Ultimate Guide To Lower Back Pain

Ultimate Guide To Lower Back Pain

Lower back pain can be a nuisance or make you worry, but it’s good to know that most cases of lower back pain are not serious.

Here’s everything you need to know about lower back pain and how to deal with it.

What causes lower back pain?

Most back pain is a result of injury, such as muscle strains, as Healthline reports. These tend to go away on their own within a few days. However, there are other conditions that can cause pain and which require further treatment.

To better understand what can be causing lower back pain, let’s take a look at the anatomy of the lower back.

Lower Back Anatomy 101

Lower Back Anatomy
  • Your body’s spine anatomy has four sections: the cervical spine (neck), thoracic spine (upper back), lumbar spine (lower back) and the sacral region, as Spine Health explains.
  • Your lower back has five vertebrae separated by discs. There are also muscles in the lower back that support the spine as well as give you the strength for bending down or twisting your torso. To further help with movement, facet joints connect the spine’s vertebrae.
  • The large muscles that are found in the lower back are the erector spinae. They’re responsible for holding and supporting the spine.
  • The lumbar spine has two sections that carry the most weight because they’re at the lowest point: L5-S1 and L4-L5. Discs in this lower area of the lumbar spine have to deal with much more weight so they are more likely to become damaged, thus being susceptible to conditions such as herniated discs.

Lower Back Pain All Around The World

Lower back pain is the leading cause of disability worldwide, as Science Daily reports.

It affects approximately 540 million people.

The World Health Organization (WHO) reports other stats about back pain which are quite alarming.

  • The lifetime occurrence of back pain is around 60 to 70 percent in industrial countries.
  • In the UK, lower back pain is the most common cause of disability in young adults – over 100 million workdays are lost to this condition every year.
  • In Sweden, low back pain has contributed to people missing more work. The number of workdays missed jumped from seven million in 1980 to 28 million in 1987.
  • In the U.S., people miss a total of 149 million days of work every year because of lower back pain.

And, Cam Solutions reports that in South Africa, approximately 80 percent of people experience severe discomfort and even disability as a result of problems that stem from lower back pain.

What Are Common Causes Of Lower Back Pain?

It’s clear that back pain is very common in many countries in the world.

But what causes it?

Let’s take a look at some of the most common lower back pain causes.

Injury (strain or sprain)

Woman Holding For Back

If you pull a muscle in your back, such as during a gym session, you’ll probably need the following treatments to help you heal.

Anti-inflammatory medication

By targeting inflammation, this will reduce the pain that you feel. You can get OTC drugs or your doctor might write you a prescription for something a bit stronger, depending on your pain.

An example is a muscle relaxant that works by inhibiting the pain receptors found in the central nervous system.

A muscle relaxant will be prescribed on a short-term basis because it often carries quite a few side effects and has addictive potential.

Ice packs

These work well to reduce inflammation at the site of the muscle injury and they’re also good for treating stiffness.

Using an ice pack on the skin for about 20-minute intervals can work. However, after a muscle injury, it’s common practice to apply cold for the first 48 hours, followed by heat.

Other tips for recovering from a lower back injury

  • Avoid doing any activities that involve twisting your back or doing any heavy lifting for the first six weeks from when your pain begins.
  • Avoid exercising for the first two weeks. When you resume your daily exercise plan, make sure that you ease into it and build+up to the amount and intensity of exercise that you were doing.

Stress

Man Holding For Head

In an online survey of back pain that was published on Statista, most people surveyed believed that stress was the cause of their back and neck pain.

If you’ve got a case of chronic stress, this causes muscles to tighten up and even the muscles in the lower back can be affected.

In addition, this tightness uses energy the muscles need to keep the spine in an upright position.

Even just sitting in a chair for many hours in the day with bad posture can put a strain on the lower back muscles and spine.

To relieve muscle tightening from stress, alleviating stress is a must. In addition, doing exercise and stretching the back muscles can help.

Consulting with a physical therapist can also be useful to teach you better posture and back exercises to prevent stress from affecting your lower back.

Inflamed Joints

The facet joints in the spine can become injured or even experience inflammation, which can lead to the muscles in the lower back contracting or experiencing spasms.

To relieve facet joint pain, doctors will likely recommend that you engage in physical activity, physical therapy, and get into the habit of having proper posture.

Anti-inflammatory medication can also be used, such as non-steroidal anti-inflammatories (NSAIDs).

Osteoarthritis

This is a condition in which the disc and facet joints experience wear and tear, and it is linked to getting older.

Pain and inflammation are common. Osteoarthritis can strike one level or multiple levels of the lower spine. Osteoarthritis can also result in spinal stenosis, which is a narrowing of the spine.

