Causes Of Lumbar Pain
Lower back pain most often results from
- Mechanical issues
- Deteriorating condition
- Abnormal spinal curvature
If the problem is deterioration or unusual spinal anatomy, deeper tissue injuries can arise such as herniated discs or nerve compression. These complications require professional attention. Never ignore serious symptoms such as severe pain, sudden weakness, shooting nerve pain, numbness or tingling. Do not delay seeking help for unusual symptoms.
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.
The Source Of Back Pain
A lot of back pain in older men is caused by weak core muscles and declining muscle mass. However, pain also could be related to osteoarthritis, an injury, or even depression. “It’s always important to get checked out by your doctor if your pain does not subside after a few weeks, or right away if it’s accompanied by other conditions like leg weakness, incontinence, or a fever,” says Dr. Shmerling.
Keep in mind that NSAIDs might not always be the best medicine for back pain. A study published online Feb. 2, 2017, by Annals of the Rheumatic Diseases reviewed 35 placebo-controlled studies that included more than 6,000 people who had all sorts of spine-related pain, including neck pain, low back pain, and sciatica.
There are several categories of back pain medication. The common ones include nonsteroidal anti-inflammatory drugs , opioids, muscle relaxants, and antidepressants. What’s your best option? It depends on your particular pain and how your body reacts to the medication and dosage.
“Advertisements pitch a particular drug as if it would work for everyone, but back pain varies from person to person, as does its response to drugs,” says Dr. Shmerling.
Here’s a look at these types of drugs and how they help with back pain:
NSAIDs. NSAIDs are often the go-to drugs for back pain relief. They can be purchased over the counter and include ibuprofen and naproxen .
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Support Your Body In A Warm Pool
The buoyancy of the water lets you enjoy the benefits of exercise with less pain. Exercising in water also helps regulate the functioning of nerves and muscles, relieving pain.14
If you prefer warmer pools, look into water exercise classes and hydrotherapy pools. Water therapy exercises are often done in water that is about 83 degrees to 88 degrees. Hydrotherapy pool temperatures are often more than 90 degrees.
See Water Therapy Exercise Program
Heat Therapy And Cold Therapy To Help Back Pain
Heat therapy and cold therapy are two sides of the same coin. Heat therapy uses warm water or heating pads to relieve muscle pain, while cold therapy uses ice or cold water. In certain situations, using heat therapy and cold therapy can help relieve pain and promote healing.
For new or acute pain like pain caused by a fall or other pain that shouldnt last beyond six weeks cold therapy can be a great way to reduce swelling, decrease inflammation and numb pain.
For chronic pain pain thats expected to last or has lasted for more than six weeks heat is usually the temperature of choice for soothing pain and stimulating the healing process.
You might benefit from both hot and cold therapy. For instance, after exercise, immediate cold therapy can reduce muscle soreness. After 24 hours, switching to heat therapy can help your muscles heal faster.
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Manage Or Reduce Stress
Stress can trigger muscle tension and painful spasms, including in the back. If long-term stress or a traumatic event seems to have caused back pain, a person can try stress-relief techniques, such as:
- Mindfulness meditation. One study showed that mindfulness-based stress reduction improved back pain. Mindfulness involves being aware of what the body is doing and using meditation techniques to assist with the pain.
- Deep breathing. Taking deep breaths in and out for several minutes can calm the bodys stress response.
- Progressive muscle relaxation. This involves tensing and relaxing muscles in the body, focusing on one muscle group at a time. Lying on their back, a person can start with their feet and gradually move up to the shoulders.
- Guided imagery. This involves focusing on specific mental images to bring about a feeling of relaxation. One study found guided imagery and music help with work-related chronic stress.
- Yoga. Yoga focuses on particular poses and breathing and can help with relaxation, especially when practiced regularly. One review found yoga to be an effective stress management tool.
Many smartphone apps are available to guide a person through relaxation techniques and meditation.
Treating Chronic Back Pain
There are two main types of back pain treatments short-term and long-term. Short-term treatments are like a temporary patch, theyll help you manage your pain for a set period of time, but the pain will eventually return. The goal of long-term back pain treatments is to provide lasting relief. Both types of treatments have their purpose.
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Can Back Pain Be Prevented
Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress , vibration, repetitive motion, and awkward posture.Recommendations for keeping ones back healthy
Specialized Physical Therapy For Back Pain
Physical therapy is a type of treatment that uses targeted exercises to improve your strength and flexibility. By strengthening the muscles that support your back, you can take pressure off your spine and reduce back pain. Physical therapy can help you ease and manage pain so you can do everyday activities. And physical therapists are experienced in helping treat both acute and chronic back pain. Theyll guide you through exercises designed to manage your specific symptoms.
Physical therapy is often the best treatment option for back pain. Improving your muscle strength and learning how to perform daily activities without straining your back can resolve your chronic pain. It typically takes about six weeks to complete a back pain physical therapy program, though many people start feeling pain relief after their first visit.
