Our column

The spine, made up of 33 bones called "vertebrae," connects the skull to the pelvis. The vertebrae are grouped into 4 different regions: cervical, dorsal, lumbar and sacral.

The vertebrae are stacked one on top of the other forming a spine, and in the cervical, dorsal and lumbar regions they are separated from each other by a kind of pad called a disc. Consider these discs as if they were a "donut", with a soft gelatinous centre surrounded by a harder and more resistant cover.

The spinal column protects the spinal cord, a cord made up of nerves and support cells that transmit information from the brain to the rest of the body.

The spinal column is an essential element for the central nervous system, so it is important to be informed in the case of pain in some area of the back.

The diagnosis of chronic low back pain is made from the medical history and physical examination performed by the doctor. It is almost enough to know the symptomatology reported by the patient to correctly guide the diagnosis.

The simple X-rays in AP and Lateral projection that we carry out are complementary tests and will allow us to rule out other types of pathologies, since the findings that we can find in them (decreased disc height, bone growths in the vertebral margins, scoliosis, etc.) are also appreciated in patients without any type of lumbar pain.

Magnetic resonance imaging (MRI) and CT or scanner are used to confirm disc herniation or other specific pathology when suspected by the clinic, but they are of little use in the diagnosis of chronic low back pain due to the high frequency of supposedly pathological findings that appear in an asymptomatic population.

Treatment for low-back pain usually depends on whether the pain is acute or chronic. In general, surgery is recommended only if there is evidence of worsening nerve injury and when diagnostic tests indicate structural changes for which corrective surgical procedures have been developed.

Hot or cold compresses: compresses have never been proven to quickly resolve a lumbar injury. However, they can help relieve pain and reduce inflammation in people with acute, subacute, or chronic pain, which in some cases allows for greater mobility.

Activity: Bed rest should be limited. Individuals should begin stretching exercises and resume normal daily activities as soon as possible, avoiding movements that aggravate pain. There is strong evidence that people who continue their activities without bed rest after the onset of low back pain appeared to have greater flexibility in the back than those who rest in bed for a week. Other studies suggest that bed rest can only worsen low-back pain and lead to secondary complications such as depression, decreased muscle tone and blood clots in the legs.

Physical therapy: Physical therapy programs to strengthen the main muscle groups that support the lower back, improve mobility and flexibility, and promote correct positioning and posture are often used in combination with other interventions.

Surgery: When other treatments fail, surgery may be considered an option to relieve pain caused by severe musculoskeletal injury or nerve compression. It may be months after surgery before the patient recovers completely and may suffer a permanent loss of flexibility. Surgical procedures are not always successful and there is a lack of evidence to show which procedures work best for the problem for which they are indicated.