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.
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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.
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Organic lower back pain is attributed to disease, such as spinal cancer.
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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 .
. 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
Avoid Prolonged Static Posture
It is important to pay attention to the joints and muscles of your spine and hip. Prevent fatigue and stresses on these joints by following simple tips, such as:
- Avoid excessive sitting or consider using a standing desk while you work. When you sit for a long duration, the pressure on your spinal discs increase. Aim to get up every hour and walk a short distance to take the load off your discs.
When you have a flare-up of symptoms, consider less exertive activities, such as reading a book, listening to music, or crafting. These activities can help divert your mind from the pain and let your back rest at the same time.
Is Your Back Pain An Emergency
Did you wake up today with the worst back pain youve ever felt?
Was it a normal day, and then severe back pain started and you dont know what to do?
In these circumstances you might think the emergency room is the place to go for help.
There are certain pain symptoms that do belong in the emergency department:
Severe back pain is rarely a medical emergency. Back pain, even with tingling or numbness in your leg, pain that makes you limp, and hurts to sit or stand for long doesnt belong in the emergency room.
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Treatment Options For Lower Back Pain
If you see a physiotherapist or GP for lower back pain, they will probably encourage you to try the self-help measures outlined above first. They can also advise you on what exercises you can do to help your back, or may refer you to a group exercise programme. But if your pain doesnt improve, they may be able to recommend other options you can try. They can also refer you to a specialist if necessary.
Other Conditions That Cause Back Pain
Sometimes pain felt in the back actually originates elsewhere in the body. Such problems may include: prostate trouble in men problems with reproductive organs in women kidney diseases, such as an infection or kidney stone diseases of the intestines or pancreas, such as cancer or a blockage cancer that has spread to the spine multiple myeloma, a form of cancer of the bone and bone marrow curvature of the spine rarely, a tumor on the spinal cord
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First Look For Possible Triggers
This fall, I had gotten away from my regular core-strengthening routine . At about the same time, I increased the consecutive hours spent sitting at my desk, typing away. Weakened core plus prolonged time seated at an ergonomically challenging workspace equals exacerbation of my chronic low back pain.
This situation is exceedingly common. I have both short-term and long-term solutions. For now, I get up and stand when my Fitbit buzzes . At least once an hour, I do toe-touches, side and back bends. Im also adding in really quick and easy in-office core strengthening exercises. As a matter of fact, my nurse practitioners and I just practiced our chair squats, one-legged chair stands, and desk planks, as we sit here at our computers for hours at a time. Try this core workout you can do right in your office.
What Exactly Is The Lower Back Anyway
Your lower back is known as the lumbar region of the spine. It has a lot of heavy lifting to do: The lumbar spine carries the weight of your entire upper body, plus biomechanical stresses that occur with movement.
The lumbar spine has five vertebraebackbones. Each vertebra has a large disc cushiony gel wrapped in a tough membrane on its front side that acts as a shock absorber. Each vertebra also has two cartilage-lined facet joints on its back side. Working together, discs and facet joints allow the spine to safely bend and twist.
Your lower back also includes ligaments, tendons, and muscles. Ligaments are strong bands that hold the vertebrae and discs together. Tendons attach muscles to the vertebrae. These structures help limit excessive movement that could harm the spinal cord.
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What Is The Outlook For People With Lower Back Pain
The outlook depends on the cause of pain. Most people with back strains and sprains recover and do not have long-term health issues. But many people will have another episode within a year.
Some people have chronic back pain that doesnt get better after several weeks. Older people with degenerative conditions such as arthritis and osteoporosis may have symptoms that get worse over time. Surgery and other treatments are effective at helping people with a range of injuries and conditions live pain-free.
Medication From The Store
There are two kinds of over-the-counter pain relievers that frequently help with back pain: nonsteroidal anti-inflammatory drugs and acetaminophen. Both have some side effects, and some people may not be able to take them. Talk to your doctor before taking pain relievers. And don’t expect medication alone to solve your pain problem. Studies show you’ll probably need more than one type of treatment.
