Lower Back Pain (“Buttock” or “Hip” pain)

Back pain is a very common symptoms affecting the general population. Patients as young as teenagers to the elderly can be affected by back pain. Pain at the lower back region (lumbar spine area) is more common than pain at the mid back region (thoracic spine). Back pain can occur from the muscles in the back, the discs (cushions), bones and joints. Fortunately, most cases of low back pain get better by itself. If it doesn’t, medical attention should be sought by someone experiencing persistent or severe low back pain.

Discs

Discs are cushions that act as shock absorbers between bones. A jelly-like substance sits inside the disc (nucleus pulposus) surrounded by collagen fibres (annulus).

Degeneration of the disc or tears in the disc (annular tears/ annular fissures) can cause back ache. In some cases, the nucleus pulposus slips out of its usual confines causing the disc to “slip” out. This is termed as a slipped disc or herniated nucleus pulposus. Slipped discs can be a cause of backache or even nerve symptoms as sometimes, they compress the nerves around them.

In rare cases, infections can occur in the disc. This is called discitis or inflammation of the disc. Discitis is a very serious condition and needs prompt medical attention.

Bones of the spine (Vertebra)

Fractures of bones of the spine can occur due to a high impact injury (such as a road traffic accident or fall from height) or due to abnormal weakening of the bone such as from a tumour or infection destroying the bones of the spine. Osteoporosis, a condition where the mineral (calcium) density of the bone decreases, can also weaken the bone causing fractures of the spine.

Joints (Facet joints and sacroiliac joints)

The bones of the spine (vertebra) move against each other at the back through the facet joints. Arthritis of the facet joints can cause low back pain. Low back pain can also occur from problems of the sacroiliac joints. These are big joints at the lower back connecting the sacrum (the bone below the lowest vertebra of the spine) to the pelvis.