What Is Lower Back Pain
Low back pain can result from many different injuries, conditions or diseases most often, an injury to muscles or tendons in the back.
Pain can range from mild to severe. In some cases, pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
Usually, lower back pain gets better with rest, pain relievers and physical therapy . Cortisone injections and hands-on treatments can relieve pain and help the healing process. Some back injuries and conditions require surgical repair.
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.
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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
You’re Having Problems With Your Bowels Or Urination
If your back pain is paired with a loss of control over your bowels or urination, then it’s time to seek help immediately at a local emergency room. These symptoms point to cauda equina syndrome, where the nerves in the lower spine have become paralyzed. While rare, this syndrome can be permanently damaging to the nerves if left untreated. If you experience these symptoms, especially accompanied by numbness in the legs, then you may need surgery to decompress the nerves and preserve their overall function.
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Is My Lower Back Pain Serious
If back pain symptoms persist after a few weeks, seeing a doctor to accurately diagnosis the cause of your back pain is a good first step. ReadLower Back Pain Symptoms, Diagnosis, and Treatment
Each case of back pain is unique, but the information below can help you determine if your lower back pain is serious.
Diagnosing Low Back Pain
Diagnosis is made by a neurosurgeon based on history, symptoms, physical examination and results of diagnostic studies. Some patients may be treated conservatively if conservative treatment is ineffective, the physician may order imaging studies of the lower back and other tests, which may include:
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The Lumbar Spine What Can Go Wrong
The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.
See Back Muscles and Low Back Pain
Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain.
There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.
Severe Pain In Your Lower Back
Your back is made up of an array of parts that help you move around daily. So, its no wonder that pain occurs from time to tome. But the appearance of reoccurring and severe back pain, especially in the lower back, can be a symptom of a potential blood clot. If you start feeling similar types of pain spreading from your back to your chest, you should take that as a serious warning sign.
Most people will try and push through the pain or mask it with Tylenol, Ibuprofen, or muscle relaxants, but if the pain is insistent, speak to a medical professional right away.
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Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
Difficulty With Standing Up Straight
If you have issues maneuvering your back into different positions or standing up straight, it can indicate that something more serious is at work. As the clot moves throughout your body, it affects you in a variety of ways, as previously mentioned. Pain, swelling, warmth in body parts and skin discoloration can all be signs of a more significant issue.
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What Questions Should I Ask My Doctor
- Which muscle is strained?
- How long will I need to rest my muscle?
- Which grade of strain do I have?
- Are there any activities I should avoid while Im recovering?
A note from Cleveland Clinic
Straining a muscle is painful. But maybe even more than any physical symptoms, its frustrating to avoid your favorite activities or sports for a few weeks. But your muscle needs to heal, and giving it that time is the best way to make sure youll be able to get back to what you love as soon as its safe. Dont be afraid to reach out to your provider with questions. Just because an injury is common doesnt mean your situation isnt unique.
How Is Low Back Pain Diagnosed
Along with a complete medical history and physical exam, tests for low back pain may include:
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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
Arthritis Of The Spine
Arthritis of the spine the slow degeneration of the spinal joints is the most frequent cause of lower back pain. All of us experience wear and tear as we age, and it is normal for your lower back to start acting up as you get older. As the cartilage breaks down between the spinal joints, surrounding tissues may become inflamed. The inflammation and the thinning of cartilage increase friction in the joints, which may cause pain in the lower back.
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Possible Conditions Causing Severe Back Pain
Dr. Drymalski also details several conditions that can cause intense back pain, many of which center on the bones or discs. But you also might be wondering, How do I know if my back pain is kidney-related? Problems with what other organs can cause lower back pain?
He shares a wide-ranging list of potential conditions that can bring about extreme back pain:
Sensations That Might Indicate A Medical Emergency
1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.
3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.
If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.
Related reading: Get help for back, neck, and leg pain caused by spinal stenosis
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What Are The Symptoms Of Lower Back Pain
Symptoms of lower back pain can come on suddenly or appear gradually. Sometimes, pain occurs after a specific event, such as bending to pick something up. Other times, you may not know what caused the pain.
Pain may be sharp or dull and achy, and it may radiate to your bottom or down the back of your legs . If you strain your back during an activity, you may hear a pop when it happened. Pain is often worse in certain positions and gets better when you lie down.
