Causes of low back pain

Medically Reviewed By : Dr K. Hari Chandana

MBBS, MS ORTHOPAEDICS
( Fellowship in Trauma, Fellowship in Pain Management )

Introduction

Low back pain affects 6% to 15% of the Indian population. There is a persistent misconception that older people experience lower back discomfort more frequently compared to younger people. This problem is affected by a variety of things.

We will explore each of them thoroughly in this blog. Firstly, there are two types of low back pain.

Acute: There is a very sudden onset of pain and discomfort due to any injury to the muscle or underlying condition. For example, a muscle strain, a herniated disc, or an injury like a fall or a sudden blow to your lower back can all result in acute low back pain.
Chronic low back pain is defined by lower back discomfort that persists for prolonged periods of time—typically longer than three months.Unlike to acute pain, which typically follows a specific event or incident, chronic pain can be caused by a number of different things and occasionally manifest itself in more complex ways.

Cause of low backpain

Let’s categorize each of these causes into a few groups.

1. Poor Posture

When we slouch, hunch, or adopt incorrect positions every day, the spine’s natural curve is disturbed, resulting in misalignment and increased strain on the vertebrae, discs, and supporting muscles. Poor posture is a common cause of low back pain because it puts excessive stress on the structures of the lower back. This misalignment can lead to weakening of the core muscles while other muscles become tight and strained, resulting in an imbalance.

Furthermore, poor posture can restrict blood flow to the lower back, impairing the body’s capacity to repair and nourish the injured tissues. These factors can lead to chronic lower back pain over time, so emphasizing healthy posture and taking important steps to alleviate lower back pain symptom.

2. Poor Paraspinal Muscle Strength

Inadequate strength in the paraspinal muscles, which travel along the spine and provide essential support, is a major cause of lower back discomfort. These muscles are essential for ideal spinal alignment and stability. When they are weak, the spine is less supported, making it more prone to misalignment and putting excessive strain on the vertebrae and intervertebral discs. This weakness can also result in bad posture as the body fights to stay upright.

As a result, the lower back muscles and ligaments are strained and forced to adjust, becoming overworked in the process. This imbalance can lead to persistent lower back pain over time, making it important to include paraspinal muscle strengthening exercises as part of an overall approach to pain relief.

3. Lifestyle

Lifestyle refers to an individual’s routines, interests, and decisions. It has an important effect on values and health. A sedentary way of life means an increase in work-from-home opportunities and hours spent in one posture.

We have all heard how harmful our lifestyle is for our health in general. Let’s further discuss what exactly happens that leads to lower back pain because of sudden life events.

Sitting for a prolonged period of time weakens the muscles that support your spine, which leads to instability and discomfort.
Talking about habits, a lot of times we sit improperly, causing stress on our muscles and ligaments.
Sitting also puts more pressure on the discs of the spine, leading to nerve irritation and disc problems.
Inactivity, or sitting for prolonged hours without frequent walks in between, can also reduce blood flow to muscles and tissues, leading to stiffness and pain.
Your flexibility is also affected by factors that contribute to stiffness and bad posture.

4. Diet

There are numerous ways in which diet might affect lower back pain. By giving our bodies the essential minerals and vitamins they need for our bones to complete their regular daily activities, what we consume inside of us has a significant impact.

Nutrient Intake: As we all know by now, calcium and vitamin D are the two most important vitamins for healthy bones. It is important to incorporate these rights into a diet so that we can achieve healthy bones and prevent diseases that are caused by a deficiency of calcium and vitamin D.

Spinal Disc Health: Consuming foods with collagen, like bone broth, might support spinal disc health. Collagen, a protein that gives bones, tendons, ligaments, and cartilage, including the discs between the vertebrae in the spine, structural support, is abundant in bone broth.

5. Diseases

There are certain diseases that cause lower back pain. The most common diseases are stated here:

Osteoarthritis: The deterioration of the cartilage between the joints can cause lower back discomfort, stiffness, and irritation.
Lumbar Spondylosis: Due to the high degree of mechanical stress in this region, there are high chances of lumbar spondylosis.
Herniated Disc: The softer inner material of a spinal disc can irritate adjacent nerves and create pain when it pushes through a tear in the more durable outer layer.
Ankylosing spondylitis: This particular form of inflammatory arthritis primarily impacts the spine, where it can cause stiffness, discomfort, and eventually vertebral fusion.
Scoliosis: When the facet joints and spinal discs are subjected to unequal amounts of pressure, it can result in pain.
Fibromyalgia: This is a disease that causes lower back pain as well as other generalized symptoms related to the muscles.
Rheumatoid arthritis: This autoimmune condition has a propensity to inflame joints, especially in the spine.
Cauda Equina Syndrome: In this rare but serious disorder, the nerve roots in the lower spinal cord are compressed, causing low back discomfort, numbness, weakness, and sometimes loss of bladder or bowel function.

