Joseph Yao, M.D.

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Low back strain

Low back strain is also known as lumbar strain and it's a common cause of low back pain. Pain results from injury to the muscles and ligaments in the low back. Truck drivers are at high risk for lumbar strain because of the many hours they spend sitting while driving.
     Their low backs are subjected to lots of stress while driving despite air suspension and lumbar support in their seats. Truck drivers are usually in a rush to keep on a schedule, so they have little time for exercise. This can cause weakening and tightness of the muscles of the abdomen and back, making drivers even more prone to injury. Athletes spend time to warm up prior to competition, but truck drivers have to hurriedly climb in and out of their rigs with no time to warm up, then throw heavy straps or chains and tug on ratchets to tie down loads, hunch over to crank up or down their trailer and often manually load/unload their freight. All of this makes truck drivers prone to back injury.
     Lumbar strain often comes on suddenly and is felt as a sharp pain in the low back. The pain may arise when a driver twists his body, bends over to pick up something or lifts something heavy. Sometimes low back pain can occur without a specific injury, and a driver may notice the pain after pro- longed sitting while driving, standing or walking. Pain is usually localized in the low back and can be either in the midline, on the right or left sides or across the entire low back. Pain may sometimes extend into one or both buttocks and occasionally into the thighs. Pain and/or numbness down an entire leg to the foot is due to a pinched nerve and not just to lumbar strain.
     An important part of treatment is prevention, which includes abdominal and back muscle strengthening exercises, stretching and using the large leg muscles while keeping the back straight when lifting. Avoiding weight gain is important because excess abdominal fat can strain the back. A well fitting, adjustable truck seat with lumbar support is important.
     Treatment of lumbar strain can include rest, heat/ice, back exercises, nonsteroidal anti-inflammatory drugs (if not medically contraindicated), massage, a wraparound lumbar brace, weight loss, physical therapy and chiropractic treatment. Most cases of lumbar strain will resolve within six weeks.    
     Diagnostic studies can be done to evaluate other possible causes of the pain including but not limited to arthritis, degenerative disc disease, fracture, disc protrusion causing nerve impingement, kidney stones, cancer and aortic aneurysm. Initial exam can include X-ray. More specialized tests can be done depending upon the diagnoses being considered. These include blood tests, MRI, CT and bone scans.
     Dr. Joseph Yao has undertaken extensive subspecialty training in joint replacement af-ter completing an orthopedic surgery residency. Dr. Yao has been in private practice orthopedic surgery since 1987, and he has treated many truck drivers for joint and nerve ailments.