Other symptoms of lower back pain include:
- Stiffness: It may be tough to move or straighten your back. Getting up from a seated position may take a while, and you might feel like you need to walk or stretch to loosen up. You may notice decreased range of motion.
- Posture problems: Many people with back pain find it hard to stand up straight. You may stand crooked or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
- Muscle spasms: After a strain, muscles in the lower back can spasm or contract uncontrollably. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.
The Link Between Heart Attacks And Back Pain
Many people find it difficult to understand the correlation between heart attacks and back pain. Back pain tends to occur prior to or during a heart attack because, when the blood flow in a coronary artery is blocked, it can cause intense pressure. This pain can radiate from the chest to the upper back, which is why people feel back pain before a heart attack. Women are more likely to experience back pain as a precursor to a heart attack because they tend to experience more subtle heart attack symptoms. Additional symptoms that women may get along with back pains can include:
- Nausea
- Stomach pain
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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
How To Manage Pain
A person who experiences back pain during labor can ask for pain medication. People who want limited or no medication may find relief from adopting different positions that support their back.
Doctors generally suggest analgesics, which reduce pain without affecting movement or muscle control, or anesthetics, which block pain and touch sensations.
The medical community does not consider certain medications, including nonsteroidal anti-inflammatory drugs such as ibuprofen, to be safe during pregnancy. A person should always consult their doctor before taking any medication when pregnant.
In addition to medication, a person may wish to try using natural methods to manage their pain.
Doctors at the University of Texas Southwestern Medical Center suggest the following methods to ease pain during labor:
- taking a warm shower or bath
- trying different positions, such as sitting on a birthing ball or squatting
- walking during labor
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Get Help For Your Back Pain
While this all may sound dire, you can take comfort in knowing that upwards of 90% of low back pain presentations in the ER are benign, according to findings. The important thing is to stay as calm as you can as you assess your pain and symptoms and rely on medical experts to assist you and get down to the bottom of why youre feeling the way you are.
Dr. Drymalski emphasizes, Remember that back pain is very common and the vast majority of the time it will be self-limiting and benign. If you are concerned or have red-flag symptoms, emergent evaluation may be necessary. It is important to always tell your doctor all of your symptoms, even if you dont know if they are related to your back pain, so your doctor can develop the most appropriate workup and treatment plan for you.
Find Back Pain Relief: Lighten Your Bags
Carrying an overstuffed purse, briefcase, or handbag can strain the low back. If you must carry a heavy load, consider using a wheeled briefcase instead. By reducing the amount of weight you’re carrying, you reduce the amount of pressure on the spine. Help keep your kids’ backs healthy by making sure their backpacks are not overloaded. A heavy backpack could mean future back pain for your little ones.
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What Are Some Less Invasive Or Noninvasive Back Pain Treatments
Your doctor has a wide range of treatments that may help your lower back pain. In general, expect your doctor to take a stepped care approach. That means starting with simple, low-cost treatments and moving to more aggressive approaches later. Keep in mind that many treatments take time to reach their full effect.
Medications. When over-the-counter pills and topicals dont do enough to relieve back pain, your doctor may recommend a prescription drug. Examples include:
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Antiseizure medication, such gabapentin or pregabalin, for nerve-related pain
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Muscle relaxants, such as baclofen or carisoprodol
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Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen
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, such as oxycodone or hydrocodone, on a short-term basis.
Physical therapy . PT for lower back pain involves passive and active therapies to help the patient build core muscle strength, improve spinal flexibility and range of motion, correct posture and more. Your physical therapy sessions may include:
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Exercise
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Ultrasound
Injections. An or a may provide short-term pain relief when lower back pain causes sciatica symptoms, such as leg pain.
Workouts That Can Cause Low Back Pain
Most athletic injuries to the back are sprains of the ligaments or strains of the muscles surrounding the spine. Serious conditions or complications can have similar symptoms to those of a routine sprain or strain. The most common sports injuries occur after repetitive overuse of the spine either through twisting, compression, or flexion. High impact sports such as running, football, or volleyball can often cause low back pain. Sports like golf, in which repetitive twisting is often involved, can also cause low back pain.
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