What Does It Mean When Lower Back Hurts

How Can You Prevent Lower Back Pain

While you cant stop aging or change your genetic makeup, lifestyle changes can help manage and prevent lower back pain. Having a healthy lifestyle may make you less likely to suffer an accidental injury, too.

Improve your physical fitness. People who are not physically fit are more likely to develop lower back pain because strong core muscles help support the lower back.

Stay active. People who lead sedentary lives may be more likely to injure themselves when they do exert themselves. As far as back health is concerned, its better to do a smaller amount of physical activity most days of the week than to sit all week and over-exert yourself on the weekends.

Lose weight if necessary. The more you weigh, the more pressure you have on your lumbar vertebrae. Being overweight or obese can put stress on the back and lead to lower back pain.

Lift heavy objects the right way. Be sure to squat while lifting so that your hips and knees do much of the work. Keep the load close to your chest while you lift.

Your legs, not your lower back, should be the main driver when you’re lifting something heavy.Make your workspace as ergonomic as possible. If you sit at a desk, make sure your chair has plenty of low-back support and your hips are at a right angle to the floor.

Dont use tobacco products. In addition to all the other health problems tobacco use causes, it can restrict blood flow and oxygen to the discs, causing them to degenerate faster.

The Underlying Cause Of Pain May Be Hard To Identify

It is usually difficult for the brain to distinguish between injury to one spinal structure versus another nearby. For example, a torn or herniated disc may feel similar to an arthritic facet joint due to their close proximity. In some cases, the same nerve root can be compressed or irritated by different structures, such as a disc or bone spur.

See Spinal Cord and Spinal Nerve Roots

Your physician will take a thorough medical history, discuss your symptoms, and conduct a physical exam in order to accurately diagnose the cause of back pain. Sometimes diagnostic testssuch as X-rays, MRI scans, or diagnostic injectionsare needed when trying to locate or confirm the underlying cause of pain.

• See Radiculopathy, Radiculitis and Radicular Pain

Once your doctor reaches an accurate diagnosis for your back pain, an effective treatment plan can begin.

Radicular pain follows the path of the nerve into the arm or leg and may be accompanied by numbness or weakness.

Sudden Muscle Or Ligament Strain

Weve all heard the story of our friend who pulled something in their back trying to move the couch. It’s extremely common for people to tweak muscles and ligaments when they are lifting with improper form or moving a load that puts too much tension on the lower back. The risk can increase when a person’s muscles are deconditioned, says Dr. Rifkin. This often occurs when someone isnt very physically active and has lost muscle tone and strength.

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What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain

In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:

Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.

Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.

Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.

Lower Back Pain Causes: 8 Reasons For Sudden & Chronic Pain

Sometimes, you know exactly why your back is hurting. Maybe you lifted something awkwardly and felt the pain right away. Or maybe your doctor has been warning you for years that your bad posture would lead to lower back pain.

But other times, the source of back pain can feel like a mystery.

“Your lumbar spine, located in your lower back, plays a crucial role in supporting the weight of your upper body. It’s also responsible for everyday movements, such as bending, twisting and coordinating the muscles in your hips, pelvis legs and feet,” says Dr. Kenneth Palmer, orthopedic surgeon specializing in spine surgery at Houston Methodist. “Due to heavy use, the bones, muscles, ligaments, disks and nerves found in your lumbar spine are quite susceptible to both injury and wear and tear over time causing pain in the lower back.”

Lower back pain symptoms include:

• Dull ache in your hips and/or pelvis
• Muscle spasms or tightness
• Sharp, tingling pain that starts in your lower back and travels down one leg
• Pain that worsens with sitting and quickly improves while walking
• Pain that is noticeably worse in the morning

“Typically, a person experiences some combination of these symptoms, which can develop suddenly or over time. In some cases, lower back pain can feel like it comes and goes flaring up now and then, but generally getting progressively worse over time,” explains Dr. Palmer.

Speaking of the various causes of lower back pain…

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What Are Some Common Lower Back Pain Causes

The causes of lower back pain are sometimes viewed as being mechanical, organic or idiopathic. Sometimes spinal conditions are congenital or acquired meaning the disorder develops later in life.

• Mechanical lower back pain is often triggered by spinal movement and involves spinal structures, such as the facet joints, intervertebral discs, vertebral bodies , ligaments, muscles or soft tissues.
• Organic lower back pain is attributed to disease, such as spinal cancer.
• Idiopathic refers to an unknown cause.

These are some of the things your doctor might look for or rule out when you schedule a visit for back pain.

The common symptoms of lower back pain.

Sprains and strains. Ligament sprains and muscle or tendon strains are the most common causes of lower back pain. Theyre often related to overuse.

Degenerative disc disease. While the name sounds worrisome, it just means you have a damaged disc causing pain. Over time, discs become thinner and flatter due to wear and tear. That leaves them less able to cushion the vertebrae and more likely to tear .

