What is lower back pain?
Low back pain can result from many different injuries, conditions or diseases — most often, an injury to muscles or tendons in the back.
Pain can range from mild to severe. In some cases, pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
Usually, lower back pain gets better with rest, pain relievers and physical therapy (PT). Cortisone injections and hands-on treatments (like osteopathic or chiropractic manipulation) can relieve pain and help the healing process. Some back injuries and conditions require surgical repair.
How common is lower back pain?
Around four out of five people have lower back pain at some point in their lives. It’s one of the most common reasons people visit healthcare providers.
Some people are more likely to have lower back pain than others. Risk factors for lower back pain include:
Age: People over 30 have more back pain. Disks (soft, rubbery tissue that cushions the bones in the spine) wear away with age. As the disks weaken and wear down, pain and stiffness can result.
Weight: People who are obese or carry extra weight are more likely to have back pain. Excess weight puts pressure on joints and disks.
Overall health: Weakened abdominal muscles can’t support the spine, which can lead to back strains and sprains. People who smoke, drink alcohol excessively or live a sedentary lifestyle have a higher risk of back pain.
Occupation and lifestyle: Jobs and activities that require heavy lifting or bending can increase the risk of a back injury.
Structural problems: Severe back pain can result from conditions, such as scoliosis, that change spine alignment.
Disease: People who have a family history of osteoarthritis, certain types of cancer and other disease have a higher risk of low back pain.
Mental health: Back pain can result from depression and anxiety.
SYMPTOMS AND CAUSES
What are the symptoms of lower back pain?
Symptoms of lower back pain can come on suddenly or appear gradually. Sometimes, pain occurs after a specific event, such as bending to pick something up. Other times, you may not know what caused the pain.
Pain may be sharp or dull and achy, and it may radiate to your bottom or down the back of your legs (sciatica). If you strain your back during an activity, you may hear a “pop” when it happened. Pain is often worse in certain positions (like bending over) and gets better when you lie down.
Other symptoms of lower back pain include:
Stiffness: It may be tough to move or straighten your back. Getting up from a seated position may take a while, and you might feel like you need to walk or stretch to loosen up. You may notice decreased range of motion.
Posture problems: Many people with back pain find it hard to stand up straight. You may stand “crooked” or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
Muscle spasms: After a strain, muscles in the lower back can spasm or contract uncontrollably. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.
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 (such as spondylolysis or osteoporosis) increase the risk of fractures.
Disk problems: Disks cushion the vertebrae (small spinal bones). Disks can bulge from their position in the spine and press on a nerve. They can also tear (herniated disk). With age, disks can get flatter and offer less protection (degenerative disk disease).
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 (curvature of the spine) 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.
Can I prevent lower back pain?
You can’t 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 (not your back). Hold heavy items close to your body. Try not to twist your torso while you’re lifting.
Sleeping Use a firm mattress for sleeping. A feather pillow or rolled-up towel will support your neck when you are sleeping on your side or back. If your lower back needs additional support, consider adding a 1-1 ½ inch roll at the small of your back.
Posture is key. Correct posture is important in the prevention of back strains and sprains. Maintaining the normal curves of the spine allows the supportive structures of the back to relax which minimizes the chances of injury. The following sections provide detailed advice on how to maintain proper posture throughout your everyday activities.
Try the following exercises to help relieve back tension:
1. Backward stretch / Extension in standing: A few times each day, get up and stretch leaning backwards. Brace yourself by placing your hands on the back of your hips. Repeat 10 times. Alternatively, spend a few minutes lying on your stomach on a firm surface while leaning on your elbows.
2. Press-up / Extension in lying: Lie on your stomach on a firm surface with your palms on the floor directly under the shoulders. Press up with arms, keeping your lower body relaxed and hips and legs on the floor. Repeat 10 times twice a day. If you experience pain that increases with each repetition, do not continue the exercises.
Try to repeat one or both of these stretches a total of ten repetitions. four times a day.
Start with your seat.
The best chair for preventing back pain is one with a straight back or low-back support. Keep your knees a bit higher than your hips while seated. Your chair back should be set at an angle of about 110 degrees and should cradle the small of your back comfortably. If necessary, use a wedge-shaped cushion or lumbar pad. Prop your feet on a stool if you need to. If you must stand for a prolonged period, keep your head up and your stomach pulled in. If possible, rest one foot on a stool or box about 6 inches high — and switch feet every 5 to 15 minutes.
Be careful how you lift. Don’t bend over from the waist to lift heavy objects. Bend your knees and squat, pulling in your stomach muscles and holding the object close to your body as you stand up. Let your legs do the lifting, not your back. Don’t twist your body while lifting. If you can, push rather than pull heavy objects. Pushing is easier on the back.
Avoid high heels. They can shift your centre of gravity and strain your lower back. Stick to a one-inch heel. If you have to go higher, bring along a pair of low-heeled shoes and slip into them if you become uncomfortable.