Herniated Disc

Illustration Of Henrniated Disc

When the discs in the spine become thinner, their gelatinous central part pushes out against a nerve.

A herniated disc means that the disc is in an early degeneration stage. Since a herniated disc is displaced, it presses on nerves and produces pain.

Herniated discs are most commonly found in the lower back.

One injury can cause a herniated disc, but discs degenerate as we get older so a strain put on it can cause a rupture to occur, as American Association of Neurological Surgeons.

The pain one feels depends on whether or not the disc is pressing against a nerve. If it isn’t, low back pain might be the only (if any) symptom.

If the nerve is involved, the person might experience pain as well as numbness and weakness in the area where the nerve is found.

How Herniated Discs Are Treated

Your doctor will tell you to rest and avoid activity for a few days or weeks to reduce nerve inflammation in the spine.

However, a herniated disc can also be treated with nonsteroidal anti-inflammatory drugs if there’s only moderate pain.

On the other hand, an epidural steroid injection might be considered if the doctor thinks directing the medicine straight to the area will help to provide more relief.

Physical therapy might also be recommended. Surgery for a herniated disc is only considered if other treatments haven’t been successful.

Nerve Problems

Illustration Of Sciatica Pain

There are also nerve-related problems that can cause lower back pain. An example is a condition called sciatica.

This is when the nerves in the back become irritated or impinged. This causes sharp pain and can also lead to sensations of numbness in the leg.

The sciatic nerve is the longest nerve in the body!

A doctor will likely suspect that your lower back pain is caused by sciatica if the pain moves into the back or side of your legs.

Spinal Stenosis

In some cases, lower back pain is a sign of spinal-canal narrowing, otherwise known as spinal stenosis. It might not even present other symptoms.

However, the back pain can point to spinal stenosis if it moves from the lower back into both legs after you’ve been standing for a long time or when you’ve walked a short distance.

Spinal stenosis affects eight to 11 percent of the population and is most commonly found in baby boomers who are over 50, as the American Academy of Orthopaedic Surgeons report (via Everyday Health).

Spinal stenosis can also arise as a result of other spinal conditions, such as osteoarthritis, as mentioned earlier.

Back Pain From Sport Injuries

It’s common that participating in sport can lead to lower back problems.

The good news is that most of these back injuries will heal on their own within about three months, as reported by Cleveland Health Clinic.

But what about the sports injuries that don’t? Let’s take a look at them.

Fractures

Radiology Image

If you play a sport that requires you to do a lot of repetitive extension movements, such as diving, cheerleading, or volleyball, this can result in a fracture.

Otherwise known as a spondylolysis, this fracture results in a crack to form in the rear portion of the spinal column, as Cleveland Clinic explains.

It can occur as a result of repeated strain and it can show up as lower back pain.

Fractures can be treated with rest and the use of a back brace to keep the spine upright and aligned so that the fracture can heal.

When To See A Doctor For Sport-Related Back Injuries

If you’re feeling lower back pain after an intense workout or game, you might wonder if you should just take OTC medication and rest a bit or schedule a visit with your doctor ASAP.

If you’re experiencing any of the following symptoms, you should definitely not wait to consult with your doctor.

  • Your pain is getting worse
  • Your pain has been around for longer than two months
  • Your pain is moving into your legs
  • Your pain is causing your limbs to feel weak
  • You’ve got changes in your bladder or bowel habits
  • You’re having trouble with balance
  • You’re battling to walk properly

Prevent Sports Injuries To Your Lower Back

Woman Stretching On Bench

In order to prevent injuries in the future, make sure you do the following:

  • Always use the right form when you lift weights so that you don’t put unnecessary strain on your spine.
  • Always warm-up and stretch before your exercise or sporting activity.
  • Avoid unhealthy lifestyle habits such as smoking as this can be a risk factor for lower back pain.
  • Work on strengthening your core. This is an important part of reducing your lower back pain risk. When you work on your core, you have better spinal alignment. Having strong abs also helps to remove pressure from your lower back.

What About “Referred Pain?”

If you’ve ever heard of referred pain, you’ll know it’s when the pain starts somewhere in the body and then migrates to another part.

Lower back pain might not always originate in the back. If there’s another health problem somewhere else in the body, this pain can end up moving into the back.

Thus, referred pain can be described as secondary pain.

Health conditions affecting the abdomen can all lead to back pain.

These include kidney infections or disease, bladder infections, ovarian disorders, appendicitis, aneurysms, and normal pregnancy can have an effect on the back.

If your back pain hasn’t started in the back, then you’re likely to experience symptoms elsewhere in the body that can point to the pain being referred to pain.

So, if you’ve got lower back pain and other symptoms, it’s best to check in with your doctor.

