Lower back pain is a common issue, affecting many people. Understanding why it happens is the first step toward finding relief. This guide aims to explain common causes, from muscle strain to other underlying conditions. Read on to gain insights into lower back discomfort.

Pain or pressure if your lower back commonly results from an injury. But it can also occur with other health conditions, including sciatica and arthritis.

Lower back pain is a familiar ailment. Most people will experience it in their lifetime.

According to a 2020 study, lower back pain is the world’s most common cause of absence from work and its most common disability.

Most lower back pain is the result of an injury. Certain medical conditions can also cause it.

Most people have their first encounter with back pain when they’re between the ages of 30 and 50 years oldTrusted Source. This is partly due to the way the body changes with age.

As you grow older, there’s a reduction in fluid between the vertebrae in the spine. As a result, discs in the spine are more easily irritated.

You also lose some muscle tone, which makes the back more prone to injury.

This is why strengthening your back muscles and using good body mechanics can help prevent lower back pain.

Lower back pain synmptoms

Lower back pain has a lot of potential causes and may result in a variety of symptoms.

Some of the most common symptoms include:

• pain when resting or sitting for long periods
• pain when lifting something heavy or bending down
• pain radiating from the glutes or hips
• stiffness after a period of inactivity or when first waking up
• numbness or weakness

There are other less common — but more severe — symptoms. They include:

• pain in the legs or feet as well as in the back
• unintentional weight loss
• fever
• lack of bowel control

Consult a doctor if you experience severe symptoms or your back pain lasts longer than 72 hoursTrusted Source.

Lower back pain causes

There are many common causes of lower back pain, including underlying chronic conditions.

Muscle sprains or strains

The muscles and ligaments in the back can stretch or tear due to excess activity. Sudden movements can also cause sprains or strains.

Symptoms include pain and stiffness in the lower back as well as muscle spasms.

Herniated disc

The discs in the back are prone to injury, and this risk increases with age.

The outside of the discs can tear or herniate.

A herniated disc is also known as a slipped or ruptured disc. It occurs when the cartilage surrounding a disc pushes against the spinal cord or nerve roots. The cushion that sits between the spinal vertebrae extends outside its usual position. This can result in the nerve root becoming compressed as it exits the spinal cord and vertebrae.

Possible causes include trauma and degenerative changes over time. Without treatment, pain from a herniated disc will typically last up to 6 weeksTrusted Source.

Sciatica

The sciatic nerve connects the spine to the legs.

If a herniated disc presses on the sciatic nerve, sciatica can occur. Sciatica can cause leg or foot pain that usually feels like burning, or pins and needles.

Spinal stenosis

Spinal stenosis causes the spaces in your spine to narrow, putting pressure on the spinal cord and spinal nerves.

Spinal stenosis is commonly associated with the degeneration of the discs between the vertebrae. The result is compression of the nerve roots or spinal cord by bony spurs or soft tissues, such as discs.

Pressure on the spinal nerves causes symptoms such as:

• numbness
• weakness
• cramping

You might feel these symptoms anywhere in the body. Many people with spinal stenosis notice their symptoms worsen when they stand or walk.

Unusual spine curvatures

Conditions that cause unusual curvatures in the spine include:

• scoliosis
• lordosis
• kyphosis

These conditions are often present at birth and are usually first diagnosed during childhood or adolescence.

The unusual curvature can cause pain and poor posture because it places pressure on the:

• muscles
• tendons
• ligaments
• vertebrae

However, some people may not have any symptoms.

Other conditions

Several other conditions can cause lower back pain. They’re usually accompanied by additional symptoms.

They include the following conditions, all associated with musculoskeletal pain:

• Arthritis: Arthritis is inflammation of the joints.
• Fibromyalgia: Fibromyalgia is long-term pain and tenderness in the joints, muscles, and tendons.
• Spondylitis: Spondylitis is an autoimmune disease that causes inflammation. It’s a form of arthritis.
• Spondylosis: Spondylosis is also a form of arthritis. This degenerative disorder may cause the loss of normal spinal structure and function. Although aging is the primary cause, the location and rate of degeneration will vary by individual.

