What May Cause Lower Back Pain

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.

The Universal Guide To Lower Back Pain: Everything You Ever Wanted To Know Straight From The Experts

In This Article: Lower Back Anatomy | How Long Does Lower Back Pain Usually Last? | Common Causes | Other Causes | Home Remedies | Nonsurgical Treatments | Complementary, Alternative, and Emerging Treatments | Surgery | When Is Lower Back Pain an Emergency? | Lower Back Pain Prevention |

If youve ever had lower back pain stop you from doing what you want, youre not alone. Lower back pain is one of the most common medical problems in the world. It is a leading reason why people visit a doctor, affecting more than 80% of adults at some point in their lives. According to the Global Burden of Diseasea significant study published in the Lancet medical journallower back pain is also a leading cause of disability.

While severe lower back pain can cause worry, pain severity is not always an indication something is seriously wrong. Photo Source: Shutterstock.

You may not be able to prevent lower back pain, especially as you age and your back loses some strength and resilience. Fortunately, there are many ways you can get relief, no matter the cause of your back pain.

When To See A Doctor

There is not always an obvious cause of lower back pain, and it often gets better on its own. Resting, trying hot or cold therapy, taking OTC pain relievers, and gently stretching may help speed up recovery.

However, a person should see a doctor for lower back pain that is severe, does not seem to be getting better, or occurs alongside other concerning symptoms, such as tingling or numbness down the legs.

People with lower back pain should seek immediate medical attention if they also have any of the following symptoms:

• difficulty walking or moving the legs
• loss of bowel or bladder function
• loss of sensation in the legs
• very severe pain

A doctor can help a person identify potential causes of lower back pain and recommend appropriate treatment.

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When To See A Medical Professional

It’s always worth having severe or chronic back pain checked out by a professional. If you’re over 55, there’s a 5% chance your lower back pain is caused by a fracture. There’s only a 1% chance it’s down to something more sinister, such as a tumour, aneurysm or infection.

Contact your GP if your lower back pain hasnt begun to ease and is preventing you doing everyday tasks after more than three days, or if youre still in severe pain or it’s worsened after six weeks. Seek urgent medical help if back pain is accompanied by:

• Fever
• Recent serious trauma, i.e. a car accident
• Numbness or tingling in groin or legs
• Loss of bladder/bowel control or an inability of pass urine
• Medical history of osteoporosis or cancer, or recent unexplained weight loss
• Night discomfort
• Leg weakness that comes on suddenly or gets progressively worse, or more pain in the leg than the back
• Inability of get comfortable sitting or sleeping when you feel back pain

Which Health Care Specialties Treat Low Back Pain

Physician specialties that evaluate and treat low back pain range from generalists to subspecialists. These specialties include emergency medicine physicians, general medicine, family medicine, internal medicine, gynecology, spine surgeons , rheumatology, pain management, and physiatry. Other health care providers for low back pain include physical therapists, chiropractors, massage therapists, psychologists, and acupuncturists.

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Psychological Stress Can Cause Back Pain

Though it might seem hard to believe, mental or emotional distress may be the reason you are experiencing back pain. In fact, there is a long list of physical symptoms that have been proven to be associated with stress and anxiety, including:

• Fatigue
• Insomnia
• Low libido

Stress itself is the bodys reaction to certain usually unpleasant situations or thoughts. You may not realize it, but when you are feeling stressed or anxious, there are chemical and physical reactions taking place in your body to try and protect you from harm. Cortisol and adrenaline are released, and there is typically an involuntary tightening of your muscles. This often occurs in the neck, shoulders, and down the spine. Prolonged tension in these areas can lead to back pain and, more specifically, lower back pain. You may have had a massage therapist tell you that you hold a lot of tension in your shoulders, and this phenomenon is what they are referencing.

Other Types Of Diagnosis

• A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
• An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
• A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.

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The Tricky One: Cancer As A Cause Of Low Back Pain And The Necessity Of Testing Just In Case When The Symptoms Justify It

Sorry I have to use the C word I know its kind of a bummer. But C happens.

A few cancers in their early stages can be hard to tell apart from ordinary back pain a bone cancer in the vertebrae, for instance and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient just in case. And yet the possibility cannot be dismissed, either! This is an unsolveable problem.

Most cancers and ominous problems will inevitably start to cause other, distinctive, ominous symptoms, and it wont be long before someone catches on that theres more going on than just back pain. So it truly is an extraordinary circumstance for back pain to be ominous without causing other symptoms that raise the alarm.

For example, in 2017, the New England Journal of Medicine reported on a creepy case of slowly growing neurological deficit caused by a very stealthy cancer, which took a lot of diagnostic effort to solve.22shudder So sneaky cancers happen but they are crazy rare.

This is an unholy combination of factors: the exact same symptoms can have either an extremely rare but serious cause, or an extremely common but harmless cause that can be greatly aggravated by excessive alarm!

My favourite epitaph: I told you I was sick!

A Herniated Or Slipped Disc

If you feel severe, sharp pain shooting through your lumbar region when walking, you might be experiencing sciatica from a slipped disc.

The bones that make up your spine are cushioned by small discs. These discs absorb shock and help protect the spinal cord. If a disc slips out of place, it can press on the spinal nerve and cause severe pain.9

What are the Symptoms of a Herniated Disc?

Symptoms may vary depending on the location and size of the injured disc. If the disc is pressing on a nerve, the symptoms may be more severe, as with sciatica.

Sciatica may cause a shooting pain, burning, tingling or numbness that occurs anywhere along the sciatic nerve from the buttocks to the legs.