How Can You Treat Low Back Pain?

As can be seen previously in this article, there are different ways to treat low back pain depending on its cause.

However, there are some general guidelines to follow that will offer pain relief and prevent the pain from getting worse.

Make Sure You Sleep Correctly

Woman Sleeping

Sleeping in an uncomfortable position in which your spine isn’t aligned can put pressure on it and make your pain worse.

Lack of sleep can also make your back pain worse, so it’s crucial to sleep in a healthy way.

If you sleep on your side, place a pillow between your knees to keep your spine in a neutral position.

On the other hand, if you sleep on your back, put a pillow behind your knees.

Maintain Good Posture During The Day

Bad posture can cause you to slump over. Sitting with your spine not aligned can result in pressure and pain in your back.

This can cause or worsen back pain. Seeing a physical therapist is recommended for back pain if you’re battling with bad posture that you can’t correct yourself.

A physical therapist will be able to teach you how to sit and stand with the right spinal alignment to take the pressure off your back.

They can also teach you what exercises you should do to strengthen your core.

Having strong abdominal muscles helps to prevent stress on your spine, and can help to prevent injury, as mentioned earlier.

Don’t Stay In Bed

When you’ve got bad back pain, it’s tempting to want to call it a day and go to bed. But this can actually make it worse.

If you stay in bed for longer than two days, this can start to weaken your muscles.

Gentle exercise is important to relieve back pain, so try an activity such as yoga, walking, or swimming. Avoid running as that can make your back pain worse.

Use Ice And Heat

Putting Ice On Backs

If your back is sore, try putting ice on it for two days. Stick to applying ice, such as in the form of an ice pack, to the affected area several times a day for 20 minutes each time.

Then, after two days, apply some heat to the area, again for only 20 minutes every time. The reason why switching from cold to hot treatment works is that they both do different things.

The cold treatment works to reduce swelling and inflammation, which is crucial especially after an injury, and then the application of heat helps the sore muscle to heal.

It does this by bringing more blood flow to the sore back muscles.

Treat It With Medication

If OTC medication isn’t enough or you’re not getting relief from home remedies, then you should consult with your doctor.

He or she will be able to prescribe you medication that’s a bit stronger.

Treatment can include:

Muscle Relaxants

These relieve lower back pain by decreasing muscle tension.

They work by influencing the central nervous system, and they’re most suitable for acute back pain – they haven’t been proven to relieve chronic conditions, as the Institute for Quality and Efficiency in Health Care reports.

NSAIDs

Five Bottles Of Medications

Your doctor might prescribe prescription-strength NSAIDs for your pain. Sometimes, opioids are also prescribed.

Opioid medication is one of the most commonly prescribed drugs, as reported by The BMJ.

However, this is alarming as opioids do carry an addiction risk along with many side effects, so they’re not always beneficial.

In fact, studies have found that opioid medication tramadol isn’t better than NSAIDs for pain relief oxycodone with titrated morphine isn’t more effective than naproxen, an anti-inflammatory medication, for pain relief, as MDedge Family Medicine reports.

Spinal Injection

Your doctor could recommend a spinal injection, such as a corticosteroid that relieves inflammation, if medication and other remedies haven’t helped you or you have a condition such as irritated nerves in the spine.

One of the most common back injection shots that make use of corticosteroid is the epidural injection.

This delivers medicine to the area around the spinal cord where nerves have spread into other parts of the body, causing pain.

An example of a condition in which this is the case is sciatica.

However, steroid shots can also be used to treat other conditions that can cause back pain, such as tendinitis or sore joints from arthritis.

However, as Harvard Health Publishing points out, steroid injections should never be the first line of treatment because of their risks.

Although rare, steroid injections can injure a blood vessel or nerve.

In addition, there’s usually a limit to how many injections you can get within the course of a year because having too many in one area of the body could lead to a disintegration of bone or cartilage in the joints, as well as cause skin thinness at the site of injection.

Alternative Treatments To Low Back Pain

Traditional treatments are not the only solution to help relieve your lower back pain. You can also try alternative ones.

Here are some of the most effective treatments to consider. 

Acupuncture

Acupuncture is a treatment that began in China over 2,000 years ago.

How it works is that it involves inserting needles into the body on certain points that are connected by pathways and create an energy flow.

By stimulating these points on the body, it’s said that energy flow can be improved, and this is thought to offer pain relief.

In addition, a theory about how acupuncture works is through what’s known as neurohormonal pathways.

By inserting a needle into certain points in the body, this stimulates the nerve that sends signals to the brain.

The brain responds by releasing beta-Endorphins. These create feelings of wellness in the body.

During acupuncture, the nerves send signals to the brain and the brain responds by releasing neural hormones such as beta-endorphins.

