Overview
The spine is an essential part of the human body. Without it, the body could not keep itself upright. It gives the body structure and support. It allows you to move about freely and bend with flexibility. The spine protects the spinal cord, which is a column of nerves that connects the brain with the rest of your body. Without a spinal cord, the human could not move any part of his body, and organs could not function. Keeping the spine healthy is vital if we want to live an active life.
Lower back pain is the most common health condition encountered in clinical medicine. An estimated 65% to 80% of the population experiences Lower Back Pain during their lifetime. Lower Back Pain is the most chronic pain syndrome and the leading reason for activity limitation in patients younger than 45. It is also the second most frequent reason for a visit to the physician’s office and the third most common reason for surgery. The prevalence of Lower Back Pain increases with age until between 60 and 65 years, then gradually declines. It is more common in women.
Lower back pain is usually harmless. It tends to start suddenly and lasts a few days or weeks. The best thing you can do then is carry on going about your daily life and stay as physically active as possible. Resting too much or spending a lot of time in bed can make the back pain last longer.
It is hardly ever possible to find a specific cause for back pain. But it’s important to know that this “non-specific” low back pain isn’t dangerous. The pain doesn’t mean that there’s something wrong with your back.
This is also true if the pain lasts long or keeps returning. But chronic pain can become a big problem at work or in your daily life. Imaging techniques, medication, injections and surgery hardly help treat non-specific back pain. And they are associated with various risks.
Types of Low Back Pain
Three common forms of lower back pain:
Non-specific Muscular Pain
By far, the most common cause of back pain is non-specific muscular pain, which is a muscle strain. It may be due to lifting, twisting, stretching, or any other movement that adds stress to the lower back. It is due to sudden, unexpected activities such as a fall.
Muscle Spasms
These are common manifestations of lower back pain but less common than non-specific muscular pain. Muscle spasms occur when the back muscles involuntarily contract. Likewise, non-specific muscular pain and muscle spasms occur because of heavy lifting, bending or other activities. The injury starts with a specific incident rather than chronic use. Three out of four people with muscular lower back pain, such as muscle spasms, can recall a particular time and activity after which they developed their pain. Back spasm relief can be achieved with the proper use of painkillers and lifestyle modifications.
Radicular Pain
Radicular pain is another common type of lower back pain that two factors can cause:
- Degeneration of the disc, which is the shock absorber for the back
- Pinching of one or more nerve roots
The nature of radicular pain differs slightly from non-specific muscular pain and muscle spasms. Patients experiencing radicular pain often experience a sharp shooting pain that starts in the back and goes into one or both legs.
Sciatic Nerve Pain
Sciatica is also a prevalent type of lower back pain. It is caused by pain affecting the sciatic nerve (a nerve that runs from the lower back down the back of the leg). What makes sciatic nerve pain unique is its symptom of a more extensive form of nerve pain – the radicular pain mentioned above. The difference between radicular pain and sciatic nerve pain is that radicular pain may begin higher up in the spine and then radiate toward the lower back, whereas sciatic pain is a feeling of intense pain in the lower spine.
Lower Back Pain Symptoms
Identifying symptoms can lead to a more accurate diagnosis and effective treatment plan.
A combination of the following symptoms typically characterizes low back pain:
Dull, aching pain
Pain within the low back (axial pain) is described as aching and dull rather than stinging, burning or sharp. This pain can accompany mild or severe muscle spasms.
Pain that travels down to the buttocks, legs, and feet
Low back pain includes a sharp, tingling, stinging or numb sensation that travels down the thighs, soft legs and feet, also known as sciatica. Sciatica is due to sciatic nerve irritation and is only felt on one side of the body.
Pain that gets worse after prolonged sitting
Keeping on sitting for a long time puts strain on the discs and causes low back pain to get worse.
Pain that feels better when changing positions
Only some positions will be more comfortable than others. Like, in spinal stenosis, walking normally may be painful, but leaning forward onto something may reduce pain.
Many people experience worse low back pain in the morning. After getting up and moving around, it gets relieved. Pain in the morning is because of stiffness caused by long rest periods, decreased blood flow with sleep, and possibly the quality of mattresses and pillows used.
Other factors include mental and emotional health, financial stress, exercise, and activity level.
Lumbago
Low back pain (lumbago) affects the lumbar region of the spine. This is the lower part of the back, between your hips and the bottom of your ribcage. The pain is usually associated with muscle tension and often limits your range of movement.
Sciatica
The pain sometimes radiates (spreads) down to one or both legs. Low back pain that radiates down to below your knee or into a foot is called sciatica. A slipped disk most commonly causes this “specific” back pain.
Although back pain and leg pain may occur together, they aren’t always caused by the same thing. It is likely to be sciatica if the leg pain is more than the back pain, if the pain spreads along a particular nerve path, or if it’s accompanied by other symptoms such as tingling or numbness.
