What Can Cause Severe Lower Back Pain

Range Of Lower Back Pain Symptoms

Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowlypossibly coming and goingand gradually get worse over time.

Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example:

• Pain that is dull or achy, contained to the low back
• Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet can include numbness or tingling
• Muscle spasms and tightness in the low back, pelvis, and hips
• Pain that worsens after prolonged sitting or standing
• Difficulty standing up straight, walking, or going from standing to sitting

In addition, symptoms of lower back pain are usually described by type of onset and duration:

Two Back Pain Situations You Should Take Seriously Right Away No Delay

These two back pain scenarios might be medical emergencies. They do not necessarily mean something horrible is wrong, but its extremely important to make sure.

If you are experiencing true numbness14 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression15 and require immediate medical attention.

And, of course, if youve had an accident with forces that may have been sufficient to fracture your spine, please seek thorough medical assessment promptly, including an X-ray to look for a fracture. You need an X-ray to ensure that your spine is not actually broken.

Isnt it rather obvious that a potential spinal fracture is an emergency?

Hot Or Cold Therapy For Low Back Pain

Hot or cold packs may help ease pain and reduce symptoms. The soothing relief from heat, or the dulling relief from a cold pack, is only temporary and will not treat more serious causes of back pain. However, they may provide greater mobility for people with acute, subacute, or chronic pain, allowing them to get up and get moving.

Also Check: What’s The Best Treatment For Lower Back Pain

What Is The Anatomy Of The Low Back

To understand various causes of low back pain, it is important to appreciate the normal design of the tissues of this area of the body. Important structures of the low back that can be related to symptoms in this region include the bony lumbar spine , discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.

The bony lumbar spine is designed so that vertebrae “stacked” together can provide a movable support structure while also protecting the spinal cord from injury. The spinal cord is composed of nervous tissue that extends down the spinal column from the brain. Each vertebra has a spinous process, a bony prominence behind the spinal cord, which shields the cord’s nervous tissue from impact trauma. Vertebrae also have a strong bony “body” in front of the spinal cord to provide a platform suitable for weight bearing of all tissues above the buttocks. The lumbar vertebrae stack immediately atop the sacrum bone that is situated in between the buttocks. On each side, the sacrum meets the iliac bone of the pelvis to form the sacroiliac joints of the buttocks.

Massage Therapy For Low Back Pain

Studies have shown that massage treatments can help relieve chronic low back pain. Massage treatment can restore people to their usual activities of daily living and lessen pain. Massage therapy is limited, and would not be the most effective solution for patients with spinal complications, injuries, or disk problems since massage focuses on the release of muscle tension and not on the structure of the spine itself.

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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.

All The Red Flags For Ominous Causes Of Back Pain

Red flags are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing even when there really is something serious going on and sometimes they are a false alarm.21 Check off all that apply hopefully none or few or only the least alarming of them!

Some of these red flags are much less red than others, especially depending on the circumstances. For instance, weight loss is common and often the sign of successful diet! Obviously, if you know of a harmless reason why you have a red flag symptom, it isnt really a red flag . But every single actual red flag in combination with severe low back pain thats been going on for several weeks is definitely a good reason to get yourself checked out.

Most people who check off an item or two will turn out not to have an ominous cause for their low back pain. But why not check?

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Five Common Causes Of Lower Back Pain

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No matter what you do, you cant get comfortable. Sitting hurts, standing hurts, laying down hurts. You wake up with pain, and you go to bed with pain. You find yourself taking days off from work when the pain is at its peak, regularly taking over-the-counter pain medication, and you have shelved your once regular work-out routine. If youre living with persistent lower back pain, then you can likely relate to these shared experiences. One of the most frustrating aspects of living with chronic back pain is not knowing where the pain comes from, or how to make it go away. Below, we list five of the most common causes of this discomforting condition that affects ten percent of the worlds population.

Anatomy Of The Lower Back

The lumbar spine is a complex structure composed of many different bones, intervertebral discs, joints, ligaments, muscles, and nerves that constantly work together to perform various movements smoothly and painlessly. The five vertebrae that make up the lumbar spine are the largest and strongest movable vertebrae.

Your lower back is the area that goes from your lowest rib to the upper part of your buttocks. There, the vertebral column or spine has a normal inward curvature called lordosis. This lordosis plays different roles, including:

• Evenly distributing the weight from your upper body to your lower extremities
• Reducing stress and impact on your spine
• Helping balance the weight of your head on your spine
• Allowing for a more efficient gait thanks to weight distribution

The spinal cord comes to an end between L1 and L2. A smaller bundle of spinal roots and rootlets forms the cauda equina, which continues down to the tailbone. Spinal nerves exit the spine between each lumbar vertebra, and these nerve roots come together to form the sciatic nerve.

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Meet Physicians Neck & Back Center: A Leader In Active Physical Therapy Programs

Your active physical therapy program needs to be intensive and specifically designed to strengthen and condition your back and core. And early on, you need specialized equipment that can help you target those specific muscles. Thats where Physicians Neck & Back Center can help.

We opened PNBC nearly 30 years ago, and weve worked with more than 200,000 patients in that time.

