Lower Back Pain Causes, Symptoms and Treatment

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 vertebrae—backbones. 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.

Most low back pain is the result of an injury, such as muscle sprains or strains due to sudden movements or poor body mechanics while lifting heavy objects.

Low back pain can also be the result of certain diseases, such as:

  • arthritis
  • kidney infections
  • infections of the spine
  • cancer of the spinal cord
  • a ruptured or herniated disc
  • sciatica

Low back pain is more likely to occur in individuals between the ages of 30 and 50. This is partly due to the changes that occur in the body with aging. As you grow older, there’s a reduction in the fluid content between the vertebrae in the spine.

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 (at birth) or acquired meaning the disorder develops later in life.

Idiopathic refers to an unknown cause.

Organic lower back pain is attributed to disease, such as spinal cancer.

Mechanical lower back pain is often triggered by spinal movement and involves spinal structures, such as the facet joints, intervertebral discs, vertebral bodies (vertebrae), ligaments, muscles or soft tissues.

These are some of the things your doctor might look for – or rule out – when you schedule a visit for back pain.

Sprains and strains

Ligament sprains and muscle or tendon strains are the most common causes of lower back pain. They’re often related to overuse.

Sciatica

Pain that results from a pinched or irritated sciatic nerve. This nerve runs down your lower back through your hips and buttocks and down each leg. Sciatica is how laypeople refer to pain that travels down the leg from the lower back, although your doctor may use the term lumbar radiculopathy.

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.

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

Spinal stenosis

A narrowing of the inside spaces of your spine, most often from a herniated disc but sometimes from bone spurs caused by spinal osteoarthritis. This can result in painful pressure on your spinal nerves. Spinal stenosis can occur in both the upper (cervical) spine and the lumbar spine, but lumbar spinal stenosis is more common.

Spondylolisthesis

A vertebra slides forward out of position, disrupting your spine’s alignment and sometimes compressing nerve roots. It is most common in the lumbar region, but can happen anywhere along the spine.

What Are Some Other Causes of Lower Back Pain?

The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:

Abnormal spinal curvature

A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:

Scoliosis, in which the spine curves from side to side, often in a C shape

Kyphosis, in which the spine is abnormally rounded in the upper back

Lordosis, in which the spine curves too far inward at the lower back

Osteoporosis

Your bones lose mass faster than it can be replaced, making them brittle. They can even fracture with little or no warning. These fractures are especially common in the spine, where they’re called vertebral compression fractures. Both men and women lose bone mass as they age, but postmenopausal women lose it much faster and so are more at risk for osteoporosis.

Arthritis

There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis (the most common by far; in the back it’s known as spondylosis), rheumatoid arthritis, and ankylosing spondylitis.

Spinal tumors

When cells divide and multiply unchecked, the result is a tumor. Both benign and malignant tumors can cause lower back pain. They can either originate in the spine or metastasize there, meaning they’ve spread from somewhere else in the body.

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Home Remedies for Lower Back Pain

Unless you’ve had a major injury, such as a fall or car accident, you probably don’t need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.

Use ice and/or heat

Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you don’t injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury; then you can try a combo of ice and heat.

Avoid bed rest

When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain – and recovered more slowly ­– than patients who stayed fairly active

Try over-the-counter (OTC) remedies

Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.

Less Invasive or Noninvasive Back Pain Treatments

Your doctor has a wide range of treatments that may help your lower back pain. In general, expect your doctor to take a stepped care approach. That means starting with simple, low-cost treatments and moving to more aggressive approaches later. Keep in mind that many treatments take time to reach their full effect.

Physical therapy (PT)

PT for lower back pain involves passive and active therapies to help the patient build core muscle strength, improve spinal flexibility and range of motion, correct posture and more. Your physical therapy sessions may include:

  • Exercise
  • Ice/heat
  • Massage
  • Transcutaneous electrical nerve stimulation (TENS)
  • Ultrasound

Medications

When over-the-counter pills and topicals don’t do enough to relieve back pain, your doctor may recommend a prescription drug. Examples include:

  • Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen
  • Opioids, such as oxycodone or hydrocodone, on a short-term basis. (For a variety of reasons, opioids aren’t good long-term options for lower back pain.)
  • Antiseizure medication, such gabapentin or pregabalin, for nerve-related pain
  • Muscle relaxants, such as baclofen or carisoprodol

Injections

An epidural steroid injection or a selective nerve block may provide short-term pain relief when lower back pain causes sciatica symptoms, such as leg pain.

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