Many people deal with low back pain—it’s not uncommon at all. Around 75-85% of Americans go through it at some point in their lives. Even though it can be really tough and hurt a lot, in about 90% of cases, the pain goes away on its own without needing surgery.
But here’s the thing: half of the people who experience low back pain end up dealing with it again within a year. When this pain sticks around for more than 12 weeks, we call it chronic.
So, what causes this discomfort? It can happen because of a strain, like an injury to the muscles or tendons in your back. There are other reasons too, like arthritis, structural issues, and disk injuries.
The good news is that rest, physical therapy, and medication often help improve the pain. To lower your chances of getting low back pain, it’s a good idea to keep your weight in check and stay active.
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What is Lower Back Pain?
Your lower back, also known as the lumbar spine, is like a well-designed system with bones, joints, nerves, ligaments, and muscles all working together. This system provides support, strength, and flexibility. But, because it’s quite complex, the lower back can be vulnerable to injury and pain.
Lower back pain can happen for various reasons, such as injuries, conditions, or diseases. Most commonly, it’s due to problems with muscles or tendons in the back.
The pain can vary from being mild to severe. Sometimes, it can even make simple things like walking, sleeping, working, or doing everyday activities challenging.
The good news is that lower back pain often improves with rest, pain relievers, and physical therapy. Treatments like cortisone injections or hands-on therapies, such as osteopathic or chiropractic manipulation, can also help relieve pain and aid the healing process. In some cases, surgical repair may be necessary for certain back injuries or conditions.
How Common is Lower Back Pain?
Lots of people, around 4 out of 5, experience lower back pain at some point in their lives. It’s a really common reason for visiting the doctor.
Here are factors that can make you more likely to have lower back pain:
Mental Health: Depression and anxiety can contribute to back pain. Taking care of your mental health is important too.
Weight: Being overweight or carrying extra weight increases the chances of back pain. The extra weight puts pressure on your joints and disks.
Age: Back pain becomes more common as you get older. The soft, rubbery disks in your spine wear down over time, causing pain and stiffness.
Overall Health: Weak abdominal muscles can’t support the spine well, leading to strains and sprains. If you smoke, drink a lot, or have a mostly inactive lifestyle, your risk of back pain goes up.
Occupation and Lifestyle: Jobs that involve heavy lifting or bending can increase the risk of a back injury.
Structural Problems: Severe back pain can be caused by conditions like scoliosis, which affects the alignment of your spine.
Disease: If certain diseases like osteoarthritis run in your family, you might have a higher risk of low back pain.
Symptoms of Lower Back Pain
Lower back pain can happen suddenly or creep up slowly. It might show up after doing something specific, like bending to pick up an object, or it could start without a clear cause.
The pain can be sharp or dull and might spread to your bottom or down the back of your legs, which is called sciatica. If you hurt your back while doing something, you might hear a “pop” sound. Pain is often worse in certain positions, like bending over, and tends to get better when you lie down.
Other signs of lower back pain include:
Stiffness: Your back may be hard to move or straighten. Getting up from sitting might take a bit longer, and you might feel the need to walk or stretch to loosen up. Your range of motion could decrease.
Muscle spasms: After straining your back, the muscles in your lower back might spasm or contract uncontrollably. This can cause intense pain and make it hard or even impossible to stand, walk, or move.
Posture problems: People with back pain might find it challenging to stand up straight. You might end up standing “crooked” or bent to the side instead of being aligned with your spine. Your lower back might appear flat instead of curved.
What Causes Lower Back Pain?
Lower back pain can be caused by various things. Here are some common reasons:
Strains and Sprains: This happens when you hurt the muscles, tendons, or ligaments in your back. It can occur from lifting heavy things improperly or making sudden movements like sneezing or bending.
Fractures: Accidents like car crashes or falls can break the bones in your spine. Conditions like spondylolysis or osteoporosis make fractures more likely.
Disk Problems: Disks act as cushions between the small bones in your spine. They can bulge or tear, pressing on nerves. As you age, disks can wear down (degenerative disk disease).