Other health conditions that can cause lower back pain include:

• kidney and bladder problems, including kidney infections
• pregnancy
• endometriosis
• ovarian cysts
• uterine fibroids
• spinal cord misalignment
• spinal infections
• cancer, such as cancer of the spinal cord

Diagnosis of lower back pain

A doctor will likely begin by requesting a complete medical history and conducting a thorough physical exam to determine where you’re feeling the pain. The physical exam can also reveal whether the pain affects your range of motion.

In addition, a doctor may check your reflexes and responses to certain sensations. This helps them determine if your lower back pain is affecting your nerves.

Unless your symptoms are concerning or you have neurologic loss, a doctor will probably monitor your condition for a few weeks before sending you for more testing. This is because most lower back pain resolves with simple self-care treatments.

Symptoms that require more testing include:

• weakness
• unintentional weight loss
• fever
• lack of bowel control

Seek medical attention immediately if you experience any of these symptoms in addition to lower back pain.

Imaging tests

You may undergo imaging tests so a doctor can check for:

• bone problems
• disc problems
• problems with the tendons and ligaments in your back

Imaging tests include:

• X-rays
• ultrasounds
• CT scans
• MRIs

Other tests

If a doctor suspects the bones in your back are weak, they may order a bone scan or bone density test.

Electromyography (EMG) or nerve conduction tests can help a doctor identify any problems with your nerves.

Lower back pain treatment

Once you have received a diagnosis and understand what you’re dealing with, it’s time to create a treatment plan.

The right one for you will depend on the severity of your symptoms and the cause of your pain.

Home remedies

Self-care methods are helpful for the first 72 hoursTrusted Source. Contact a doctor if your pain doesn’t improve after 72 hours of home treatment.

Home remedies to consider include:

• heat therapy
• cold therapy
• the RICE protocol (rest, ice, compression, and elevation)
• over-the-counter pain medication, such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol)
• a warm bath, which can often relax stiff and knotted back muscles

Sometimes lying on your back causes more discomfort. If this is the case, try lying on your side with your knees bent and a pillow between your legs.

If you can lie comfortably on your back, place a pillow or rolled-up towel beneath your thighs to reduce the pressure on the lower back.

Medical treatment

Possible medical treatments include:

• medications
• medical appliances
• physical therapy

Medications that a doctor may prescribe include:

• muscle relaxers
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• corticosteroid injections to reduce inflammation
• narcotics, which might be prescribed in the short term for severe pain or used to help treat chronic pain related to cancer

Medical appliances may include back braces or supporters.

Physical therapy may incorporate:

• massage
• stretching
• strengthening exercises
• back or spinal manipulation

Surgery

For severe cases, surgery may be necessary.

Surgery is usually only an option when all other treatments fail. However, you may undergo emergency surgery if you experience loss of bowel control, loss of bladder control, or progressive neurological loss (like leg numbness or weakness).

Types of surgery for lower back pain include:

• Discectomy: If a bulging disc or bone spur is pressing on your nerve root, a discectomy can relieve the pressure. During this procedure, a surgeon will remove a small piece of the lamina, a bony part of the spinal canal.
• Foraminotomy: A foraminotomy is a procedure that opens up the foramen, the bony hole in the spine where the nerve root exits.
• Intradiscal electrothermal therapy (IDET): In IDET, a surgeon inserts a needle through a catheter into a disc and heats the needle for 13.5 to 16.5 minutes. This makes the disc wall thicker and reduces the inner disc’s bulging and irritation of the nerve.
• Nucleoplasty: During a nucleoplasty, a surgeon inserts a wand-like device through a needle into a disc. The device can then remove the inner disc material. It also uses radio waves to heat and shrink the tissue.
• Radiofrequency lesioning: Radiofrequency lesioning or ablation uses radio waves to interrupt the way nerves communicate with each other. A surgeon inserts a special needle into the nerves and heats it, destroying the nerves.
• Spinal fusion: In this procedure, a surgeon removes discs between two or more of your vertebrae. Then they fuse the vertebrae next to each other with bone grafts or special metal screws. This process makes the spine stronger and reduces painful motion. Learn more about spinal fusion.
• Spinal laminectomy: In a spinal laminectomy, a surgeon enlarges the spinal canal by removing the lamina. This relieves pressure on the spinal cord and nerves. This procedure is also known as spinal decompression.