Our active physical therapy program for back pain focuses on spine strengthening. Through this program, youll start by doing an intake with a doctor or a physical therapist who specializes in spine care. Theyll work with you to determine your best treatment plan. Then youll start working one-on-one with a physical therapist who specializes in helping people heal chronic pain.

Want to learn more about PNBC? Watch this short video.

Your therapy will happen at one of our facilities that features state-of-the-art medical exercise equipment. Programs range usually from six to 12 weeks, but it all depends on your progress and your goals. Youll learn about what chronic pain is and how the brain processes it. Youll also focus on body mechanics such as proper lifting, standing and sleeping all the things that can contribute to back pain but you may not think about.

Since our programs are intensive and last for several weeks, its a good time to use your Flexible Savings Account dollars or your insurance .

Serious Injury From Accidents

Forceful injuries from impact sports, car accidents, and falls may all cause sudden back pain. Anyone who experiences back pain after such an event should visit the doctor right away because the pain might be a sign of something more serious, such as a fractured bone in the back.

Other signs of serious injury in the back can include:

• loss of bladder control
• numbness in the groin or pelvis
• weakness in the legs

Read Also: How To Relieve Intense Lower Back Pain

Low Back Pain Fact Sheet

If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.

Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.

There are two types of back pain:

• Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.
• Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.

Change The Pressure Settings On Your Cpap Machine

Perhaps one of the most common reasons why you are experiencing CPAP related stomach bloating is because the pressure on your CPAP machine is either too high usually its too high or too low. In this case, you want to speak with your physician about adjusting the CPAP pressure. Additionally, your CPAP machine could accidentally be set to the wrong pressure setting all you have to do is change it back. So, make sure that the pressure settings are correct on your CPAP machine.

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Lumbar Sprain Or Muscle Strain Could Be To Blame

Your lower spine is supported by a network of soft tissues, including muscles, tendons, and ligaments. If you feel irritation, muscle spasms, or tightness across your lower back, hips, or buttocks when walking, the tissues may be damaged. This can lead to lumbar sprain or muscle strain.6

What are the Symptoms of Lumbar Sprain and Muscle Strain?

When you sprain or strain your lumbar spine, the soft tissues in your back can become aggravated and inflamed. The pain can range from slight to debilitating. Depending on the extent of the injury, you may experience:

• Muscles spasms
• Stiffness or soreness in your lower back
• Restricted range of motion
• Tightness in lower back muscles
• Pain that radiates from your back to your buttocks7

Possible Causes Of Lumbar Sprain And Muscle Strain

You can strain your lower back by pulling or twisting your lower back muscles suddenly or awkwardly. Chronic strain can occur if you overuse muscles in a repetitive fashion.

Remember the old saying, Lift with your legs, not with your back? You can also experience muscle strain by lifting something improperly or by putting too much stress on your back muscles.

Lumbar sprain can occur when one or more ligaments in your back are stretched beyond their normal range.

This can happen after a fall, an unexpected twist, or a forceful blow to your body.

Excessive activity from aerobic exercise or low-impact exercise can cause a sprain. Displaying incorrect form while exercising can also be troublesome.

Musculoskeletal Conditions That Can Cause Sudden Pain In Lower Back

The commonest cause of sudden lower back pain is injury or damage to the muscles and ligaments supporting the back and other joint related conditions. These include

• Injury to bones, joints, spinal vertebrae, muscles, ligaments, soft tissues and blood vessels in the lower back region. Sport injuries, falls, direct blows, accidents, etc. can cause damage to these structures leading to sudden lower back pain.
• Protrusion or herniation of intervertebral disc, annular tears and bulging of discs. These discs are protective cushions in between the spinal vertebrae, which if protrude from these original position, cause severe and sudden pain in lower back. This commonly occurs when the person is bending or lifting heavy objects or may occur with gradual wear and tear.
• Tensed muscles in the lower back can cause sudden sharp pain with a feeling of weakness in the muscles and inability to move or lift objects.
• Joint conditions and aging related problems like lumbar spondylosis, various types of arthritis, ankylosing spondylitis affecting lower back.

Being overweight and an inactive lifestyle can contribute to lower back pain. Poor posture, sitting for long hours, awkward movements, excessive use of lower back muscles causing overuse injuries or inappropriate ways of lifting weights, etc.

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What Is The Function Of The Low Back

The low back, or lumbar area, serves a number of important functions for the human body. These functions include structural support, movement, and protection of certain body tissues.

When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.

Protecting the soft tissues of the nervous system and spinal cord as well as nearby organs of the pelvis and abdomen is a critical function the lumbar spine and adjacent muscles of the low back.

More Advanced Care Options

Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:

Implanted nerve stimulators

• Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
• Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
• Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.

Also Check: Why Do I Have Sudden Lower Back Pain

All Of The Worst Possible Causes Of Back Pain And Their Major Features

None of these are common. All of them usually cause serious symptoms that are easy to take seriously. Some of them can fly under the radar in early stages, but usually not for long. The names of the conditions link to carefully chosen articles from good sources.

Finucane LM, Downie A, Mercer C,et al. International Framework for Red Flags for Potential Serious Spinal Pathologies. J Orthop Sports Phys Ther. 2020 Jul 50:350372. PubMed #32438853