Other symptoms may include:

• Lumbar spinal pain
• Severe, electric shock-like pain

• A sedentary lifestyle11

What To Do If You Think You Have A Herniated or Ruptured Disc

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Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome describes pain that is felt along the outer hip area. Causes include sports injury, muscle tears, and injury due to motor vehicle accidents. The pain is caused by a combination of inflammation in two distinct areas: the bursa of the hip and pain in the buttock . Pain may also be caused by tendinitis of the hip abductor muscles. Symptoms of greater trochanteric pain syndrome include hip pain at night lying on side, dislocated hip symptoms, and hip muscle weakness. Hip pain relief can be sought through anti-inflammatory medications, physical therapy, and stretches for hip pain.

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

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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.

Tips To Prevent Or Decrease Bowel Problems

• Make sure you eat regularly: take at least three meals spread across the day and no more than three to four snacks in-between.
• Take time to eat and chew well.
• Ensure that your food contains sufficient fibre .
• Drink 1.5 to 2 litres of water per day.
• Go to the toilet on time, or even allocate a set time to go to the toilet undisturbed.
• Do not use laxatives without the permission of a doctor.
• Take sufficient and frequent exercise.

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Why Your Back Muscles Hurt

This may sound suspiciously like common sense, but your back muscles hurt when you pull them too far or place them under too much strain.

But contrary to common misperception, the underlying cause of this back muscle pain is not poor posture, how much you exercise or even your genetic history.

Instead, poor posture can be strong evidence of the real cause. Exercise of the wrong kind can make it worse . And the good news is you can do something about this underlying cause of back pain regardless of your genetics.

The root cause of virtually all non-trauma related back muscle pain and a major contributor to many back conditions like herniated discs are muscle imbalances.

One way to visualize muscle imbalances and how they cause back pain is to think of your car. If the wheels are out of alignment, the tires will wear unevenly, making them more susceptible to an early blowout.

Imbalanced muscles do the same thing to your back. Muscle pain results when one muscle or group of muscles overpowers an opposing set of muscles that get stretched out of shape.

And heres the kicker many of the muscles affecting your back pain arent in your back!

For example, sitting all day long leads to weak abs, glutes, and hamstrings which go unused much of the day. In the meanwhile, your hip flexors, quadriceps and lumbar muscles remain tight to keep you in an upright position.

This video explains how muscle imbalances affect your pain, and how to fix them.

Other Potential Causes Of Lower Back Pain When Walking

Lower back pain when walking is not limited to these causes. Here are some other potential causes of lower back pain when walking:

• Cauda Equina Syndrome

The compression of nerve roots, commonly resulting from a herniated disc in the lumbar area.15

• Degenerative Disc Disease

Can be caused by the drying out of a disc, daily physical activity and sports, or injury.16

• Compression Fractures

When part of a bone in the spine, a.k.a. a vertebrae, collapses.17See Your Doctor for Lower Back Pain When Walking

You dont want to gamble with your back health. Call your doctor to advise you on any type of treatment. Heres what your doctor might recommend:

• NSAIDs
• Massage
• Acupuncture

While youll always want to call your doctor for advice, especially if your pain is severe, there are also several things you can do at home that might help you manage lower back pain.

• Change up your exercise routine
• Apply heating pads and ice packs
• Buy a more supportive mattress
• Pay attention to your posture
• Lose weight
• Focus on relaxing and natural stress relief18

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Tips To Strengthen Your Back

Flexion and extension exercises are commonly used to prevent low back pain. Be sure to review with the doctor any program you are considering.

Easy Low Back Exercises

• Ankle Pumps: Lie on your back and move ankles up and down.
• Heel Slides: Lie on your back and bend then straighten the knees one at a time.
• Wall Squats: With your back flat against a wall, sit like you would in a chair with your knees lined up over your ankles. Gently press against the wall, keeping your abdominal muscles tight. Hold for five seconds.
• Single Knee to Chest Stretch: Lying down with back flat, pull your knee into the chest.

How Is Lumbar Strain Diagnosed

In addition to a complete medical history and physical exam, diagnosing low back pain may include the following. However, specialized tests aren’t often required.

• X-ray. A diagnostic test that produces images of internal tissues, bones, and organs onto film.
• CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. It shows details of the bones, muscles, fat, and organs.

• MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body.
• Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into your blood to be detected by a scanner. This test shows blood flow to the bone and cell activity in the bone.
• Electromyogram . A test to evaluate nerve and muscle function.

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How Long Does Lower Back Pain Usually Last

Lower back pain can be categorized as acute, subacute or chronic. Acute episodes of lower back pain usually last from a few days to 4 weeks and subacute lower back pain lasts between 4 to 12 weeks. However, according to the National Institutes of Health, about 20 percent of people with acute back pain go on to develop chronic back paindefined as pain that lasts 12 weeks or longer. Even in these cases, there are many different treatment options to help relieve lower back pain symptoms.

When your back is really killing you, you might worry something is seriously wrong. The same goes for back pain that seems unending. The good news is that while back pain is a major inconvenience, it is rarely an urgent medical issue. In fact, most of the time you dont have to treat it. Back pain usually resolves on its own unless you have a major underlying issue.

Viii Lower Back Pain And Cancer

Cancer involving the lumbar spine is rare. However, in people who have a prior history of cancer, for example, in the breast or prostate, or who have weight loss or loss of appetite along with back pain cancer needs to be considered.

Night pain can be a clue to cancer in the spine. A benign tumor called osteoid osteoma, which most often affects young people, causes pain that tends to respond well to aspirin. Multiple myeloma is a malignancy that occurs when the plasma cells in the bone marrow begin spreading uncontrollably. It is most common in older people, and can cause pain in many parts of the spine. When tumor or infection are suspected, blood tests may be ordered, including a CBC , sedimentation rate , and protein electrophoresis .

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