What Causes Lower Back Pain
Many injuries, conditions and diseases can cause lower back pain. They include:
- Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.
- Fractures: The bones in the spine can break during an accident, like a car crash or a fall. Certain conditions increase the risk of fractures.
- Disk problems: Disks cushion the vertebrae . Disks can bulge from their position in the spine and press on a nerve. They can also tear . With age, disks can get flatter and offer less protection .
- Structural problems: A condition called spinal stenosis happens when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord can cause severe sciatic nerve pain and lower back pain. Scoliosis can lead to pain, stiffness and difficulty moving.
- Arthritis: Osteoarthritis is the most common type of arthritis to cause lower back pain. Ankylosing spondylitis causes lower back pain, inflammation and stiffness in the spine.
- Disease:Spine tumors, infections and several types of cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysm.
- Spondylolisthesis: This condition causes the vertebrae in the spine to slip out of place. Spondylolisthesis leads to low back pain and often leg pain as well.
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Poor Quality Sleep And Insomnia Are Probably Major Causes Of Morning Back Pain
Dont get me wrong: some people sleep just fine and still have morning back pain. But poor quality sleep and pain tend definitely to go together,15 and mornings can be the roughest part of that link.
The more interesting question is the chicken/egg thing: which comes first? Pain or sleeplessness? Once you have both insomnia and pain, they surely cause each other, but one side of that equation is probably more important than the other, like a cyclist pushing much harder on one pedal than the other.
In 2017, Gerhart et al studied the which-came-first question of pain and insomnia in 105 chronic low back pain patients.16 Their subjects bravely filled out five detailed questionnaires per day for two weeks thats quite a lot of paperwork tracking and rating many aspects of their pain and sleep quality. The goal was to study lagged temporal associations: what tends to happen after what? Are bad sleeps often followed by bad days with back pain? Are rough days with back pain followed by lousy sleeps?
Yes and no to those two questions.
Poorer sleep was strongly linked to everything being worse which is about as surprising as a dog barking at a squirrel. Its the timing of that relationship that this study zoomed in on, and not only did a bad night clearly herald trouble across the board the next day more pain, more disability, more doom and gloom but especially during the early part of the day.
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Muscle Tightness In Thighs And Hips
Weve talked before about how hamstring stretches can help alleviate back pain. Tight hamstrings are short hamstrings, and these muscles connect to your lower back. Tightness in your hamstrings can affect the curvature of your lower spine, disrupting the precise alignment of your spine with your pelvis.
Hamstrings may be tight as a result of physical activity, injury, or a failure to stretch before and after exercising. Luckily this problem can be easy to manage at home with some targeted stretching. If you need some help getting started, a physical therapist can help guide you through some basic movements.
When To Contact A Medical Professional
- Back pain after a severe blow or fall
- Burning with urination or blood in your urine
- History of cancer
- Loss of control over urine or stool
- Pain traveling down your legs below the knee
- Pain that is worse when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Severe pain that does not allow you to get comfortable
- Unexplained fever with back pain
- Weakness or numbness in your buttocks, thigh, leg, or pelvis
Also call if:
- You have been losing weight unintentionally
- You use steroids or intravenous drugs
- You have had back pain before, but this episode is different and feels worse
- This episode of back pain has lasted longer than 4 weeks
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How Can You Get An Upper Back Pain Diagnosis
When you go to a doctor for your upper or mid back pain, youll start with a conversation. Expect the doctor to ask you about any events that may be directly responsible: A fall, a car accident, or any changes or increases to your fitness routine.
You might be asked to rank your pain on a scale of 0-10. You should also be prepared to talk about how your pain does, or does not, interfere with the activities of your daily life. Can you cook dinner, get dressed, take a shower?
Then comes the physical exam: the poking and prodding part of your visit. The doctor wants to see how your upper back pain affects your movement. Expect to sit, stand, reach, and bend in the exam room. After that, youre likely to get an X ray.
If symptoms persist or you have red flags such as a progressive weakness or bowel or bladder control problems, you may get more advanced testing, Dr. Knight says. He explains that MRI would be the likely choice.
Heres a look at several types of advanced testing for upper back pain.
Reasons Your Back Pain Is Worse When You Wake Up
1) Fluid in spinal discsSpinal fluid is necessary to allow for all of our spinal motions without it the spine would crack and break. The fluid is a shock absorber that circulates nutrients and chemicals filtered from the blood and removes waste products from the brain. Our spinal discs constantly fill and empty of this fluid. Our spinal discs are at their fullest in the morning because they fill up with fluid when we lie down at night. This means that when we get up in the morning we will be a little bit taller than usual, but also a little bit stiffer! This stiffness can cause morning back pain that will ease off as the day goes on. Practicing gentle back exercises such as cat/cow will help to get the spinal fluid moving and alleviate any discomfort caused by it.
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Treatment Options If You Already Have Back Pain
If youre already suffering from back pain or spinal injuries, there are a variety of treatment options available. Some involve the use of sports medicine, others involve spinal surgeons, and then there are options that cater to our bodys natural ability to heal itself.
