Lower back pain causes, symptoms, diagnosis and treatment
Medically Reviewed By : Dr Sravya, MBBS, MS
Overview
Who suffers from lower back pain the most? Most of us would have experienced lower back pain at one or other point in our lives. It is a common ailment seen in 1 out of 10 people worldwide. The nature of the pain can be a dull ache to a shooting or stabbing sensation. The causes of lower back pain can be as simple as over-straining of muscles to chronic bone diseases or conditions. Lower back pain can be due to specific or nonspecific causes. Here in this article let’s dive into the details of lower back pain causes and its symptoms, diagnosis as well as treatment.
What does lower back pain mean?
Lower back pain or lumbago occurs due to injury to muscles or ligaments, improper lifting, poor posture, lack of exercise, fracture or ruptured disc or arthritis. The lower back region or lumbar spine supports much of the weight of the upper body. The 5 vertebrae, named L1 to L5 form the lumbar spine. The spaces found between the vertebrae have intervertebral discs which are the shock absorbers of the spine. The ligaments hold the vertebrae in place and the tendons attach the muscles to the vertebrae. Most often the pain can occur due to an injury to the tendon, muscle or ligaments. This type of pain goes away with rest, painkillers and physical therapy. In cases of severe injuries or disease, conditions may require surgeries for recovery.
Who gets lower back pain?
Certain people are more prone to get lower back pain than others. Let’s know who is at risk for lower back pain.
- Age: As we age the intervertebral disk which acts as a shock absorber gets worn down. This will cause stiffness and pain.
- Occupation: If you are a person with a job demanding constant bending or heavy lifting, it can cause back injuries.
- Weight: Being overweight or obese can lead to extra weight on the joints causing pain.
- Disease: Many diseases and conditions in bone such as arthritis, osteoporosis, and bone tumour can end up in joint pain.
- Structural issues: Low back pain can occur from spine alignment conditions, such as scoliosis.
Lower back pain causes
Your lower back pain is one of the numerous reasons varying from a simple injury to symptoms of various chronic disease conditions affecting the bone. Let’s see some common lower back pain causes below.
- Muscle sprains or strains: A sudden movement or strenuous activity can tear or stretch the ligaments. This results in low back pain, stiffness and muscle spasms.
- Herniated disc: A trauma or increasing age, can cause the cartilage surrounding the intervertebral disc to tear or bulge out pushing toward the nerves and the spinal cord resulting in pain.
- Sciatica: The sciatic nerve connects the nerves from the legs to the spinal cord, a herniated disc pressing this nerve leads to pain, pins and needles to the legs.
- Spinal stenosis: The degeneration of intervertebral discs forms irregularities and bone spurs, these compress the nerves emerging out from the spinal cord in turn causing pain, numbness or cramping.
- Fractures: Spine bone breaks or cracks during some trauma or a fall. Some conditions like osteoporosis, can cause bone porosity and increase bone fracture. These can give you sudden back pain.
- Structural problems: The unusual spinal alignment such as scoliosis, kyphosis or lordosis will cause poor posture and put pressure on ligaments, muscles, tendons and vertebrae leading to lower back pain.
- Other conditions: Some conditions show lower back musculoskeletal pain along with other symptoms. They include conditions like arthritis, spondylitis, spondylolisthesis, spondylosis and fibromyalgia.
- Other health conditions: Various other health conditions can show lower back pain as a symptom such as kidney or bladder problems, pregnancy, endometriosis, spinal infections, spine tumours, uterine fibroid and cysts.
Lower back pain symptoms
The lower back pain symptoms can occur gradually or suddenly after an activity such as bending over or after a strenuous activity. In some other cases, you cannot specifically identify the cause of the lower back pain. The pain can be dull, achy or sharp radiating to the legs, gets worse at certain positions and gets better on lying down. Let’s look at the most common lower back pain symptoms.
- A pain in the lower back region on bending down or heavy lifting.
- A pain on sitting for too long
- A radiating pain to the hips or glutes.
- A stiffness in the lower back after a period of rest or when waking up.
- Weakness or numbness
The lower back can be of 3 types according to the duration of the back pain. They are the following:
- Acute back pain: If the pain lasts for less than 6 weeks.
- Subacute back pain: If the episode of pain lasts for 6 to 12 weeks.
- Chronic low back pain: If the pain exists for 12 weeks or more.
Lower back pain diagnosis
Your healthcare care provider will take a detailed medical history before arriving at a final diagnosis. The medical history will include all past medical conditions, medication, surgeries, trauma or accidents you underwent. This will help to find the lower back pain cause. Certain procedures or tests will also be advised by your physician to have a detailed look at the current condition. They may include:
- Blood test and urine test: This is done to rule out any conditions or disease-causing lower back pain. Also to rule out kidney diseases like kidney stones.
- X-ray: A spine X-ray will take a bone image using radiation. This will help to see in detail study about the current bone conditions.
- MRI: This will take images of the bone, ligament, tendon and adjacent soft tissue. This helps to see any other soft tissue damage as well.
- CT scan: This will provide a 3-dimensional image of the bone and adjacent tissues.
- Electromyography: This is done to study any nerve or muscle damage.
Lower back pain treatment
The treatment will mainly focus on pain management. The pain usually subsides with rest, ice pain medications and physical therapy. If not, you might need more focused treatment or surgeries according to the condition.
- Home remedies for lower back pain: The home remedies are helpful for the first 72 hours. This includes rest and heat compression for the initial hours following over-the-counter pain medication. Lying on your back also helps. You can follow the RICE protocol (rest, ice, compression and elevation) for the home remedies.
- Medication: Non-steroidal anti-inflammatory medication and muscle relaxants prescribed by your physician will help with pain reduction and relax your muscles.
- Physiotherapy: Your physician might advise you for physiotherapy. Being active increases blood flow and helps to heal faster. This will help you to increase flexibility and strength in your spine. The physiotherapy includes massages, strengthening exercises, stretching and spinal manipulation.
- Injection: This includes corticosteroid injection, which helps to relieve pain and inflammation. Using a needle and syringes the medication is injected into the affected area.
- Surgery: Some type of condition needs surgical repair for recovery when all other treatments fail and you have severe lower back pain. Commonly done procedures are discectomy, foraminotomy, intrathecal electrothermal therapy, nucleoplasty, radiofrequency lesioning, spinal fusion and spinal laminectomy.
How to prevent lower back pain?
You can avoid injuries or trauma causing lower back pain. You cannot prevent lower back pain caused by any other disease condition. An active lifestyle, with exercise and stretching, will help to keep your spine and muscles strong. Also, maintain a healthy body weight by intake of a balanced diet for bone health.