Types of pain: In relation to different diseases

Following are various types of pain and some of the illnesses or problems that each type is linked to:

Sr. No	Type of Pain	Underlying Conditions
1.	Dull, aching type of pain	– Osteoarthritis – Fibromyalgia – Muscle strains – Tendonitis – Lumbar Spondylosis
2.	Burning Pain	– Neuropathy (nerve damage) – Complex regional pain syndrome (CRPS)
3.	Radiating Pain	– Sciatica (compression of the sciatic nerve) – Herniated disc – Cauda equina syndrome
4.	Stinging or Shooting Pain	– Nerve compression or damage – Neuralgia (nerve pain) –Trigeminal neuralgia
5.	Intermittent Pain	– Rheumatoid arthritis – Gout – Crohn’s disease
6.	Chronic Pain	– Chronic back pain – Fibromyalgia

It’s crucial to remember that these correlations are broad and not all-inclusive. People experience pain in a variety of ways, and a comprehensive medical evaluation by a healthcare professional is crucial for an accurate diagnosis and appropriate treatment.

Diagnosis

Your physician might take a detailed case and ask you about the nature of the pain, onset, duration, progression, lifestyle, diet, and physician activity. Your physician might also advise you to take some tests for a more accurate diagnosis. Here are some tests your physician will ask you to do:

Physical Examination: Your physician might perform a physical examination, which may vary from condition to condition. Physical examination: A thorough physical examination can aid in locating painful spots, weak muscles, and restricted ranges of motion. To replicate the discomfort or make it go away, specific movements and tests may be carried out, which can help identify its cause.
X-rays: X-rays give precise pictures of the spine's bones. They can aid in locating problems like fractures, concerns with the spine's alignment, and degenerative changes to the vertebrae.
Magnetic Resonance Imaging (MRI): A detailed image of soft tissues, such as discs, nerves, and muscles, can be obtained from an MRI scan. They are particularly helpful in the diagnosis of spinal stenosis, nerve compression, and herniated discs.
Computed Tomography (CT Scan) Compared to X-rays, CT scans can provide sharper views of the bone structures by providing cross-sectional images of the spine. They are frequently used to evaluate bone anomalies, complicated spinal conditions, and fractures.
Functional Test: Functional evaluations can measure how the spine moves during a range of activities. These examinations can aid in locating movement irregularities that may be causing the pain.
Blood Test: Blood tests may be performed to look for signs of infection, inflammation, autoimmune diseases, or other systemic illnesses that may be connected to the pain.
EMG (Electromyography) and Nerve Conduction Studies: The electrical activity of muscles and nerves is measured by these tests. They can assist in figuring out whether nerve compression or an injury is causing the pain.Treatment

Treatment

Your doctor will identify the underlying source of the issue and treat it because the treatment for lower back pain depends on its underlying cause. NSAIDS, anti-inflammatory medications, and even physical therapy may be used in the course of treatment.

Prevention

There is a famous quote from Atomic Habits by James Clear: “Success is the product of daily habits, not once-in-a-lifetime transformation.

Adopting healthy habits, maintaining appropriate posture, remaining physically active, and being aware of your body mechanics are all necessary to prevent lower back pain. Here are some recommendations for avoiding lower back pain:

Keep a healthy weight
Remain Active
Use seating, workstations, and computer configurations that encourage excellent posture to maintain it.
Avoid bending at the waist when lifting large objects; instead, bend at the hips and knees. Use your leg muscles, not your back, to lift the object while keeping it close to your body.
Sunlight is your best friend
Include calcium and vitamin D in your diet or take supplements after consulting your physician.
Stretch frequently. Good footwear can help encourage good posture and lessen lower back strain.
Select a pillow and mattress that will adequately support your spine as you sleep. Back pain can be avoided by sleeping with your spine in a neutral position.
Bone broth, which is mostly made up of water, helps with general hydration. Healthy discs are essential for the health of the spine.

Do not be afraid to ask for some professional assistance if your lower back is giving you trouble. It’s like treating your back like a VIP. You’ll thank yourself later when you’re pain-free!