Other Symptoms of Lower Back Pain Include
- Stiffness. It may not be easy to move or straighten your back. Getting up from a seated posture may take a while, and you may need to walk or stretch to loosen up.
- Posture problems. Many people with lower back pain find it hard to stand up straight. They may stand bent, with the torso off to the side rather than aligned with the spine. The lower back may look flat, not curved.
- Muscle spasms. After pressure, muscles in the lower back can spasm or contract uncontrollably. It can cause too much pain and make it difficult to stand, walk or move.
Reasons for Lower Back Pain
Many injuries, diseases and conditions can cause lower back pain. Like:
Strains and sprains
Strains and sprains are the most common reasons for back pain. You may injure your tendons, muscles or ligaments by lifting something too heavy. Some people strain their back by coughing, sneezing, bending over or twisting.
Fractures
The bones in the spine may break during an accident.
Disk problems
Disks cushion the vertebrae and can bulge from their original position in the spine and press on a nerve. Disks may get flatter and offer less protection with age.
Structural problems
Spinal stenosis may occur when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord may cause severe sciatic nerve pain and lower back pain.
Arthritis
Osteoarthritis is a class of arthritis and the reason for lower back pain. Ankylosing spondylitis causes lower back pain.
Disease
Spine tumors, infections, and cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysms.
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Spondylolisthesis
This causes the vertebrae in the spine to slip out of place. Spondylolisthesis is a reason to low back pain and often leg pain as well.
Chronic pain in the low back often consists of a disc problem, a joint problem, or an irritated nerve root. The following are the common causes:
Lumbar herniated disc
The jelly-like center of a lumbar disc may break through the solid outer layer and irritate a nearby nerve root. The herniated part of the disc is full of proteins that cause Inflammation once they reach a nerve root, and Inflammation, also nerve compression, causes nerve root pain. The disc wall is also supplied mainly by nerve fibres, and a tear through the wall may cause severe pain.
Facet joint dysfunction
In the lumbar spine, there are two facet joints behind every disc at each motion segment. These joints may be painful by themselves or with disc pain.
Degenerative disc disease
At birth time, intervertebral discs are full of water. With age, discs lose moisture and wear down. As the disc loses water, it cannot resist forces as well and pass energy to the disc wall, which may grow tears and cause pain. The disc can also collapse and fortify stenosis.
Sacroiliac joint dysfunction
The Joint connects the sacrum at the lowest side of the spine to every side of the pelvis. It is a low-motion, vital Joint that primarily absorbs shock and tension between the upper and lower body. The Joint can become painful if it becomes inflamed or if there is too much or too little joint motion.
Spinal stenosis
This condition causes pain by narrowing the spinal canal where the nerve roots are located. The narrowing can be central, formal, or both and at single or multiple levels in the lower back.
Spondylolisthesis
This situation happens when one vertebra slips over the adjacent one. The pain may be due to instability (back) or compression of the nerves (leg).
Osteoarthritis
This condition occurs from wear and tear of the disc and facet joints. It causes Inflammation, pain, instability, and stenosis to a variable degree and can occur at single or multiple lower-spine levels. Spinal osteoarthritis is accompanied by aging and is slowly progressive.
Deformity
The deformity may be linked with lower back pain if it compels the breakdown of the facet joints, discs, sacroiliac joints or stenosis.
Diagnosis of Lower Back Pain
At your first visit, your doctor or orthopedist will usually start by asking you a few questions.
History
They may want to know whether this is the first time you have had low back pain or whether you have had it before, where exactly you feel the pain, and whether it is only painful when you move or when you are resting. It is also essential to let them know whether you have recently had an accident, whether you regularly take certain medications such as steroids, have any other health issues, and have other symptoms like numbness or paralysis. They will also ask you about any specific emotional or physical stress that may be contributing.
Physical Examination
As part of the physical examination, the doctor will do things like feel your muscles to see if there are any painful or tense areas, test your reflexes and check how well you can move. Your answers to the questions (anamnesis) and the physical examination are usually enough to rule out any major health problems.
Investigations
If that is the case, no further investigations such as x-rays, CT (computed tomography) or MRI (magnetic resonance imaging) scans are needed. It is advised not to use such imaging techniques if there are no signs of a more serious underlying cause. These examinations can’t tell you much about what’s causing non-specific low back pain. X-rays often “discover” visible bone or spine abnormalities that can also be seen in many people who don’t have back pain. These abnormalities are usually caused by normal, harmless wear and tear of the bones. For example, some studies looked at CT scans of the spines of adults who didn’t have back pain. It was found that about 30% of all 20-year-olds and more than 80% of all 80-year-olds have protruding spinal disks.
