Lower Back Pain Injury Overview

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Lower back pain includes discomfort in the lower part of the back between the bottom of the ribcage and the top of the glutes. It may involve any part of the lower back, including the vertebrae, intervertebral discs, muscles, ligaments, and nerves.

Lower back pain is one of the most common complaints among adults. The Institute for Health Metrics and Evaluation says that low back pain is the leading cause of disability worldwide. In 2020, about 619 million people globally suffer from lower back pain.

Living with lower back pain can adversely impact a person's health and overall well-being. It can affect someone's employment, finances, recreational activities, physical functioning, and mood. For instance, low back pain can cause decreased work productivity, leading to financial difficulties. It can also lead to social isolation if an individual cannot participate in everyday activities.

The article below provides an overview of low back pain, including causes, symptoms, and treatment options.

Anatomy of the spine

The lower back, also called the lumbar spine, includes five vertebrae in the lower part of the back between the pelvis and the ribs. The vertebrae are cushioned by small discs, which help absorb impact on the spinal bones. The discs are flat and have a strong outer layer called the annulus. That layer surrounds a gelatinous material called the nucleus.

Causes of Lower Back Pain

Muscular strains and sprains

According to the Cleveland Clinic, sprains and strains are the most common cause of lower back pain. Tendons or ligaments in the lower back can get injured from everyday activities. This includes twisting, bending over, or lifting incorrectly. Common causes of muscular strains and sprains in the lower back include:

• Overexertion (typically from heavy lifting)
• Poor posture
• Sudden movements

Herniated discs

A herniated disc occurs when the disc nucleus protrudes into the spinal canal from the vertebrae. The disc may press on the spinal nerves, which often causes pain. Herniated discs can occur anywhere along the spine. However, according to the American Association of Neurological Surgeons, they are most common in the lower back.

Symptoms of a herniated disc in the lower back may include:

• Low back pain
• Tingling and numbness down the leg
• Pain that radiates into the buttocks or leg and possibly the foot

Arthritis

Lower back pain can also be caused by arthritis. Arthritis involves pain, tenderness, and swelling of the joints in the body. Arthritis may also affect the joints along the spine.

• Osteoarthritis: This form of arthritis involves joint wear and tear. It is the most common form of arthritis affecting the spine. It may develop when the cartilage that cushions the ends of the bone wears down.
• Rheumatoid arthritis: This type of arthritis is an autoimmune disease. It happens when the immune system reacts incorrectly, leading to joint inflammation. If inflammation develops in the lining of the joints in the vertebrae, rheumatoid arthritis can lead to back pain.

Other potential causes of low back pain include:

• Spinal stenosis: Spinal stenosis involves narrowing the spaces in the spine. This can put pressure on the spinal cord and nerves, leading to lower back pain.
• Kidney stones: Kidney stones are hard deposits of acid salts and minerals. Pain may radiate to the lower back as they pass through the urinary tract.
• Spinal infections: Spinal infections can develop in the vertebrae or the soft tissue around the spine. Bacteria or fungi may cause them.

Symptoms of Lower Back Pain

Lower back pain symptoms can vary in intensity and location. The cause of lower back pain may also play a role in symptoms.

The quality of the pain may present as sharp, aching, or dull. It may also vary and include a combination of the types listed above. Pain may be intermittent, activity-related, or constant.

Common symptoms can also include radiating pain, which compresses the sciatic nerve. Once the sciatic nerve is compressed, it may lead to pain that travels down the buttocks and back of the leg.

In addition to pain, other lower back pain symptoms include:

• Muscle spasms
• Limited range of motion
• Muscle weakness
• Numbness and tingling
• Stiffness
• Posture problems, including standing up straight

How to Prevent Lower Back Pain

Proper posture

Proper posture when sitting and standing is essential to reducing your risk of lower back pain. You should be intentional about maintaining good posture until it becomes a habit. Consider the following suggestions for proper posture.

When sitting:

• Keep your knees bent to a 90-degree angle.
• Avoid excess extension or hunching.
• Keep your feet on the floor, and don't cross your legs.
• Relax your shoulders and avoid rounding them forward.

When walking:

• Stand upright with your shoulder back.
• Try to maintain a natural gait, balancing your weight on both feet.
• Keep your core tight and abs engaged.
• Keep your head level as much as possible.

