It's hard to find any part of Elin Laird's life that hasn't been touched by pain. "I can't stand for too long. I can't sit for too long. Pretty much if I'm at home, I'm lying in bed," says the 39-year-old single mother. "I can't be as active in my son's life. I can't travel as much. I've lost so much of my life."
Laird describes the pain of her herniated disc as similar to having "an ice pick shoved in the base of my spine." It's a pain that no therapy – from steroids to painkillers to surgery – has managed to budge. And she is far from alone in her discomfort.
"Eighty percent of the population of the United States, at some point in their life, is going to have back pain," says Ronald J. Wisneski, MD, an orthopedic surgeon, specialist in spinal disorders and spine surgery, and associate in the Department of Orthopedic Surgery at Geisinger Medical Center in Danville, Pa. Most of the time, that pain is centered in the lower back and non-specific, meaning there is no primary cause found. About 2% to 10% of people who experience low back pain develop chronic low back pain, which affects daily living for at least 3 months.
What could be triggering your back pain? To get an idea, WebMD talked to two orthopaedic surgeons about the most common causes of chronic lower back pain -- and what you can do about it.
What Causes Degenerative Discs and Herniated Discs
Why is the lower back a target area for pain? "Generally speaking, the lower back is subject to a lot of mechanical stress and strain,” says Gunnar Andersson, MD, PhD, professor and chairman emeritus of the Department of Orthopedic Surgery at Rush University Medical Center in Chicago. “The reason is the weight of the upper body, which always puts loads on the lower back."
Supporting all that upper body weight is the spine, which is made up of more than 30 small bones called vertebrae stacked one on top of the other. A spongy piece of cartilage, called a disc, sits between each vertebra. It acts as a shock absorber, preventing the bony vertebrae from grinding against one another.
With age, these cushioning discs gradually wear away and shrink, a condition known as degenerative disc disease. Discs can also tear or become injured. Sometimes the weakening of a disc can put pressure on its jelly-like center. Wisneski describes this process as similar to a bubble forming on your car's tire.
"You hit a bump in the road, then all of a sudden that tire goes pop," he says. In the case of your back, that pressure can lead to a herniated disc (also called a "slipped disc" or "ruptured disc"), in which the center of the disc bulges.
Sometimes that bulging causes the material from inside the disc to press on the sensitive nerves that carry messages to the brain. The result can be the kind of excruciating pain Laird has experienced. "If I move wrong, I get what I call a 'sonic boom’ -- this jolt of electricity through my pelvic area," she says.
A herniated disc in the lower back can put pressure on the nerve that extends down the spinal column. This commonly causes pain to radiate to the buttocks and all the way down the leg. This condition is called sciatica.