Too much testing can even do more harm than good. Imaging techniques might find an apparent cause of back pain that has nothing to do with the symptoms. This “misdiagnosis” can lead to unnecessary or wrong treatments and anxiety.
Examinations using X-ray, MRI, EMG, or CT scans may be helpful if your doctor has good reason to believe that there may be a specific underlying cause or disease or if the symptoms don’t go away – or even get worse – within six weeks.
How to Treat Lower Back Pain Medically?
A doctor will prescribe medical treatments alongside a physical therapy program to lower back pain.
The following are the standard medical treatments:
Muscle relaxants.
This acts as a depressant of the central nervous system and increases the mobility of tense muscles, relieving pain from muscle tightness.
Narcotic pain medications.
Narcotic drugs, Strong painkillers for lower back pain also known as opioids or painkillers, alter one’s perception of pain by decreasing signals sent to the brain.
Back braces.
Few patients find that a back brace can provide comfort and reduce pain. There is some evidence that using an inelastic corset-style brace, worn daily, combined with physical therapy and a lower back pain exercise program, can reduce pain and speed healing.
Epidural steroid injections.
This injection consists of steroids administered directly into the outer portion of the dural sac, which surrounds the spinal cord. A live x-ray, called fluoroscopy, guides the needle to the right area. The purpose of the injection is to relieve pain temporarily by reducing Inflammation around a compressed nerve root.
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Home Remedies for Lower Back Pain
Depending on the reason for your back pain and its severity, you might try the following few home remedies.
Keep Moving.
You might not feel like it is moving when you’re in pain. But this is likely the first thing your doctor will recommend. A common misconception in patients with isolated lower back pain is that they can’t move. Try to follow your usual level of daily activity and movement. It may be a 30-minute walk or circling.
Stretch and Strengthen.
Strong muscles, especially in the abdominal core, help support the back. Strength and flexibility both relieve your pain and prevent it.
Yoga, tai chi and Pilates are just a few methods to strengthen your core and the muscles around your hips. Exercise that targets the whole upper and lowers back is to lie on your belly and lift your legs and arms in the flying position.
Keep a Good Posture.
This helps to ease the pressure on the lower back. You can use straps, tape, or stretchy bands to help keep your spine in alignment. The Aim of this is to keep your head centered over your pelvis. While working in front of a screen, keep your arms evenly on the table and keep your eyes level with the top line of the screen.
Maintain a Healthy Weight.
Shedding extra weight lightens the load on your lower back.
Quit Smoking.
Research shows that if you smoke, you may be four times more likely to have degenerative disk disease or other spine problems than nonsmokers.
Nicotine in cigarettes and other products can weaken your spinal bones and remove vital nutrients from the spongy disks that provide cushions to your joints.
Throw in the Towel.
A rolled-up towel can be a handy and straightforward tool for back pain relief. Keep it under your pelvis when you’re lying down.
Cold and heat therapies.
It’s best to apply an ice pack or cold compresses, not heat, right away following a back injury since this can lessen pain by freezing the area and prevent or lessen the swelling. But after 48 hours of back pain, apply heating pads or a hot water bottle to your back. The warmth soothes and aching muscles and increases blood flow in the body. Heat therapy is helpful only for the first week.
Risk Factors
The following are some risk factors for lower back pain:
- Age.
People of age more than 30 years have more back pain. Disks wear out with age. As the disks wear down and weaken, pain and stiffness can result.
- Weight.
People who are overweight/obese are more likely to have back pain.
- Overall health.
Weakened abdominal muscles can’t support the spine and lead to back strains and sprains. Individuals who smoke, drink alcohol excessively or live a sedentary lifestyle have more risk of lower back pain.
- Occupation and lifestyle.
Jobs and activities that need heavy lifting or bending can enhance the risk of a back injury.These usually are causes of lower back pain in males.
- Structural problems.
Severe back pain can result from conditions like scoliosis that change spine alignment.
- Disease.
People with a family history of osteoarthritis, certain types of cancer and other diseases have more risk of lower back pain.
- Mental health.
Back pain can occur because of depression and anxiety.
- Pregnancy
Lower back pain in females can occur during pregnancy and when on the menstrual cycle (PMS).
Prevention
The most important thing people can do is to protect their backs before a painful condition can start. To maintain a good back and healthy spine, doctors may recommend the following:
- Develop a proper diet and exercise regimen
- Adhere to proper posture
- Quitting health-impacting habits like smoking or excessive drinking
- Take less stress.
The following few exercises can help in the prevention of lower back pain:
- Bridge exercise
- Cat stretch
- Shoulder blade squeeze
How do I Know if my Lower Back Pain is Severe?
If your back pain is associated with any of the following symptoms, go to a hospital because you could be dealing with a more dangerous condition:
- A sudden spike in pain, weakness, discomfort, or numbness
- Loss of bladder function
- High fever
- Severe stomach pain
- Unexplainable weight loss
- The pain results from a fall or powerful blow to your back
Can Lower Back Pain be a Sign of Something Serious like Cancer?
