Lower Back Pain: What Could It Be
Do you have lower back pain? You are not alone. Anyone can experience lower back pain at any time, even if you dont have a prior injury or any of the risk factors. It is not always serious and can often get better on its own. But in some cases pain is your bodys way of telling you that something isnt right.
Learn more about lower back pain and what causes it from rehabilitation physician Akhil Chhatre, M.D., who specializes in back pain in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
Can Misaligned Pelvis Cause Lower Back Pain
Many times, patients that see a chiropractor in Apex for lower back pain are usually experiencing symptoms of a pelvic tilt or misalignment of the pelvis. Once the foundation is tilted or rotated, it will cause an unstable balance in the spine, causing discs to shift and compress usually causing back pain.
How Is Back Pain Treated
Acute back pain usually gets better on its own. Acute back pain is usually treated with:
- Medications designed to relieve pain and/or inflammation
- analgesics such as acetaminophen and aspirin
- non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
- muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
- topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.
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Can Spinal Stenosis Cause Difficulty Walking
Spinal stenosis is not uncommon among people 50 years and older, primarily due to wear and tear on the body over time. If you begin to experience significant neck or lower back pain then your doctor may want to assess for spinal stenosis. Treatment varies with the severity, starting with conservative approaches and then minimally invasive spine surgery in order to help avoid major spine surgery as much as possible. Your neck and back are key to supporting the rest of your body and it is important to seek treatment and relief from pain in order to move comfortably through your daily life. Something as common as your daily walk around the block might become difficult or even unbearable with spinal stenosis.
What Are The Symptoms Of Lumbar Spinal Stenosis
Early lumbar spinal stenosis may have no symptoms. In most people, symptoms develop gradually over time. Symptoms may include:
- Pain in the back
- Burning pain going into the buttocks and down into the legs
- Numbness, tingling, cramping, or weakness in the legs
- Loss of sensation in the feet
- A weakness in a foot that causes the foot to slap down when walking
- Loss of sexual ability
Pressure on nerves in the lumbar region can also cause more serious symptoms known as cauda equine syndrome. If you have any of these symptoms, you need to get medical attention right away:
- Loss of bowel or bladder control
- Severe or increasing numbness between your legs, inner thighs, and back of the legs
- Severe pain and weakness that spreads into one or both legs. This makes it hard to walk or get out of a chair
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What Are The Risk Factors For Developing Low Back Pain
Anyone can have back pain. Factors that can increase the risk for low back pain include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.
Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.
What To Do If You Suspect Something Else
Theres only one major tiphere: See a doctor, whether it is your primary care physician or aspecialist. Each condition that mimics spinal problems comes with its own treatments,but the first step is an accurate diagnosis. For example, a nerve test such aselectromyography can help a doctor spot neuropathy, and a blood-flow testsuch as the ankle-brachial index can distinguish between spinal stenosisand peripheral arterial disease.
Its so important to look atall of your symptoms and history and do a thorough examination, Dr. Khalafsays. Its how we can tell the difference between a back issue and a medicalcondition.
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Inflammatory Walking Difficulty Causes
Walking difficulty may occur due to the following inflammatory conditions.
- Arthritis: Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness of the bones and joints. Arthritis can affect the bones and fluid-filled areas of the knees, ankles and even hips resulting in significant difficulties with walking.
- Autoimmune: Many inflammatory diseases that result in the body attacking itself can also affect the nerves and muscles and cause injuries that result in gait abnormalities. Conditions such as multiple sclerosis and lupus are examples of such autoimmune diseases that can attack multiple components of the systems necessary for walking.
What Structures Make Up The Back
The lower backwhere most back pain occursincludes the five vertebrae in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
Other regions of vertebrate are cervical , thoracic , and sacral and coccygeal segments.
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Which Lifestyle Factors Contribute To Lower Back Pain
There are three major lifestyle factors that may affect your chances of developing lower back pain:
- Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
- Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
- Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.
Pain That Feels Better When Changing Positions
Depending on the underlying cause of pain, some positions will be more comfortable than others. For example, with spinal stenosis walking normally may be difficult and painful, but leaning forward onto something, such as a shopping cart, may reduce pain. How symptoms change with shifting positions can help identify the source of pain.
See Spinal Stenosis Symptoms and Diagnosis
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How Common Is Lower Back Pain
Two out of every three adults suffer from low back pain at some time. Back pain is the #2 reason adults visit a doctor and the #1 reason for orthopedic visits. It keeps people home from work and interferes with routine daily activities, recreation, and exercise. The good news is that for 9 out of 10 patients with low back pain, the pain is acute, meaning it is short-term and goes away within a few days or weeks. There are cases of low back pain, however, that take much longer to improve, and some that need evaluation for a possible cause other than muscle strain or arthritis.
Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand straight.
Walking And Lower Back Pain
Most people don’t make a connection between walking and lower back pain and don’t think that the way they walk could be part of the reason why they are in pain.
Or, they don’t think that the way that they walk could prevent their healing.
But when we are in pain, acute or chronic, every movement counts. And we walk a lot. Even the most sedentary person is taking 3000 steps a day. If those steps were well executed it would be a lot easier to heal.
Yet when people get injured they are often steered towards physical therapy or exercise class to find help. Instead of walking around in search of different doctors and therapies, I think you should use walking to heal your pain.
