Lower Back Pain Causes and Treatment
Medically reviewed by Amy Kwan, PT
Lower back pain can feel like a sharp or dull ache in the lower part of your spine. You may also experience stiffness, shooting pain down the leg, trouble standing, and limited movement.
Lower back pain is often a symptom of an injury or medical condition that affects the muscles, ligaments, or spine. Your pain may start suddenly or develop slowly over time.
Causes of Acute Lower Back Pain
Acute lower back pain happens suddenly and lasts a few days or weeks. Back muscle and spine injuries typically lead to acute lower back pain.
Strains and Sprains
Lower back pain associated with “throwing out your back” is often related to lower back muscle strains or sprains. Strains happen when an injury or gradual overuse causes your lower back tendons or muscles to overstretch. Sprains are caused by torn ligaments, bands of tissue that connect bones.
Strain or sprain pain often includes stiffness and muscle spasms that last up to two weeks. More severe strains or sprains may need medical attention. In addition, strains that do not heal can cause chronic pain.
Herniated or Ruptured Discs
Discs are the thin cushions between your vertebrae (spinal bones) that help your spine bend. Injury from poor posture or lifting heavy objects can cause discs to slip (herniate) or break open (rupture). As a result, a herniated disc can push into the spinal cord and nerves, causing lower back pain and in some cases, pain or numbness shooting down the legs (sciatica).
Herniated discs and the lower back pain they cause typically resolve in six weeks or less. However, severe cases may cause chronic lower back pain and require additional medical treatment.
Sciatica is any damage to the sciatic nerve, which runs from the lower back down each leg. When this nerve is damaged, you may experience pain, numbness, or tingling in the back and leg. A ruptured disc, spinal canal narrowing (spinal stenosis), or pelvic injury can cause sciatica.
As the uterus (womb) grows during pregnancy, the abdominal muscles stretch and weaken. Since your abdominal muscles help support the spine, pregnancy can strain your back muscles and cause lower back pain. Some people may also have lower back pain in the months after giving birth while their muscles heal.
Other health conditions or infections
Sometimes lower back pain isn’t directly related to your spine or lower back muscles. Health conditions that affect organs close to the lower back may also cause lower back pain, including:
Gallbladder problems, such as gallstones
Endometriosis (a condition in which uterine tissue grows outside of the uterus)
Ovarian cysts (fluid sacs on the ovary)
Uterine fibroids (non-cancerous growths in the uterus)
Causes of Chronic Lower Back Pain
People with chronic lower back pain experience daily pain that lasts 12 weeks or longer. Chronic lower back pain may start suddenly or increase slowly over time. Spinal health conditions and injuries can cause chronic lower back pain.
Continuously having poor posture can eventually cause neck and lower back pain. People can also be born with abnormal curvatures of the spine that cause pain. Conditions that affect the curve of the spine include:
Scoliosis: A sideways curved spine, often seen as an abnormal S- or C-shape in children.
Lordosis: An inward curved spine, typically of the lower back.
Kyphosis: Curving of the spine that causes a rounded upper back.
Compression fractures—or small breaks—along the spinal bones can cause severe, stabbing pain in the middle and lower back. People may also experience numbness, tingling, or trouble walking. People with osteoporosis, a disease that causes brittle and fragile bones, are more at risk of back compression fractures.
Degenerative Disc Disease
Degenerative disc disease is when the discs between their vertebrae break down. Discs that become too thin put pressure on the spinal cord and nerves, causing lower back pain. Vertebrae may also begin to rub together and cause spinal conditions like spinal stenosis and arthritis. People’s discs naturally start to break down as they age, but not everyone experiences pain.
Arthritis causes painful inflammation in joints and ligaments. Ankylosing spondylitis, a type of arthritis, targets the joints and ligaments connected to the spine. As a result, people with the condition can experience lower back pain, stiffness, and in severe cases, fused vertebrae.
