Low back pain is very common, and most people will experience lower back pain at some point in their lives. In fact, it’s the most common reason employees miss work. For most people, these episodes of back pain resolve without the need for any medical intervention. For those with persistent back pain, most of the time their pain can be improved without the need for any surgical intervention.
What are the symptoms of lower back pain?
Depending on the cause of your lower back pain, symptoms can range from a dull ache to a sharp, shooting pain. The pain can appear suddenly after an injury or gradually over time, often the result of age-related wear and tear.
Most back pain resolves within a few days or weeks. If pain lasts for more than 12 weeks, even after treatment, it is considered chronic. If you have severe low back pain after an injury or fall, it is important to see your doctor as soon as possible.
Low back problems may cause hip and leg pain as well. Age-related degenerative changes in the back may cause pain that radiates into the hips. Back problems may also cause nerve pain, which often feels like sharp, shooting, “electric” type pain, but may also include toothache-type pain, numbness, or weakness.
What are the causes of lower back pain?
The lower back is comprised of five vertebrae in the lumbar region. These vertebrae are responsible for supporting nearly all the weight in the upper body. The intervertebral discs act as shock-absorbers between your vertebrae. These vertebrae and discs surround and protect your lumbar nerve roots. These nerve roots travel through your spinal canal, then exit between the bones and discs and go down through the pelvis to your legs. These nerves control the muscles in your legs and convey sensation from the legs up to your spinal cord and brain.
In many cases, there is no clear identifiable cause for low back pain. Often, it is related to normal age-related wear and tear in the vertebrae and discs. It is a normal part of aging for people to develop degenerative disc changes, bone spurs, and occasional low back pain. More than half of all people over 50 have some degree of degenerative changes seen in x-rays, CTs, or MRIs of the lumbar, regardless of whether they have back pain symptoms at all.
Some common causes of lower back pain include:
- A sedentary lifestyle. Weakened core strength and lack of moderate daily physical activity are major contributors to low back pain. Prolonged sitting can also contribute to low back pain.
- Nicotine use. Long term nicotine use (including vaping, smoking, or chewing) can cause advanced degenerative changes in the bones and discs in the lumbar spine.
- Being overweight or obese can put excess pressure on your lower back and may lead to low back pain.
- Sprains and strains. Exercise, work and sports injuries can cause sprains in the ligaments and strains in the tendons and muscles of the lower back. Repetitive lifting, pulling and twisting motions increase the risk of back pain.
- Traumatic injury. A car accident, fall or lifting injury can injure the bones, discs, tendons, ligaments and muscles in the back.
- Osteoporosis: Poor bone quality can lead to compression fractures, which are painful fragility fractures of the vertebrae.
- Spinal degenerative disc disease is often inherited, and some people are more likely to develop back problems regardless of lifestyle changes.
Some people with chronic lower back pain have a condition called sacroiliac (SI) joint dysfunction. The SI joint is a shock-absorbing joint that connects the pelvis (ilium) to the tailbone (sacrum). Sacroiliac joint dysfunction can cause lower back pain, buttock pain, groin pain, or even pain that radiates down the lower extremities.
How can you prevent lower back pain?
The best way to prevent low back pain is to adopt a “back-healthy” lifestyle. This includes maintaining a healthy weight and exercising regularly, focusing on moderate cardio exercise as well as core strengthening exercises. Walking is a great exercise for back health. Core strengthening exercises can include yoga and Pilates, among others. It is also important to avoid nicotine use.
How is lower back pain treated?
Depending on the cause of low back pain, you may have several treatment options. Always talk to your doctor before beginning a new workout regimen or trying at-home treatments. Treatment options include:
- Hot or cold packs. Applying heat or cold to the affected area can reduce pain, stiffness and inflammation.
- Physical activity. It’s best to stay active and return to your normal activities as soon as possible, limiting movements that aggravate back pain. Studies have shown bedrest can make back pain worse and lead to secondary issues like depression or blood clots. Just simply walking for short periods of time can gradually help with back pain.
- Research has shown yoga is effective at reducing lower back pain. At-home stretches may also be beneficial. If you are new to yoga, stretching or exercise in general, seek out a professional instructor and get your doctor’s permission before you begin. Other fitness classes such a barre, Pilates, and tai chi can be beneficial as well.
- Massage therapy. Getting regular massages in addition to exercising and stretching may help relieve low back pain.
- Your doctor may recommend over the counter or prescription pain relievers to reduce pain and inflammation. In general, narcotic pain medications are not helpful in the long term treatment of low back pain.
- Physical therapy. A physical therapist can create a personalized regimen of stretching and strengthening exercises to rehabilitate your back. PT may also help address muscle imbalances within your back, hips, and legs that can contribute to back pain.
- Your doctor may recommend an injection, such as a nerve root block or an epidural steroid injection, to address pain and inflammation. These are typically done by a pain management doctor who specializes in these procedures.
- For the most severe cases of low back pain that involve an injury or nerve compression, surgery may be necessary. There are many traditional and minimally invasive surgical procedures available today. Not all back pain is responsive to back surgery, and no surgery is a “fix” for all back problems.
While back pain can be discouraging and affect your quality of life, you don’t have to live with it. Talk to your primary care doctor, who can refer you to a spine surgeon for evaluation.
To learn more about lower back pain treatment at Pardee, visit pardeehospital.org/spine.