Which option is best for you is far too broad of a question to answer in a single article. Regardless of your condition, you should always seek out medical advice from a doctor or other medical professional.
In our program Hit It Great, we go over many different exercises designed to strengthen specific muscles and help keep the doctor away! Pay attention to your body and make sure youre not pushing yourself past your limit and causing significant pain and even permanent damage to your back.
If youre looking for a team of experts to help improve your golf game and keep your body healthy, then you have two great options:
Here’s Coach Joey D with his take on the golf swing, back pain, pre-hab and how you can stay ahead of the curve:
What Do You Do About Trigger Points And Fibromyalgia
Those are both big, separate topics, but there are many resources on PainScience.com where you can get started. Self-massage and heating are by far the best ways to start working on muscle knots. Fibromyalgia is much more complicated, but the basics are sleep improvements, lots of light but thorough exercise, and learning about sensitization and the weirdness of pain.
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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.
What Are The Symptoms Of Back And Neck Pain
Symptoms associated with back pain may include:
Dull, burning, or sharp pain in your back. The pain can be confined to a single spot or cover a large area
Leg numbness or tingling above or below your knee
Stiffness or achiness that occurs anywhere along your spine
Sharp, shooting pain that radiates from your low back to your buttocks, down the back of your thigh, and into your calf and toes
Consistent ache in the middle or lower part of your back, especially after standing or sitting for an extended period
Loss of bladder and bowel control, with weakness in both legs, are symptoms of a serious condition that requires immediate medical attention.
Symptoms associated with neck pain can be:
Arm numbness or tingling
Sharp shooting pains or a dull aches in your neck
Pain that occurs suddenly in your back or neck, due to an injury, is considered to be acute pain. Acute pain comes on quickly and may leave sooner than chronic back or neck pain. This type of pain should not last more than 6 weeks.
Pain that may come on quickly or slowly and lingers for weeks, 3 months or greater, is considered to be chronic pain. Chronic pain is less common than acute pain.
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Its Rarely About Range Of Motion
I am an extremely stiff person I have significant troubles with chronic pain,3 and I usually feel like I cannot move nearly as well as I would like to move.
And yet I can move just fine. If I test myself, my range of motion is perfectly normal.
People with normal ROM, or even good ROM, can feel amazingly stiff and tight. In fact, abnormal hyper-mobility is a common cause of stiffness!4 In a , more than 80% of people with hypermobility disorders claimed to feel more stiff than the average person, or way more stiff.
At the other end of the spectrum, people with measurably lousy range of motion can actually feel perfectly fine, no stiffness at all.
Why such variety? Probably because stiffness, just like pain, is an extremely unpredictable sensation overprotectively imposed on us by our brains for reasons we are often oblivious to.5
There are a handful of conditions which involve truly restricted movement , but most people with those problems usually dont talk much about stiffness. It would be like complaining about your house being too warm while its burning down.6
The symptom of stiffness usually occurs well within normal ROM, whether its large or small. You can feel stiff when you stand up from a chair an action that isnt even constrained by really poor flexibility. And when youre sore after a hard workout, you can stretch just as far as normal but it will hurt more, and many people describe that as stiffness rather than sore or painful.
Tightness Elsewhere In The Body
Tight hamstrings, due to a sedentary lifestyle or poor stretching, can cause excessive spinal flexion when bending down. Excessive flexion from the spine can leave the lower back tense and sore.
Hip flexors allow you to walk, bend, and turn your hips. Tight tips can cause the tissues around the lumbar spine to become inflamed and tender.
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When Should I Call My Health Care Provider
See your health care provider if you have:
Loss of bladder or bowel control, with weakness in both legs. These symptoms require immediate attention
Severe back or neck pain that does not decrease with medication and rest
Pain after an injury or a fall
Weakness, numbness, or tingling in your legs or arms
Back and neck problems range from minor aches to severe, disabling pain
Often, the reasons for your pain cannot be identified.
See a health care provider if you have numbness or tingling, severe pain that does not improve with medication and rest, difficulty urinating, weakness, pain, or numbness in your legs, fever, unintentional weight loss, or pain after a fall.
Often, back and neck pain will improve over time. Consult with your health care provider if your pain is not decreasing.
Use prevention strategies to keep yourself healthy and injury-free.
For severe, disabling, or chronic back pain, consider an individualized rehabilitation program.
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:
- 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.
- 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.
- 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
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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.
Job Posture And Other Possibilities
Do you work a 9-5 office job? Are you sitting in an ergonomic chair for long periods? That just maybe the reason your back is so stiff. Sitting for long periods will cause your back to become compressed and can lead to backaches and pain. It is recommended that you get up at least once every hour to stretch your legs and mussels. Paying close attention to how you are sitting can help with back pain. When working on a computer or taking notes, try to keep a good posture and keep your back straight. This will reduce back pain and keep your spin aligned and help with posture. Another good remedy for back pain is a chiropractic visit at Revive Medical Center in Lawrenceville, GA.
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