Spondylolisthesis is a condition that causes a vertebra to move forward from the spine’s alignment onto the vertebra below. Birth defects or spinal injuries in children can cause the condition. Adults may develop spondylolisthesis from arthritis, or from repeatedly performing activities that put stress on the back bones.
In addition to lower back pain, the condition can cause stiffness, tight hamstrings, tenderness around the affected vertebra, and weakened legs.
Spinal column narrowing, known as spinal stenosis, puts pressure on your spinal cord and nerves. This can cause lower back pain, weakness in the leg or arm, and numbness throughout the body.
Some people can be born with too little space around their spinal cord, which leads to spinal stenosis. Aging, herniated discs, spinal cord injury, arthritis, and bone diseases can also cause spinal stenosis.
Cancer can cause pain throughout the body, including the lower back. Cancer of the spinal cord can directly cause pain in the back. Tumors that develop around and on the spine can compress the spinal cord nerves, leading to neck and back pain.
Fibromyalgia is a chronic condition that causes widespread pain, fatigue, and sleep issues. People with fibromyalgia may experience lower back pain and stiffness.
Fibromyalgia can also cause tingling in the hands and feet, memory issues, and headaches. Researchers don't know what causes fibromyalgia, but people with rheumatoid arthritis and lupus are more likely to develop the condition.
How To Treat Lower Back Pain
Depending on what causes your lower back pain, treatment can range from at-home therapy to surgery. Your healthcare provider may also suggest medications and physical therapy to help treat lower back pain.
If your lower back pain is from straining or spraining your back, you can typically treat it at home. Treating pain at home can include:
Applying ice packs to the lower back for the first 48-72 hours of injury
Applying heat to the lower back
Taking a warm bath
Taking over-the-counter pain relievers like Advil (ibuprofen) or Tylenol (acetaminophen)
Placing a pillow between your legs and sleeping in the fetal position
Placing a rolled towel or pillow under your knees while sleeping on your back
In more severe cases of lower back pain, your healthcare provider may suggest medication to help manage pain, reduce inflammation, or relax the muscles. Some medical treatments for lower back pain include:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Oral medications that help treat pain and inflammation, including over-the-counter drugs like Advil (ibuprofen) and Aleve (naproxen), or prescription drugs like Celebrex (celecoxib).
Muscle relaxers: Oral medications that help relax tight muscles to reduce acute lower back pain, including Robaxin (methocarbamol) and Soma (carisoprodol). Muscle relaxers like carisoprodol are controlled substances and can be addictive.
Anti-inflammatory or numbing injections: Injections that can help reduce inflammation and pain that travels down the leg, including corticosteroid injections.
Narcotics (opioid drugs): Prescription pain relievers used to treat severe acute and chronic pain, including codeine and hydromorphone. Narcotics can be highly addictive and are often used for short periods.
Neuromodulatory agents: Prescription medications that alter how the nervous system processes pain to help reduce severe pain, including anticonvulsant agents and ketamine.
Physical therapy can help strengthen your muscles, improve posture, and reduce pain if you have weak or injured back muscles. Your physical therapist may create a treatment plan that includes the following:
Lower back and core exercises
Manipulation and massage of the spine and surrounding muscles
Transcutaneous electrical nerve stimulation (TENS), a therapy that applies low-voltage electrical currents to reduce pain
Lower back pain caused by severe injuries or medical conditions may require surgery. Some surgical options to treat lower back pain include:
Discectomy and microdiscectomy: Removing parts of a herniated disc to help relieve nerve and spinal pressure.
Disc replacement surgery: Replacing a damaged disc with an artificial disc.
Laser surgery: Applying laser energy via a needle to decrease the size of a damaged disc and relieve nerve pressure.
Laminectomy: Removing bony spurs and vertebrae bone walls to open the spinal column and treat spinal stenosis.
Foraminotomy: Surgically cleaning and widening the area where nerves exit the spinal canal. This can help relieve nerve pressure from spinal stenosis.
Radiofrequency lesioning: Passing high-frequency radio waves through a small needle to help block pain signals from entering the spinal cord.
