How To Help Your Lower Back Pain

Try To Boost Your Mood

No, the lower back pain isnt in your head, but obsessing over it could be making it worse. Fear, anxiety, and catastrophizing can amplify pain, says Dr. Mackey. Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Start by accepting that you have pain, Dr. Mackey says. Then say to yourself, it will get better. If you struggle with overall mental wellbeingsay, you have anxiety or depressionin addition to your physical aches, it could be worth seeing a therapist to manage negative thought processes while exploring other lower back pain treatments.

Medication From The Store

There are two kinds of over-the-counter pain relievers that frequently help with back pain: nonsteroidal anti-inflammatory drugs and acetaminophen. Both have some side effects, and some people may not be able to take them. Talk to your doctor before taking pain relievers. And don’t expect medication alone to solve your pain problem. Studies show you’ll probably need more than one type of treatment.

Chronic Conditions That Cause Back Pain

Conditions that can lead to chronic low back pain include spinal stenosis, spondylitis, and fibromyalgia. Spinal stenosis is narrowing of the normal spinal canal through which the spinal cord passes. Spondylitis is chronic inflammation of the spine. Fibromyalgia is a muscle disorder that features chronic muscle pain and tenderness.

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What Causes Low Back Pain

Injuries are a common cause of low back pain. Examples include a muscle strain or spasm, ligament sprain, joint problem, or a slipped disk. A slipped disk, or herniated disk, has to do with your spine. It occurs when a disk between the bones of your spine swells or bulges and presses on your nerves. Twisting while lifting often causes this. Many people who have a slipped disk do not know what caused it.

You may have low back pain after doing an activity you arent used to, such as lifting heavy furniture or doing yard work. Sudden events, such as a fall or a car wreck, can cause low back pain. You also may have low back pain from an injury to another part of your body.

Age And Gender Issues

Age and gender are important factors to consider when diagnosing low back pain. In a young patient, a benign tumor of the spine called an osteoid osteoma may be the culprit. Inflammatory bowel disease in young people can be connected with spondylitis and sacroiliitis . Low back pain from disc disease or spinal degeneration is more likely to occur as people get older. Conditions such as abdominal aneurysm or multiple myeloma are also considered in older individuals.

Osteoporosis and fibromyalgia are much more common triggers of back pain in women than in men. Osteoporosis is a progressive decrease in bone density that leaves the bones brittle, porous and prone to fracture. Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain, fatigue, and multiple tender points in the neck, spine, shoulders, and hips.

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What Exactly Is The Lower Back Anyway

Your lower back is known as the lumbar region of the spine. It has a lot of heavy lifting to do: The lumbar spine carries the weight of your entire upper body, plus biomechanical stresses that occur with movement.

The lumbar spine has five vertebraebackbones. Each vertebra has a large disc cushiony gel wrapped in a tough membrane on its front side that acts as a shock absorber. Each vertebra also has two cartilage-lined facet joints on its back side. Working together, discs and facet joints allow the spine to safely bend and twist.

Your lower back also includes ligaments, tendons, and muscles. Ligaments are strong bands that hold the vertebrae and discs together. Tendons attach muscles to the vertebrae. These structures help limit excessive movement that could harm the spinal cord.

What Are The Most Common Lower Back Surgery Procedures

Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:

Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.

Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.

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Lower Back Pain Causes

Nonspecific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be an over-stretch of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two spinal bones , or a minor problem with a small facet joint between two vertebrae. There may be other minor problems in the structures and tissues of the lower back that result in pain. However, these causes of the pain are impossible to prove by tests. Therefore, it is usually impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.

To some people, not knowing the exact cause of the pain is unsettling. However, looked at another way, many people find it reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine.

Medical History And Physical Examination

After discussing your symptoms and medical history, your doctor will examine your back. This will include looking at your back and pushing on different areas to see if it hurts. Your doctor may have you bend forward, backward, and side to side to look for limitations or pain.

Your doctor may also measure the nerve function in your legs. This includes checking your reflexes at your knees and ankles, as well as strength testing and sensation testing. This might tell your doctor if the nerves are seriously affected.

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Who Should I See For Lower Back Pain

Your primary care physician knows you best and should be your first contact for lower back pain. If he or she is unable to diagnose or treat the issue, you may get referred to a specialist, such as a rehabilitation physician . These specialists practice a comprehensive approach to lower back pain, and can diagnose and treat a variety of conditions that have lower back pain as a symptom.

Later, you may get referred to a physical therapist, a chiropractor or another practitioner depending on the nature of your back pain. The good news is that surgery is rarely needed for lower back pain. Only about one in ten patients needs lower back surgery, Chhatre says.

Pain Medications To Treat Back Pain

A wide range of medications is used to treat both acute and chronic low back pain. Analgesic medications are specially formulated to relieve pain. They include over-the-counter acetaminophen and aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine.