Herniated disc. The protective covering on intervertebral discs can tear over time. When this happens, the soft inner disc tissue may push through the outer layer. A disc that bulges or slips out of place is known as a herniated disc, bulging disc, or slipped disc. The herniation may press on nerve roots, leading to symptoms such as pain, tingling, numbness or weakness in the area that the nerve serves

When You Should Go To The Er For Back Pain

If your back pain is accompanied by any of the following symptoms, head to your closest emergency room because you could be dealing with a more serious condition or injury:

• Sudden spike in pain, discomfort, weakness or numbness
• Loss of bladder function
• Unexplainable weight loss
• The pain results from a fall or severe blow to your back

If you experience any of these symptoms, its a good idea to talk to your doctor so you can determine next steps for managing pain.

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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.

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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What Causes Low Back Pain

It might develop suddenly, like after you lift something heavy. Or it might come on slowly.

As you get older, the structure of your back begins to show wear and tear. Doctors call it âspondylosis,â which means your spineâs joints, disks, and vertebrae get worse over time. This slow decline can lead to many problems, like the following:

• Strains. This means you overstretch or tear your tendons or muscle. You can do this by twisting, lifting something thatâs too heavy, or lifting something the wrong way.

• Degenerated disks. When these are healthy, they cushion your back as you bend, flex, and twist. As disks begin to wear out, they no longer absorb the shock of these movements well.

• Herniated or ruptured disks. Normal disks are rubbery. When they become squeezed, a portion bulges out between your vertebrae.

• Radiculopathy. A spinal nerve can become pinched or inflamed. This can cause low back pain to travel down your legs. It can also cause numbness or tingling.

• Sciatica. This is the type of radiculopathy that affects the sciatic nerve, which runs from your butt down the backs of your legs. When itâs inflamed, you may feel burning or pain like an electrical shock that may go all the way down to your feet.

• Spondylolisthesis. In this condition, a vertebra slips out of place and pinches spinal nerves.

• Spinal stenosis. Your spinal column may narrow over time, putting pressure on your nerves. Your legs may feel numb and grow weaker.

Whenyour Back Pain Could Be A More Serious Medical Problem

There are a few ways to tellthe difference between spinal stenosis and something more serious:

• Pain that gets worse when going uphill is more common with peripheral arterial disease, a buildup of plaque in the blood vessels leading to the your limbs.
• Arterial disease patients dont get relief from the grocery cart position.
• If your symptoms are worse at night but better with exercise, neuropathy may be to blame.
• In younger people, morning stiffness that lasts longer than 30 minutes and gets worse with stillness may be a sign of inflammatory arthritis, such as ankylosing spondylitis.
• Other unexplained symptoms such as weight loss and fatigue may be signs of a cancerous growth very rare, but absolutely worth looking into.

Serious issues such asmalignancies or abdominal aortic aneurysms rarely present with spine symptoms,Dr. Khalaf says, but sometimes they do. Theyre serious enough that rulingthem out is important.

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What Can I Do For Low Back Pain At Home

If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.

Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.

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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When Should I See A Doctor If I Have Lower Back Pain

In many cases lower back pain stops on its own. But if it doesnt, here are some guidelines on when you may want to start seeking professional help:

• If the pain lasts four weeks or longer
• If the pain keeps getting worse as time goes by
• If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.

How Sleep Can Contribute To Back Pain

Although there are many potential sources of lower back pain, how youre sleeping can be a factor. When youre sleep-deprived, your tolerance for pain is lower than it would be if you slept well. Studies have shown that losing sleep can heighten sensitivity to painful stimuli. In theory, sleep loss increases painful inflammation and getting enough sleep may reduce inflammation.

Another factor that can increase back pain is your response to pain medication when youre sleep-deprived. In a study of healthy normal adults, the analgesic effects of codeine are diminished in sleep-deprived individuals versus non-sleepy individuals. Sleeping well may help your pain medications work better.

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What To Do If Youre Waking Up With Back Pain

Back pain is a common complaint for adults. About 80 percent of adults will experience lower back pain at some point in their life. More than a quarter of adults report experiencing low back pain within the last three months. Low back pain is the most common cause of job-related disability and a major contributor to missed workdays.

If youre waking up with back pain, chances are youre not getting the restorative sleep you need at night. Common causes of back pain include getting into an accident and lifting something heavy. Sometimes back pain can develop over time with age. A sedentary lifestyle can lead to low back pain, especially if you have a burst of activity your body isnt prepared for.

Most low back pain is short-term, lasting just a few days to a few weeks. Often, it resolves on its own or with a treatment of the underlying cause. However, chronic back pain persists for 12 weeks or longer. Sometimes, a medical or surgical procedure can relieve the pain, but sometimes, pain persists despite treatment.

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 Research Is Being Done

The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.

As a primary supporter of research on pain and pain mechanisms, NINDS is a member of the NIH Pain Consortium, which was established to promote collaboration among the many NIH Institutes and Centers with research programs and activities addressing pain. On an even broader scale, NIH participates in the Interagency Pain Research Coordinating Committee, a federal advisory committee that coordinates research across other U.S. Department of Health and Human Services agencies as well as the Departments of Defense and Veterans Affairs.

When Should I Call My Healthcare Provider

• Can’t stand or walk
• Temperature over 101.0°F
• Chills
• Frequent, painful, or bloody urination
• Severe belly pain
• Pain or numbness in your leg
• Pain in a new area of your back
• The pain isnt decreasing after more than a week

• Pain radiating down the leg.
• Pain that is accompanied by fever or chills, leg weakness, or loss of control of the bladder or bowels.

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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.