You may also undergo surgery for conditions such as endometriosis, fibroids, or cancer.

Stretches and exercises for lower back pain

Whether you’re trying to prevent lower back pain or treat current pain, these four moves are a great addition to your workout regimen. You can do them 1 or 2 times a day.

Consult a doctor before adding these or any new stretches or exercises to your workout routine.

Knee-to-chest stretch

The knee-to-chest stretch relaxes the lower back, hips, glutes, and thighs.

Follow these steps:

1. Start by lying on your back with both legs flat on the ground.
2. Bend your right leg, grab your knee, and pull your knee into your body. Keep your left leg extended.
3. Lengthen your spine as you hold your knee in. Avoid lifting your hips.
4. Hold for 1 minute or however long feels comfortable.
5. Repeat on the other side.

Child’s Pose

Known as one of the most restorative poses in yoga, the Child’s Pose stretches the paraspinal muscles, glutes, and thighs.

Follow these steps:

1. With your knees on the ground, sink back to rest your hips on your heels.
2. Extend your arms out in front of you as you hinge at the hips, sinking your hips deeper into your heels.
3. If it feels comfortable, keep your arms in front and turn your palms face up. If that’s too intense, extend your arms alongside your body.
4. Hold for 1 minute or however long feels comfortable.

Thread the Needle

Add a twist to your stretching or workout routine with Thread the Needle, a yoga pose that targets the spine, pelvis, and hips.

Follow these steps:

1. Start with your knees and hands on the ground in a tabletop position. Your back should be completely flat.
2. Lift your right arm toward the sky.
3. Bring your right arm down almost immediately and insert it through the opening between your left shoulder and your body.
4. Extend your right arm out as far as possible to the left. Hold for 30 seconds.
5. Repeat on the other side.

Superman

If you’re looking for a more rigorous move, try the Superman.

Follow these steps:

1. Lay down with your abdomen against the ground and your arms extended out in front of you.
2. Lift your arms and legs. You should feel your weight shift to your lower spine.
3. Hold your arms and legs up in the air for 30 seconds before dropping. If 30 seconds feels uncomfortable, hold the pose for a shorter period.

When performing these moves, go slowly when possible and move with care. If you feel any pain, stop and take a rest day.

What to do about severe lower back pain

If you have severe back pain, connect with a doctor as soon as possible.

You may discuss diagnostic tests if a healthcare professional hasn’t already identified the cause of your back pain. After you receive a diagnosis from the doctor, you’ll discuss treatment options.

If your lower back pain is accompanied by a loss of bowel or bladder control, or progressive neurological loss, seek immediate medical attention. You might need emergency surgery.

How to prevent lower back pain

There are many ways to prevent lower back pain. Taking these measures may help prevent pain altogether or lessen the severity of your symptoms if you manage to get injured.

Prevention may involve:

• exercising the muscles in your abdomen and back
• losing weight if you have overweight
• lifting items properly by bending at the knees and lifting with your legs
• maintaining proper posture

You may also want to:

• sleep on a firm surface
• sit on supportive chairs that are adjusted to the correct height
• avoid high-heeled shoes
• quit smoking if you smoke, since nicotine causes spinal disc degeneration and reduces blood flow

Also, talk with a doctor about your lower back pain. They can identify the cause and help you create a plan that works for you.

Feeling that persistent lower back pain? Don't just live with it. Our expert physical therapists at Miller PT can help you understand the root cause and create a personalized plan for lasting relief and a more active life. Our own overview of lower back pain can be found HERE. Contact us today at (561) 278-6055. For more tips and advice, follow us on Instagram @millerphysicaltherapy.

Reference: [https://www.healthline.com/health/low-back-pain-acute ]