Structural Issues: Spinal stenosis occurs when the spinal column is too narrow for the spinal cord, causing severe pain. Scoliosis, a curvature of the spine, can also lead to pain and stiffness.
Arthritis: Osteoarthritis is a common cause of lower back pain. Ankylosing spondylitis can cause pain, inflammation, and stiffness in the spine.
Disease: Conditions like spine tumors, infections, and certain cancers can lead to back pain. Other issues like kidney stones or abdominal aortic aneurysm can also cause back pain.
Spondylolisthesis: This condition makes the vertebrae in the spine slip out of place, causing low back pain and often leg pain.
Diagnosis of Lower Back Pain
To find out what’s causing lower back pain, your doctor will ask about your symptoms and do a physical exam. They might also order some tests to get a closer look. Here are the common ones:
- Spine X-ray: It uses radiation to make pictures of your bones.
- MRI (Magnetic Resonance Imaging): This uses a magnet and radio waves to create detailed images of bones, muscles, and other soft tissues.
- CT scan (Computed Tomography): X-rays and a computer work together to make 3D images of bones and soft tissues.
- Electromyography (EMG): This test checks nerves and muscles for issues like neuropathy (nerve damage), which can cause tingling or numbness in your legs.
In some cases, blood or urine tests may be needed:
- Blood tests: These can find genetic markers for certain conditions that lead to back pain, like ankylosing spondylitis.
- Urine tests: They check for kidney stones, which can cause pain in the sides of your lower back.
These tests help your doctor see a clear picture of your spine, disks, muscles, and more to figure out the best way to treat your back pain.
Treatments for Lower Back Pain
Dealing with lower back pain? Here are various treatments you can consider:
Physical Therapy (PT): Strengthen those muscles! PT not only builds support for your spine but also enhances flexibility, reducing the risk of future injuries.
Hands-on Manipulation: Different hands-on treatments like osteopathic manipulation or chiropractic adjustments can ease tight muscles, alleviate pain, and improve posture. Massage therapy works wonders too.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or prescription drugs can ease pain. Muscle relaxants may also help prevent spasms.
Injections: If pain persists, your provider might inject medication into the troublesome area. Steroid injections can relieve pain and bring down inflammation.
Surgery: In some cases, surgery might be necessary for repair. There are various surgical approaches, including minimally invasive techniques, depending on the nature of your back pain.
Rest and Ice: Take it easy, use ice, and grab over-the-counter pain relievers. Rest for a few days, then slowly resume normal activities. Being active boosts blood flow and aids healing.
Remember, it’s essential to consult with a healthcare professional to determine the most suitable treatment for your specific situation.
How to Prevent Lower Back Pain?
To keep your lower back healthy and avoid pain, you can try the following tips:
Strengthen your core: Engage in exercises like Pilates to build strong abdominal muscles that support your spine.
Lift smart: When lifting things, use your legs, not your back. Hold heavy objects close and avoid twisting while lifting.
Watch your weight: Being overweight adds stress to your spine. Keep a healthy weight to ease the pressure.
When to See a Doctor
If you’re dealing with lower back pain, here are signs that it’s time to see your healthcare provider:
- Severe pain or muscle spasms that mess with your usual activities.
- Tingling, numbness, weakness, or pain in your buttocks or legs.
- Pain that shoots down your leg or makes it challenging to stand.
- Difficulty controlling your bladder or bowels.
- The pain doesn’t improve after a week of resting and self-care.
- You notice a fever, weight loss, or other systemic symptoms.
Sophia Anderson, PT, DPT is a physical therapist who offers online pain management consultations. She helps people with various types of pain, especially neck, back, and knee pain.
She graduated from the University of St. Augustine with a Doctor of Physical Therapy (DPT) degree. She has experience in orthopedic physical therapy, sports medicine, neurological rehabilitation, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.
If you’re experiencing any pain, let Sophia Anderson, PT, DPT help you out.