
If pain persists or symptoms worsen despite conservative treatment, surgical treatment should be considered. In particular, surgery may be an essential treatment option if there are clear structural abnormalities accompanied by neurological symptoms. Of course, surgery should be a last resort and should only be chosen after various non-surgical treatments have been thoroughly attempted.

Spinal Structure and Mechanism of Low Back Pain

In order to effectively understand and treat low back pain, it is important to accurately understand the structure of the spine and the mechanism of pain. The spine is a structure formed by a series of bones called vertebrae, and between each vertebra is a piece of cartilage called an intervertebral disc.
These intervertebral discs are commonly referred to as “disks” and serve to provide both mobility and stability to the spine.
Most causes of chronic low back pain originate from changes in these intervertebral discs. When the intervertebral discs undergo degenerative changes or herniate, their height decreases, the stability between the spinal segments deteriorates, and abnormal bones called osteophytes grow from the surrounding bones.
These structural changes narrow the intervertebral foramen, which is the passageway through which the nerves from the spine pass, causing pressure on the nerves. When the nerve roots are compressed, sensory abnormalities and radiating pain occur in the areas of the body controlled by those nerves.
Sometimes, the herniated disc itself directly irritates or compresses the nerve root, causing severe pain. Therefore, in the treatment of low back pain, it is important to accurately identify which area is being compressed and how. Based on imaging tests and clinical evaluation, the cause of the pain must be accurately diagnosed and an appropriate treatment plan must be established.

Conclusion

Low back pain is too complex and multifaceted to be described simply as “back pain.” This pain, which began in the evolutionary history of humankind, still threatens the daily lives and quality of life of countless people today. It is important to recognize low back pain not as a simple symptom, but as a health problem that is deeply related to quality of life.
With accurate diagnosis, appropriate treatment, and consistent management, lower back pain can become a manageable health issue rather than unbearable pain. Furthermore, with a shift in awareness and preventive efforts for spinal health, lower back pain can serve as a warning sign for a healthy life rather than a major obstacle.