The most common cause for low back pain is a strain of the muscles, or other soft tissue such as  ligaments and tendons that attach to the spine. In the majority of back pain cases there is no serious underlying problem, and it will sort its self out within a few days to a few weeks.

The phenomenon of a painful disc is described. Fissures or annular tears may develop in a disc as it ages or as a result of injury. If pain receptors in the outer disc annulus are irritated then the phenomenon of discogenic back pain is the result.

As the spine age, discs become dehydrated, lose height and then bulge. As the disc height reduces, increased stress and thus associated degenerative changes occur over the lumbar facet joints, these hypertrophy. The net result is ingrowth and impingement into the spinal canal, this is spinal stenosis.

Hyperextension injury may result in a fracture of the pars interarticularis. The result of which will be increased shear stresses across the intervertebral disc. If these shear stresses increase then slippage of one vertebra with respect to its neighbor below may occur, this is spondylolisthesis

Osteoporosis becomes increasing common in old age. If the bone is sufficiently weakened then it may fracture, in the spinal column this is referred to as osteoporotic vertebral compression fracture (VCF)

Lumbar Spine Problems

After the lung and liver, the spine is the 3rd most common site for tumour metastasis. Possible scenarios that may develop are pain due to instability and or neurological compression. Palliative surgery for relief of pain, stabilization of the spine and decompression are often performed.

Often seen as a result of high energy trauma typically after a motor vehicle accident.

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This occurs when the softer jelly-like inner part of the disc, the nucleus pulposus herniates through the outer fibrous layer, the annulus fibrosus. The result is that if a disc protrusion is severe enough it can cause pressure over the nerves that lie within the spinal canal. These nerves may go on to become the the sciatic nerve  hence  cause sciatica develops.