Walking and lower back pain is an issue for more people than I ever imagined when I began this work. People get lower back pain and hip pain for many many reasons but here are a few that walking correctly can help:
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How Is Lumbar Strain Treated
Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment may include:
- Ice packs or heat and compression applied to the back
- Exercises
- Stretching and strengthening exercises
- Learning how to use and wear appropriate protective equipment
Medicines, such as anti-inflammatories, muscle relaxants, and spinal injections, may also be used to ease pain and inflammation.
Back Pain Culprit: Your Bag
Although you may wear your purse, backpack, or briefcase over your shoulder, it is the lower back that supports the upper body — including any additional weight you carry. So an overstuffed bag can strain the lower back, especially if you carry it day after day. If you must tote a heavy load, consider switching to a wheeled briefcase.
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Learning Proper Walking Posture
The right way to walk involves keeping your spine aligned with the rest of your body, preventing any weight from being concentrated on a specific area, and reducing the amount of pressure on your extremities. This method helps your back distribute the weight of your entire body and cushion the impact of each step you take.
Here are some general tips to follow for the best posture when you walk:
- Keep your head up and avoid looking down too much when you walk. This reduces the amount of strain you put on your neck.
- Push from the rear leg. Taking long strides puts more weight on one foot, which can hurt the tendons and ligaments connecting it to the lower back.
- Avoid slouching. If your shoulders are tense or pushed up, you strain the muscles on your back. Relax and let your shoulders roll naturally when you take your steps. Shrug occasionally.
- Dont roll your hips. Make sure your hips stay level when you walk. Unnatural swaying can cause you to put too much weight on one side of your body, and can even make you lose balance.
- Pull in your stomach. Engaging your core muscles lowers your center of gravity, helping you keep your balance. This also avoids unevenly distributing your weight around your lower back.
- Practice proper footwork. Your foot should hit the ground heel-first, rolling through to the ball of your foot, and pushing off with your toes. Avoid flat steps or striking the ground toe-first.
Why Is Lower Back Pain Such A Common Problem
The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.
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Exercise And Physical Therapy
Aside from aging, prolonged inactivity is a significant factor in developing sciatica. If you lead a sedentary lifestyle or dont get a lot of physical exercise, your joints and muscles will stiffen and freeze up. This can make standing, walking, or even sitting down painful.
Inactivity isnt solely caused by lifestyle choices either its also a frequent consequence of traumatic injuries or conditions that force the patient to stay in bed. Even after recovery, any kind of movement will be painful since the spine isnt used to bearing the bodys weight anymore.
Physical exercise is one of the best ways to address chronic pain. However, older patients need to balance the need for physical exercise with their special considerations. In cases like these, physical therapy is a better alternative since medical staff will be close by to assist them.
Exercise and physical therapy are two of the most effective ways to alleviate mild-to-moderate sciatica. Your therapist will put you through a strict training regimen designed to loosen your joints and strengthen your muscles, allowing your spine to better support your weight. They may also recommend some exercises that you can follow at home.
Whenback Pain Is Likely Spinal Stenosis
Spinal stenosis is one of themost common causes of spinal pain not related to injury. This narrowing of thespace around the spinal cord puts pressure on the nerves. If you have thefollowing symptoms, spinal stenosis may be to blame:
- A heavy feeling in the legs, which may lead to trouble walking.
- Increased pain going downhill.
- Symptoms that get worse with activity.
- Relief from the grocery cart position bending forward like youre leaning on a shopping cart.
However, Dr. Khalaf notes howcommon false positives are. Around 21% of asymptomatic people over age 60will show signs of spinal stenosis on an MRI, she says. And sometimes spinalstenosis and peripheral arterial disease co-exist. Thats why you need aphysical exam, and possibly other tests, to get a clear diagnosis.
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But What About The Low Back As An Origin Of Pain In The Shins
Yes, it is possible for shin pain to be caused by referred sciatic pain originating in the upper to mid lumbar vertebrae , says Dr. Tom Carpenter, corrective exercise specialist, certified personal trainer and chiropractor, inventor of Stand Corrected, a portable harness-like stretching tool that helps alleviate back, neck and shoulder pain.
Dr. Carpenter adds, It is important to determine if this in fact is the source of the problem, as other factors could be causing these symptoms also, such as a foot issue or muscular imbalance in the lower leg.
Sciatica is often referred to by laypeople as a pinched nerve. An MRI can determine if there is nerve compression originating from the vertebral column.
However, sciatica can also be caused by the piriformis muscle compressing against the sciatic nerve.
Tingling and numbness in the butt or leg may also result from sciatica.
Dont give up on finding out whats causing your shin pain.
The origin may very well be in your low back.
Used daily and over time, the Stand Corrected stretching tool can reverse back damage caused by years of poor posture.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
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Your Posture Could Be Causing The Pain
The way you hold your body when walking can play a major role in your comfort level and ease of walking. While good posture can result in little to no pain or stress, bad or inefficient posture can cause lower back pain and postural stress.
What are the Symptoms of Postural Stress?
Beyond lower back pain, if youre suffering from postural stress, you may also experience:
- Aches and pains in other parts of the body, such as the neck, shoulders, and knees
- Slumped or rounded shoulders
- Looking down at a cell phone while walking4
Can Correct Posture While Walking Prevent Lower Back Pain?
Maintaining good posture while walking may help prevent pain in the lumbar spine. Study the way you hold your body when you are walking. Are you following these steps?
Stand up straight, without leaning forward or back.Pull in your stomach and rotate your hips forward with your buttocks in.Keep your eyes forward with your chin parallel to the ground.
It is also a good idea to increase strength in your hamstrings and back muscles to help maintain good posture. Stress management may also help decrease postural stress.5
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