[Kim Jae-ho's Life Story]<175> The Power of Lower Back Pain

Back pain, commonly referred to as low back pain, is one of the most common symptoms and is so powerful that almost no one is free from it, so it requires wise management. According to the Korea Disease Control and Prevention Agency, 80% of people experience it at least once in their lifetime, and 50% of workers experience it annually. According to the Health Insurance Review & Assessment Service, the number of patients treated for spinal diseases in South Korea was 8.87 million in 2018, an 11.5% increase from 2014. Female patients numbered 5.08 million, exceeding the 3.79 million male patients.

Back pain occurs across various age groups and mainly appears in the spine, back, and lower back, but sometimes it can also manifest in the hips, calves, or feet. Back pain is not a single independent disease but a symptom caused by problems in various tissues that make up the spine, such as vertebrae, intervertebral discs (discs), muscles, ligaments, and nerves. Since symptoms vary depending on which tissue is affected and how, understanding back pain requires knowledge of the spine's structure.

The human spine is divided into five parts: cervical spine (neck vertebrae), thoracic spine (mid-back vertebrae), lumbar spine (lower back vertebrae), sacral spine (sacrum), and coccygeal spine (coccyx). It consists of 26 vertebrae (out of 33 total, the 5 sacral vertebrae and 4 coccygeal vertebrae fuse into one each in adulthood). Among these, 24 vertebrae (7 cervical, 12 thoracic, and 5 lumbar vertebrae) are connected by tough fibrous tissues called ligaments.

Several muscles surround the vertebrae, enabling movements such as standing upright, bending, and extending the back. Between each vertebra is cartilage called the intervertebral disc, which absorbs shocks applied to the spine. Inside each vertebra is a hollow space called the spinal canal, through which the spinal cord runs from the brain, sending out pairs of spinal nerves at each vertebral level.

Most back pain naturally heals over time or with conservative treatments such as exercise or physical therapy, and pain often subsides quickly. However, many people suffer from chronic pain, experience recurrences, and functional impairments. If pain does not improve over time, especially if it persists for more than three months and becomes chronic, it is necessary to identify the cause of the pain and respond appropriately.

Causes of back pain include herniated discs where the intervertebral disc is damaged, torn, or protrudes, compressing the spinal cord or nerves; injuries causing ligaments or muscles that connect and protect the spine to stretch or tear; herniated discs compressing the sciatic nerve that connects the spine to the legs; spinal canal narrowing compressing the spinal cord or spinal nerves; inflammation or diseases affecting the spinal joints, among others.

If back pain is caused by a specific injury or disease, priority should be given to resolving the cause and addressing the resulting problems. Additionally, regular exercise and activity, especially appropriate spinal exercises and stretching, and adopting postures that do not stress the spine should be practiced to restore spinal function and strengthen the spine.

Activities that strengthen the spine are also very helpful in healing back pain with unclear or unknown causes and are a shortcut to preventing back pain. Medications, including painkillers, temporarily relieve pain but do not cure the underlying cause, and surgery should be considered a last resort and avoided if possible.

It is advisable to avoid sitting or driving for too long, and if unavoidable, take appropriate breaks in between. Slouching while sitting, standing, working, resting, or walking stresses the spine, so it is better to straighten the spine by opening the chest and shoulders and lifting the head while pulling the chin back so that the side profile forms a straight line.

When lifting objects, minimize the burden on the lower back by lifting close to the body in a seated position and using the legs to stand up. When sleeping, a firm bed is better than a soft one, and high-heeled shoes should be avoided. Preventing obesity through healthy eating and regular exercise is also important. Smoking constricts blood vessels, hindering the supply of nutrients and oxygen to the spine, so quitting smoking is essential.

Kim Jae-ho, Independent Researcher