Spinal fusion: Removing discs between vertebrae and replacing them with metal devices or bone grafts to fuse two or more vertebrae. This is used to treat severe degenerative disc disease and spondylolisthesis.
Spinal cord stimulation: Stimulating the spinal cord with electricity to help block pain signals to the brain.
Preventing Lower Back Pain
Maintaining good posture and keeping your back and core strong can help you avoid injuries that cause lower back pain.
Abdominal and Back Exercises
Research shows exercise can help improve lower back pain and function. Abdominal strength helps prevent you from straining your back muscles when you bend and lift. A strong back and core also help improve posture and flexibility.
Here are some exercises that can help strengthen your core or lower back muscles:
Low-impact aerobic activities: Walking, swimming, or riding an upright stationary bike for 20-30 minutes can help improve blood flow to back muscles for healing and strength.
Heel slides: Lying on your back, slowly bend and straighten one knee at a time as you slide your heel toward your butt. Repeat 10 times on each side.
Ankle pumps: Lying on your back, bend your feet at the ankles up and down. Repeat 10 times.
Wall squats: Standing with your back on the wall, walk out your feet about a foot in front of you. Keeping your core engaged, slowly bend your knees to a 45-degree angle and hold for 5 seconds.
Straight leg raises: Lying on your back with your legs straight and hands at your sides, bend your left leg with your foot on the floor. Slowly raise your straight right leg, engage your core, and hold for 1-5 seconds. Slowly lower your legs and repeat on the left side.
Lumbar stabilization exercise with exercise ball: Lying over an exercise ball on your stomach, place your hands on the floor shoulder width apart. Slowly walk your hands forward, rolling the ball under your legs. Then slowly walk your hands back so you ball in under your stomach.
Lumbar stabilization exercise ball hand raise: Lying over an exercise ball on your stomach, place your hands on the floor shoulder width apart. Slowly walk your hands forward, rolling the ball under your legs. Then slowly raise your right arm over your head. Lower and repeat with your left arm.
Chat with your healthcare provider or physical therapist before starting exercises for lower back pain. Exercising too soon can increase pain if you have a lower back injury.
Your physical therapist can let you know which exercises are right for you, and at which time. They may want to monitor more advanced exercises, such as those with an exercise ball.
Learn How to Lift and Bend Properly
Lower back injuries are often caused by lifting heavy objects or bending down incorrectly. Here’s how to properly lift and bend to prevent injury:
Keep your feet spread hip distance or wider for a supported, solid base
Stand as close to the object as possible before bending down to pick it up
Bend with your knees rather than at your waist
Lift back up with your leg muscles and engage your core muscles
As you lift, keep a straight back and avoid leaning forward
Avoid twisting while bending, lifting, or carrying an object
When lowering an object, engage your core muscles and bend your knees, keeping your back flat
Adjust Your Workstation
If your lower back pain worsens after a long day hunched over a computer, your posture may be causing you pain. Here’s how to adjust your workstation to help you avoid lower back pain:
Place your screen 20-30 inches away from your eyes
Adjust the height of your monitor or laptop with books or a stand so your neck is straight when you look at the screen
Choose a desk chair that adjusts, swivels, and has back and armrests
Sit up straight with your head, hips, and spine inline
Slightly recline your chair if sitting up straight is uncomfortable
Use a lumbar pillow or rolled towel for additional lower back support
Keep your knees slightly above your hips by placing a stool or books under your feet
A Quick Review
Lower back pain can start suddenly or worsen gradually, and it can be temporary or long-lasting. Injured muscles, torn ligaments, or damaged discs can cause lower back pain. Over time, poor posture or certain medical conditions can slowly cause chronic lower back pain.
Lower back pain caused by strains can often be treated at home with rest and heat application. But if your pain isn’t going away, talk to your healthcare provider. You may have an injury or condition that needs additional surgery, medication, or physical therapy.
Exercising regularly, being careful when lifting heavy objects, and keeping good posture while working can help you avoid future lower back injuries.
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Read the original article on Health.