Nonsteroidal anti-inflammatory drugs can also be used to relieve pain and inflammation. Over-the-counter NSAIDS include ibuprofen, ketoprofen, and naproxen sodium. Several others, including a type of NSAID called COX-2 inhibitors, are available only by prescription.

There are also many topical creams or sprays that can dull and soothe low back pain. These are applied to the skin and thus stimulate localized nerves to provide feelings of warmth or cold in order to dull the sensation of pain. Topical analgesics can reduce inflammation and increase blood flow.

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Can I Prevent Lower Back Pain

You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.

To reduce your risk of a back injury, you should:

• Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
• Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
• Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.

Understanding The Lower Back

The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.

Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.

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Can Further Bouts Of Back Pain Be Prevented

Evidence suggests that the best way to prevent bouts of low back pain is simply to keep active and to exercise regularly. This means general fitness exercise such as walking, running, swimming, etc. There is no firm evidence to say that any particular back strengthening exercises are more useful to prevent back pain than simply keeping fit and active. It is also sensible to be back-aware. For example, do not lift objects when you are in an awkward twisting posture.

What Does It Mean If Lower Back Pain Is Shooting Into Legs

Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.

If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.

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The Importance Of An Accurate Diagnosis

The physician will need to take a careful medical history and do a physical exam to look for certain red flags that indicate the need for an X-ray or other imaging test. In most cases, however, imaging such as X-ray, MRI , or CT scan is unnecessary.

There may also be certain clues in a patients medical history. Low back, nonradiating pain is commonly due to muscle strain and spasm. Pain that radiates into the buttock and down the leg may be due to , a condition in which a bulging disc presses on the sciatic nerve, which extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This nerve compression causes pain in the lower back radiating through the buttocks and down one leg, which can go to below the knee, often combined with localized areas of numbness. In the most extreme cases, the patient experiences weakness in addition to numbness and pain, which suggests the need for quick evaluation.

A persistent shooting or tingling pain may suggest lumbar disc disease. A pain that comes and goes, reaching a peak and then quieting for a minute or two, only to reach a peak again, may suggest an altogether different cause of back pain, such as a kidney stone.

When tumor or infection are suspected, the doctor may order blood tests, including a CBC and sedimentation rate .

What Are The Warning Signs Of A Serious Problem

Very rarely back pain or pain that travels down the leg is a sign of a serious problem.

If you have any of the following symptoms, you should seek urgent medical attention:

• difficulty controlling or passing urine
• loss of control of your bowels
• numbness around your back passage or your genitals
• serious weakness in your legs so you find standing really difficult
• severe and ongoing back pain that gets worse over several weeks.

The above symptoms could potentially be linked to a rare but serious condition that needs urgent medical attention.

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Nonspecific Low Back Pain

This is the most common type of back pain. The majority of cases of sudden-onset low back pain are classed as nonspecific. This is the type of back pain that most people will have at some point in their lives. It is called nonspecific because it is usually not clear what is actually causing the pain. In other words, there is no specific problem or disease that can be identified as the cause of the pain. The severity of the pain can vary from mild to severe. This type of back pain is discussed further below.

Injections For Low Back Pain Relief

Epidural steroid injections are a commonly used short-term choice for treating low back pain and sciatica. These injections work by reducing inflammation to relieve pain. Injections are intended for short-term use and should not be utilized for an extended period of time as they may worsen pain in the long run.

For those with chronic pain or sever spinal injury, a nerve block may be utilized to prevent nerve conduction in a certain area. This essentially blocks all feeling from nerves. Nerve blocks are typically only used in extreme cases of severe pain.

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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.

Is Your Job Causing Back Pain

A job that involves pulling, lifting, or twisting with the low back can cause injury and low back pain. Even prolonged sitting in an awkward position can cause low back pain. Standing on your feet for hours on end? That can cause lower back pain too. The best way to prevent back pain is to know if you are at risk.

Jobs That Can Cause Lower Back Pain

• Airline crew
• Surgeons
• Office personnel

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When Should I See My Healthcare Provider About Lower Back Pain

Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.

See your provider if you have:

• Pain that doesnt get better after about a week of at-home care.
• Tingling, numbness, weakness or pain in your buttocks or legs.
• Severe pain or muscle spasms that interfere with your normal activities.
• Fever, weight loss, bowel or bladder problems or other unexplained symptoms.

A note from Cleveland Clinic

Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.

Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.

References

Unexplained Acute Low Back Pain

Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.

Common causes:

• Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
• Ankylosing spondylitis, a form of arthritis.
• Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
• Certain types of cancer, in rare cases.

Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.

If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.

An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.

Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.

Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain

Symptoms that always occur with unexplained acute low back pain:lower back pain

Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever

Urgency: Self-treatment

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