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Prevention Of Back Pain
You may be able to prevent back pain from overuse or improper body mechanics. The following recommendations can help you have a healthy back and lifestyle:
- Perform regular exercise that keeps your back muscles strong. Exercises that increase balance and strength can decrease your risk of falling and injuring your back or breaking bones. Exercises such as tai chi and yoga or any weight-bearing exercise that challenges your balance are good ones to try. Remember to warm up before exercise or other physical activities.
- Eat a healthy diet that includes enough calcium and vitamin D, nutrients that keep your spine strong.
- Maintain a healthy weight. Being overweight can put unnecessary and injury-causing stress and strain on your back.
- Practice good posture and avoid slouching. Try to remember to support your back when sitting or standing.
- Avoid lifting heavy items whenever possible. If you do lift a heavy item, use your leg and abdominal muscles instead of your back.
Find Activities That Make You Happy
Ongoing back pain can wreak havoc on your life, affecting your cherished relationships, finances, and your ability to get stuff done at work and at home. Finding activities that make you happy can help reduce some stress and may relieve some pain.
Some people find that even doing just 3 things that make them feel good each daysuch as enjoying a comforting cup of tea or coffee, calling an old friend, walking the dog, or receiving a longish 30-second hug from a loved onecan make pain more tolerable.
Even something as simple as laughter with a friend may stimulate feel-good endorphins.1, 2
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Imaging And Blood Tests
Most people do not need additional testing however, sometimes doctors order tests to rule out a specific cause for your pain or to confirm a cause for your back pain. Your doctor may order the following.
- X-rays only show bones and can help diagnose:
- Broken bones or fractures.
- Changes due to aging.
- Changes in the alignment of the spine.
Fractures And Lower Back Pain
are often very difficult pain problems and indicate the possible presence of . In patients with severe osteoporosis, spinal fractures can occur with no early warning and no significant trauma the patient does not have to fall to fracture a vertebrae.
Patients with spinal compression fractures experience spasms and, often, very high pain levels.
In patients with low back pain where the cause is difficult to determine, especially for elderly patients with osteoporosis, a fracture in the sacrum may be the cause of the pain. A standard X-ray or bone scan may not show a sacral fracture. Imaging techniques such as CT scan or MRI can often reveal these fractures.
It is very important that patients with acute lumbar compression fractures be tested for osteoporosis. A bone density study is needed, unless the patient has no other osteoporosis risk factors and has had a very high impact fracture. Studies have shown that many patients with fractures in the U.S. are discharged from hospitals with no plans for management of their bone density problems, which then are left to worsen.
Although pain can be very intense, it is best for patients with lumbar fracture to resume activity as soon as possible. This is especially true for elderly patients, who can too easily become weakened, and develop other complications, if mobility is reduced for too long. may be needed for pain control, for as brief a period as possible.
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What Can Cause Lower Back Pain
Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:
Congenital
- Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
Injuries
- Sprains , strains , and spasms
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
Degenerative problems
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
Nerve and spinal cord problems
Non-spine sources
Vertebral Fractures Causing Back Pain
Osteoporosis can lead to fragility fractures, in which a fall from a standing height or lower causes a bone to break. Fragility fractures can occur anywhere in the body but are commonly seen in the spine, hip, or wrist.
Symptoms of vertebral fractures can include:
- Back pain ranging from mild to severe and debilitating
- Spinal stiffness
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Bonus Tip: Consider Taking A Vitamin D3 Supplement
If your doctor agrees, consider taking a vitamin D3 supplement. Vitamin D is essential for bone, neuromuscular, and immune system function. Taking a vitamin D3 supplement can help reduce back pain by increasing the absorption of calcium in your body and improving bone strength.15
See Calcium and Vitamin D Requirements
Finding the perfect pain relief technique is usually a process of trial and error, making it worth exploring various approaches. Try these natural pain-relieving strategies for your back pain and see what works best for you. Severe pain that is not relieved by self-care must be evaluated by a health professional for an accurate diagnosis and treatment plan.
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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How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
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Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
Being Mindful Of Your Movements
How many times has someone told you to lift with your legs, not with your back? Though its almost become cliché, its good advice. Your lower back supports a lot of the function of your body. Even if you lift using correct posture most of the time, a few haphazard hoists can be all it takes to cause long-term pain.
For example, parents with small children will lean over and pick them up out of a crib several times a day. Once or twice might not put much strain on the back, but repeating this movement hundreds or thousands of times over the years can cause serious discomfort. Mind those movements today, and your back will be more forgiving in the future.
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Treating Back Pain At Home
Aside from such severe injuries or arthritis, most lumbar pain is short term and may respond well to home care, especially if its a recent occurrence and you suspect you know how you may have caused it. If the level of pain is mild, here are five things you can try at homebut if pain lingers or gets worse, discontinue your efforts and consult your doctor:
