The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.
^ North American Spine Society (February 2013), Five Things Physicians and Patients Should Question, Choosing Wisely: an initiative of the ABIM Foundation, North American Spine Society, retrieved 25 March 2013, which cites
The discs are pads that serve as cushions between the individual vertebral bodies. They help to minimize the impact of stress forces on the spinal column. Each disc is designed like a jelly donut with a central, softer component (nucleus pulposus) and a surrounding, firm outer ring (annulus fibrosus). The central portion of the disc is capable of rupturing (herniating as in a herniated disc) through the outer ring, causing irritation of adjacent nervous tissue and sciatica as described below. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae to each other and surround each of the discs.
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Congenital bone conditions: Congenital causes (existing from birth) of low back pain include scoliosis and spina bifida. Scoliosis is a sideways (lateral) curvature of the spine that can be caused when one lower extremity is shorter than the other (functional scoliosis) or because of an abnormal architecture of the spine (structural scoliosis). Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit by support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.
A lumbar support is a device that offers support to this section of the back, much like an orthotic does for the soul of your feet. A lumbar support comes in many shapes and sizes depending on where and how you hope to use it.
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The importance of proper lumbar support cannot be underestimated. Damage to the musculature in the lumbar area can result in excruciating pain. In addition, the damage may ultimately lead to a decreased capacity to walk, even possibly causing paralysis if enough damage is done to the area. For anyone who notices slight twinges of pain in the lower back, taking steps to secure some type of back support could make a substantial impact on the quality of life in future years.
Exercises: In acute back pain, there is currently no evidence that specific back exercises are more effective in improving function and decreasing pain than other conservative therapy. In chronic pain, studies have shown a benefit from the strengthening exercises. Physical therapy can be guided optimally be specialized therapists.
Keeps lower back in an upright or extended position and reduces the strain on pain producing muscles, ligaments, discs and nerve roots of the lower back. Double Pull Lumbar Lower Back Support Brace. N…
The Xtreme Comforts Back and Lumbar Cushion is designed to prevent unhealthy sitting positions by providing the proper support to maintain the natural curve of the spine. The design helps increase blood flow, prevents muscle fatigue and back tightness, and allows you to sit comfortably without pain. At 13 inches wide, the cushion design includes unique four-point quick snap straps that allow the cushion to be secured to any chair. The cushion is made from 100 percent Deluxe Body Active Memory Foam that conforms to your individual shape while maintaining uniform density. The cushion cover is crafted from 100 percent bamboo, providing superior air circulation and breathability to keep your back cool. The cover is removable and can be washed in the machine with cold water.
THE TAKEAWAY: Many people with poor postural alignment or asymmetry have zero pain while others with better alignment suffer from chronic pain. So, automatically blaming these factors is misguided since physical imperfections seem to be normal variations, not pathology. As Mark Comerford, author of Kinetic Control: The Management of Uncontrolled Movement puts it, “There’s a big difference between dysfunction and simply a variation on normal.”
According to Eyal Lederman, Ph.D., an osteopath and author of several manual therapy textbooks and research papers, “There is no correlation between pelvic obliquity/asymmetry and the lateral sacral base angle and LBP. But there may be an association between severe scoliosis and back pain.”
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You may not realize it but pain in your neck may be related to a lack of lumbar support in your office chair. Alignment of the head and spine relates to neck pain; if your spine is suffering due to lack of lumbar support, you may also experience pain in your neck.
The straight leg raise test can detect pain originating from a herniated disc. When warranted, imaging such as MRI can provide clear detail about disc related causes of back pain (L4–L5 disc herniation shown)
Another possible cause of chronic back pain in people with otherwise normal scans is central sensitization, where an initial injury or infection causes a longer-lasting state of heightened sensitivity to pain. This persistent state maintains pain even after the initial injury has healed. Treatment of sensitization typically involves low doses of anti-depressants.
Infections are not a common cause of back pain. However, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis; the intervertebral discs, called discitis; or the sacroiliac joints connecting the lower spine to the pelvis, called sacroiliitis.
While past authors have commonly measured comfort through subjective means , objective measures such as changes in posture (or ‘micro movements’) may be good indicators of discomfort [18-21], as small movements are necessary to alleviate pain caused by static postures. While several past studies have examined the effects of various lumbar support pads, few have quantified the level of comfort through ‘in chair movements’, and most studies have been restricted to healthy individuals. The purpose of this study was to examine for differences in lordotic curvature and comfort between a support device that accounts for pelvic tissue bulk against a typical chair in healthy individuals and patients with LBP. Comfort was measured through subjective and objective means. The hypothesis underlying this work postulates that there will be differences in comfort and lordotic angulation for healthy individuals and patients with pain between the support conditions.
Occupational risk factors: Having a job that requires heavy lifting, pushing, or pulling, particularly when it involves twisting or vibrating the spine, can lead to injury and back pain. An inactive job or a desk job may also lead to or contribute to pain, especially if you have poor posture or sit all day in a chair with inadequate back support.
Sitting in an upright chair while watching TV or using a computer can cause painful pressure on the lumbar area of your back. Back support cushions can help relieve back pain even while sitting in your favorite chair at home. Lumbar support cushions might provide just the right amount of support for you, and cushion your lower back. Therapeutic and affordable, these chair accessories come in a large variety, including memory foam cushions and roll pillows for customized comfort.
Being portable and weighing a slight amount, you can take it with you anywhere. Use it at home, work, on the bed to read or watch TV and when traveling. It is firm to soft and will support your lower back giving you pain relief. The cover has a zipper to remove and it can be washed.
Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and infertility.
In retrospect, researchers should not be surprised that movement is an important part of back pain management. Animal studies throughout the last quarter of the 20th century, in which investigators used a cast to restrict exercise after an injury, have revealed that muscular health and functioning rely on regular use. In other words, muscles need to bear weight, stretch and move to continue supporting the body effectively.
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THE TAKEAWAY: There’s no need, nor is it recommended to “draw in” your belly button during exercise or sporting activities. Core strengthening may or may not help you relieve or prevent LBP. As Comerford says, “If all back pain was due to weakness, than the strongest athletes in the world would never have pain, but they do.”
While additional authors have investigated the effect of various support systems on bodily symptoms, much of this work has been performed on healthy individuals. Aota et al.  measured the biomechanical effects and comfort levels when using a lumbar support cushion that inflated from 0.5 to 8.0 cm thick in a continuous passive motion chair. They noted significant improvements in the subjective measures of LBP, stiffness and fatigue with use of the system in both static and dynamic states. Conversely, Carcone and Keir  noted that, while a lumbar pad measuring 9 cm thick best maintained the lumbar lordosis in sitting, participants tended to complain that it pushed their body forward, the result being a centre of pressure (CoP) that was more anteriorly located on the seat pan. In their study, participants also reported that configurations with less lordosis (i.e., less than 3 cm) were more comfortable . Portable devices that do not account for the bulk of posterior pelvic soft tissue volume may push the lower body forward and distort the intended relationship between the seat pan features and the body . The preferred degree of lordosis may be related to the pain state of the individual , in that comfort may be affected by the angular change as well as the interaction between the buttocks and the seat pan.
Bone and joint conditions: Bone and joint conditions that lead to low back pain include those existing from birth (congenital), those that result from wear and tear (degenerative) or injury, and those that are due to inflammation of the joints (arthritis).