8 out of 10 of us have experienced back pain at some point in our lives, according to neurosurgeon Patrick Roth. Pick a group of people at random off the street and “20% will say they have it right now, 40% will have had it in the past year, and 80% have had back pain over the course of their lives,” he says. The causes of lower back pain are often difficult to pin down. 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 and a 1% chance it’s down to something more sinister, such as a tumour, aneurysm or infection. However, it’s important to note that it can usually be attributed to lifestyle factors or normal wear and tear. Read on to discover some of the most common lower back pain causes – we think some of them might just surprise you…
Sprains and strains
Lower back pain is most often caused by torn or pulled ligaments or muscles. These kinds of injuries may occur suddenly or due to repetitive strain over time. Common causes include poor posture, lifting heavy objects with poor form (e.g. twisting the spine whilst lifting), sports injuries and sudden movements that put undue strain on the lower back such as falls.
Also known as degenerative joint disease, spondylosis refers to osteoarthritis of the spine. Spondylosis causes progressive wear and tear of the spinal discs and facet joints over time, which can result in pain, inflammation, instability and spinal stenosis (an abnormal narrowing of the spinal canal).
Stenosis is an abnormal narrowing of the spinal canal, typically caused by the intervertebral discs becoming thinner and dryer with age. Stenosis often results in morning stiffness and may cause pain when you stand for a long time or walk for even short distances. Minor trauma often results in sciatica (damage to the nerve that runs between your feet and lower back) for stenosis sufferers.
Ankylosing spondylitis is a form of inflammatory arthritis which causes swelling of the joints in the spine. Sufferers experience pain and stiffness which is often worse in the morning and improves with movement.
Spondylolisthesis occurs when a bone in the spine slips out of position, causing lower back pain and stiffness, numbness and tingling. It may be caused by a birth defect, wear and tear or injury.
Lumbar Herniated Discs
Also known as prolapsed or slipped discs, intervertebral discs in the lumbar spine can herniate if their jelly-like centre bulges or breaks through their tough outer layer, compressing or irritating a nearby nerve root. Nerve root impingement caused by a lumbar herniated disc tends to be sharp and may be felt in other parts of the body and/or cause numbness as well as pain. Sciatica, which affects the nerve running from the lower back to the feet, is often caused by nerve root impingement, and may cause pain or numbness in the leg, as well as the lower back.
Back pain may be ‘referred’ from other areas of the body which are injured or inflamed. For example, kidney stones and urinary tract infections such as cystitis may cause bladder inflammation which radiates to the lower back. Lower back pain may also be referred from a hip or pelvis injury, appendicitis or digestive issues.
Smoking compromises blood supply to the spine, which can cause the intervertebral discs to age more quickly, increasing susceptibility to injury and herniation.
We all know ‘sitting is the new smoking‘, but did you realise that sitting in a chair puts 30% more pressure on the spine than standing or walking? If you sit at a desk all day (or on the sofa all evening), try to get up and walk around at least once an hour, avoid slouching and, if you can, adjust your seat so it tilts slightly back.
Get your gait wrong, however, and you could do just as much damage on your feet as you do sitting down. Physiotherapist Alex Hunter recommends having your gait assessed by a physiotherapist. “A common issue is letting the knees hyperextend,” he says. “This forces us to arch our back forwards, resulting in compressed joints and a sore back.” And if you wear heels, or carry a heavy handbag on one shoulder, you’re setting yourself up for even more problems…
Sorry, you’re not even safe in the air. Pressurised cabin air can irritate the spinal discs, making them vulnerable to bulging and herniation. Try to avoid heavy lifting and vigorous activities when touching down after a long flight. If you must use those overhead lockers, exercise caution! Take a few minutes to stroll and stretch once you disembark.
The softer your mattress, the less evenly your weight will be distributed, and the more likely you are to experience back pain as a result. A medium to firm mattress is your best option.
Constrictive clothing like skinny jeans and Spanx can restrict the spine’s normal range of motion and inhibit normal conditioning of stabilising muscles, causing the lower back to become more susceptible to strain and injury, say experts. So let it all hang out, ladies – doctor’s orders.