Lower back pain is a common feeling for most people, but having persistent pain can reveal something dangerous about your health. It can even be a symptom of cancer too. However, before you get worried too much, lower back pain is a common issue that millions of people suffer from. There are various reasons for it, just one of which is cancer.
The following are possible ways lower back pain can be a sign of cancer.
Spinal Tumors
Spinal tumors are rare, abnormal, and potentially cancerous masses that thrive in the spinal column or spinal cord. Not all spinal tumors are cancerous, but their presence can still be the reason for severe pain in the back. It can also cause paralysis, numbness, and faulty coordination of the legs and arms.
Breast Cancer
While other symptoms may come with developing breast cancer, sometimes, lower back pain is the only symptom present for diagnosis.
Lung Cancer
Lung cancer can also cause problems like lower back pain.
Cancer of the Skin and Tissue
Skin or tissue cancer, like melanoma, may cause lower back pain. If left undiagnosed and untreated, melanoma can spread and affect the area of the spine, which results in back pain.
Gastrointestinal (GI) Cancers
Cancers that may occur in the stomach, colon, or rectum of the gastrointestinal tract can cause lower back pain.
Prostate Cancer
The American Cancer Society suggests that advanced prostate cancer can spread into the spine, causing lower back pain.
Could Lower Back Pain be Kidney Pain?
A kidney problem rarely causes lower back pain, but it’s common to mistake it for kidney pain. Kidney issues are easier to identify through other symptoms, such as pain when you urinate.
Mistaking kidney issue for back pain is common, but you should consult one of our doctors if in doubt.
Which Lifestyle Factors Contribute to Lower Back Pain?
Low back pain is associated with physical activity at work and leisure time, certain lifestyle factors and demographic characteristics.
Individuals with low back pain often experience a more physically heavy workload at work and lower physical activity during leisure time. They were also more likely to have been smokers, had higher body mass indexes, lived in smaller communities, and were less educated than people without low back pain.
Consult one of our doctors online now, to discuss lifestyle modifications that will help you with the management of lower back pain.
Symptoms of Lower Back Pain that Require Urgent Care
1. Incontinence
Incontinence is due to the loss of voluntary control over your urinary or rectal functions. If you often rush to the bathroom due to unavoidable accidents, you may have a condition that needs immediate attention.
Another rare but severe condition if you are experiencing back pains and incontinence is cauda equina syndrome (CES). Correctly. Other signs include weakness, numbness, or tingling in your legs.
2. Leg Weakness
Sudden leg weakness commonly can indicate serious complications. It may also be associated with numbness, tingling, or severe pain.
3. Abdominal Pain
Experiencing both abdominal pain and back pain simultaneously is a cause for concern. Your abdomen has several essential organ systems, such as your stomach, kidney, liver, and intestines, so if there is no apparent reason for a sudden onset of back pain, you should seek medical help.
4. Debilitating Pain
If the pain is debilitating or crippling and you can barely roll out of bed, have trouble doing simple activities, or can hardly sleep due to the pain, you should see a physician.
5. Sharp, Sudden Pain That Won’t Go Away
It’s a more significant cause for concern if a sharp pain suddenly occurs, even if you haven’t been engaged in strenuous activity. It may be after an accident, like lifting something heavy and pulling a muscle.
6. Numbness or Tingling
Back pain with numbness or tingling should not be ignored. These signs may be due to nerve irritation or damage and should be discussed with a doctor immediately.
Consult one of our online doctors now and discuss if you need urgent care regarding your lower back pain symptoms
FAQs about Lower Back Pain Answered by Your Doctors Online Team
Symptoms related to several human systems can present as lower back pain. These include
Renal system
Genitourinary
Appendicitis
Ulcerative colitis
Gallbladder dysfunction or Inflammation
Gynecological disorders
Fibroids
Liver problems
Pancreatitis
Abdominal Aortic Aneurysm
Ice is better than heat for lower back pain that an acute injury may cause. Ice shuts down swelling, Inflammation and pain early on, whereas heat may worsen an injury.
If you’re suffering from lower back pain, regardless if it’s due to stress, bad posture, arthritis, or any other medical condition, the following five best sleeping postures for lower back pain can help you improve the quality of your sleep.
1. Lying on your side in a fetal position
2. Lying on your back in a reclined position
3. Lying on your stomach with a pillow below your pelvis and lower abdomen
4. Lying on your side with a pillow supporting your knees
5. Lying flat on your back with a pillow underneath your knees
Treatment with pain medication, rest, spinal injections, and physical therapy is an initial step to recovery. People gets improve in 6 weeks and return to regular activity. If symptoms continue, surgery may be the solution.