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Top 7 Most Serious Causes Of Back Pain
Approximately 80% of adults in the United States will suffer from back pain at some point. Fortunately, most of the time that pain is due to a straightforward problem such as a herniated disc or degenerative disease in the spine. These problems are bothersome, and can even be dangerous if too much time is allowed to pass, but they are not considered a medical emergency.
On the other hand, anytime back pain is associated with weakness or loss of bladder or bowel control, it should be considered an emergency that requires immediate treatment. These symptoms can suggest compression of the spinal cord or cauda equina. Moreover, sometimes back pain can be a sign of more significant trouble. Here are some of the most serious causes of back pain that both doctors and patients must be careful not to miss.
Bonus Tip: Soothe The Pain With Cold And/or Hot
Don’t underestimate the pain reduction of simply applying cold packs and/or hot packs to help reduce your lower back pain.
- Cold therapy helps reduce inflammation and pain. Some examples include wrapping ice in a cloth, a pack of frozen peas from the freezer, or a cold gel pack. Always keep at least one layer between your skin and the ice/cold pack.
- Heat therapy helps improve blood flow, relaxation, and pain relief. Heat therapy can come in many forms. It’s best to try several to find what works best for you. Taking a warm bath or shower, soaking in a hot tub, or using a heating pad or heat wrap are all ways to bring warmth to your lower back.
Whether applying ice or a heat pack, limit applications to 15 or 20 minutes with at least 2 hours of rest in between to protect your skin. Never sleep with a heating pad or frozen pack as this can lead to permanent skin damage.
Hopefully these overlooked remedies can help you try some new approaches to better manage your lower back pain and find lasting relief.
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What Is The Treatment For Chronic Nonspecific Low Back Pain
Initial treatment is similar to sudden-onset attacks. That is, aim to keep as active as possible. Also, painkillers can help. In addition to the painkillers listed above, your doctor may advise a course of an antidepressant medicine in the tricyclic group – for example, amitriptyline. Tricyclic antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including back pain.
Also, a national guideline , referenced below) recommends one or more of the following treatments should be considered. Each of these treatments has some evidence from research trials to suggest that they will help to ease symptoms in some people :
- Structured exercise programme. This means a programme of exercise supervised by a professional such as a physiotherapist. This is likely to be in a group setting. Exercises may include aerobic activity, movement instruction, muscle strengthening, posture control and stretching. It typically consists of up to eight supervised sessions over 8-12 weeks with encouragement to keep on doing the exercises at home between sessions.
- Manual therapy. Typically this includes several sessions of massage, spinal mobilisation and/or spinal manipulation. With spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist moves joints beyond the usual range of movement.
- A course of acupuncture. It is not clear how this may work.
Nonspecific Low Back Pain
This is the most common type of back pain. The majority of cases of sudden-onset low back pain are classed as nonspecific. This is the type of back pain that most people will have at some point in their lives. It is called nonspecific because it is usually not clear what is actually causing the pain. In other words, there is no specific problem or disease that can be identified as the cause of the pain. The severity of the pain can vary from mild to severe. This type of back pain is discussed further below.
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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.
Signs Your Back Pain Might Be An Emergency
In our 20s and 30s, normal back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.
In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.
Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.
Approximately 80% of adults will experience back pain in their lives, so its important to be able to identify the severity of your symptoms and track how long the pain lasts.
If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, its usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
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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
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.
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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:
Should You Visit The Emergency Department For Back Pain
People with pain expect to leave the emergency department with some relief of their pain, and they are frequently disappointed. Getting good help for chronic pain is not what the ED is designed to do. Even if your back, neck or other pain is severe, theres only a small chance that its a medical emergency.
A checklist for visiting the ED:
- Did you have an accident or trauma?
- Have you been ill or had recent surgery?
- Do you have unsafe practices like IV drug use?
- Do you have unexplained fever?
- Do you have dizziness, nausea or vomiting?
- Are your legs weak, numb or unable to move?
If the answer to these questions is no, even if your back pain is very severe, you probably wont benefit from an emergency room visit.
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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.