These can make the person feel better, which increases their pain threshold. This is why they then experience less pain, as Live Science reports.

But can acupuncture work on lower back pain?

The research definitely shows promising results.

A study published in JAMA Internal Medicine found that when 20,000 people with chronic pain were given real acupuncture treatments, no acupuncture, or fake acupuncture treatments, the ones who had been treated with the real acupuncture stated that they had 50 percent improvement in their chronic pain.

Some of the points that will be stimulated for lower back pain include points on the feet, lower back, hands, behind the knees, stomach, and hip.

If you’re dealing with back pain, you’ll likely require several treatments as this has been shown to be more effective than just one treatment.

Yoga

This mind-body therapy is highly beneficial for back pain because it helps you to gain greater awareness of your body.

It can also help you to notice where you’re tightening your muscles, thus causing strain and pain.

When you do yoga poses daily, you can also gain stress-relieving benefits that will no doubt help you better manage your pain.

But does yoga really work to alleviate back pain?

A study that was published in the Annals of Internal Medicine journal monitored participants to see what effects yoga or physical therapy would have on their pain over the course of 12 months.

Interestingly, people who had been experiencing chronic back pain showed a similar result as those in physical therapy, both when it came to pain and how limited their activity was.

The good news is that people in both groups were less likely to need pain medication after three months.

When Is Back Surgery Required For Pain?

It’s good to know that back surgery is not usually considered when a patient presents with pain in the back.

It will be recommended when the pain is as a result of a problem with the spine and/or the pain is persistent.

Here are some common back surgeries.

Spinal Fusion

Illustration Of Spinal Fusion

This is when two vertebrae in the spine are fused together to form a single unit, so that motion which causes pain can be restrained.

This is a procedure that can be risky, but it’s indicated for conditions such as spondylolisthesis. This is when the vertebrae are no longer aligned.

The method of fusing them together with rods or screws will provide the spine with greater stability.

However, it’s worth bearing in mind that spinal fusion doesn’t always remove the pain. It might just reduce it. }

Discectomy

A common sign that there’s a problem with the discs is sciatica and if it worsens then your doctor might recommend a discectomy.

This surgery basically involves removing the disc portion that’s pressing on nerves, as Harvard Health Publishing reports.

The telltale sign of a disc problem is sciatica—pain that radiates down the buttock, thigh, back of the leg, or calf.

For new disc pain, conservative care is the best first step. If sciatica persists or worsens despite conservative care, you might consider discectomy to relieve pain by removing the portion of the disc pressing on nearby nerves.

The site goes on to say that research has shown that conservative therapy, such as painkillers and exercise, can be as beneficial as this surgery, so it really depends on how bad your pain is and if you want immediate relief from it.

Laminectomy

Illustration Of Cervical Laminectomy

Stenosis is the narrowing of the spine and a laminectomy is a surgical procedure that’s most commonly used for this condition that can cause various types of pain, such as pain when standing.

During a laminectomy, the lamina or bony plate of the vertebra is removed so that the spinal nerves have more space.

As reported by Harvard Health Publishing, this procedure can be more effective than spinal fusion and it’s also safer.

In addition, it can bring patients up to 90 percent of pain relief.

A laminectomy can also be done to remove some bone or soft tissue that is compressing a nerve due to spinal stenosis.

Related Questions

Can back pain be genetic?

Chronic lower back pain can be in the genes because some people have more nociceptive fibers (sensitive receptors) that send pain signals to the brain than other people do, as orthopedic surgeon Ronald J. Wisneski tells WebMD.

Why is back pain such a common ailment?

As we age, our bones and muscles lose their elasticity, which means that the vertebrae in the back aren’t cushioned enough.

They can break or spasm. However, the lifestyles we lead also play a role. Bad posture and sedentary lifestyles can also contribute to a less-than-healthy spine and back.

What’s the outlook for back pain?

Although it can be worrying to experience, 90 percent of acute back pain goes away in two weeks. Many of the other 10 percent of people will recover within 12 weeks.

It’s important to speed up healing by leading a healthy lifestyle and resisting the urge to take bed rest as that can make it worse.

Conclusion

Having lower back pain can make going about your daily activities much more difficult.

You might also worry about what could be causing the pain. Whether you’re an athlete or not, you want to bounce back from your pain as quickly as possible.

That’s where diagnosing your back pain quickly to determine its cause can help you because you’ll be put on the correct treatment.

However, sometimes home remedies are enough to relieve your pain, such as with the use of heat treatments or ice packs, and this is especially the case when you’ve hurt your back muscles, such as by straining them.

It can also be beneficial to try some alternative therapies, such as acupuncture, which have been proven to alleviate back pain.

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