Proper lifting techniques are also essential to reduce the risk of muscle strain or sprain injuring your lower back. Correct lifting techniques include:

• Create a strong support base, such as keeping your feet shoulder width apart or maintaining a staggered stance.
• Bend at your knees.
• Lift primarily with your legs and avoid bending at your waist.
• Keep the load close to your body.
• Avoid twisting when lifting.
• Know your limits and get assistance if something appears to be too heavy for you.

Physical activity

One of the most important things an individual with lower back pain can do is try to exercise regularly. Regular exercise can help improve range of motion, mobility, core strength, and maintain a healthy weight. While not every exercise type is appropriate for those with significant lower back pain, most can find some exercise.

Good exercise options include:

• Walking
• Swimming
• Strength training
• Yoga
• Pilates

Ergonomic considerations

A comprehensive program on how to prevent lower back pain should also include ergonomic considerations.

Your workplace setup should promote good posture and low back support. Proper ergonomics at your desk should include:

• Sitting as close to your desk as possible so your arms are parallel to your spine.
• Keeping your buttocks pressed against the back of the chair.
• Use low back support to maintain a slight arch to prevent slumping forward as you fatigue.

Your sleeping posture can also increase or decrease your risk of lower back pain. Good sleep posture includes:

• Sleep on your side when possible.
• Draw your legs up slightly and place a pillow between your legs.
• Avoid stomach sleeping, which may put additional pressure on your back.

Weight management

Extra weight may weaken your abdominal muscles. It can adversely affect your posture, putting you at a higher risk for low back injury. Maintaining a healthy weight reduces the stress placed on your spine.

Stress management

Stress may increase muscle tension and tightness. Psychological stress may also lead to increased cortisol, which can cause physical tension in the body. Practicing stress management techniques can help reduce muscle tension.

Stress management techniques include:

• Breathing exercises
• Yoga
• Tai Chi
• Meditation

Treatment Options for Lower Back Pain

Lower back pain treatment may include at-home treatment and professional medical treatment. Usually, the least invasive treatment options are recommended first. Treatment for lower back pain may include:

Self-care measures

Self-care measures that you can do at home include:

• Rest
• Alternating applying ice or heat therapy
• Over-the-counter pain relievers such as acetaminophen or ibuprofen
• Easy stretching to release muscle tension

Physical therapy

Physical therapy may be helpful for people with lower back pain. It may include teaching an individual the right exercises and stretches to do. Seeing a physical therapist can also help with posture, body mechanics, and alignment, which may reduce lower back pain.

Additional physical therapy modalities may include:

• Cold therapy
• Therapeutic ultrasound
• Massage
• Electrical muscle stimulation

Medications

Medications, including muscle relaxants, which can reduce low back spasms, may be effective for lower back pain.

Pain relievers may also be prescribed in the short term. However, they often are not a long-term solution because they risk dependency and side effects.

Injections

Injections may help reduce symptoms of lower back pain. Examples include epidural injections, which contain a medication to relieve pain, and corticosteroid injections, which reduce inflammation.

Surgery

Surgery is a last resort when conservative treatment doesn't work, or symptoms worsen or become severe. The type of procedure performed may depend on the cause of lower back pain. Back surgery procedures may include:

• Laminectomy
• Spinal fusion
• Artificial disks
• Diskectomy

When to See a Doctor

Many mild low back pain cases are treatable at home with self-care remedies. However, it is essential to see a doctor as soon as possible if the following situations develop:

• Persistent or worsening pain
• Pain that interferes with daily activities
• Low back pain that keeps reoccurring

There are also symptoms related to low back pain that may indicate a serious condition requiring immediate medical attention.

Seek immediate medical attention if any of the following red-flag symptoms develop:

• Sudden loss of feeling in one or both legs or the groin
• An inability to walk or stand
• An inability to control bowel movements or urinary incontinence
• Problems passing urine
• Sudden intolerable pain
• Back pain following a trauma such as a car accident or fall
• Loss of consciousness

Frequently Asked Questions

If you have upper back pain, you may have questions, such as those listed below.

Can dehydration cause lower back pain?

Dehydration can contribute to or exacerbate lower back pain. For example, it may lead to muscle spasms in the back. Dehydration can also cause the spinal discs to lose water, leading to disc shrinkage and potentially lower back pain.

Can lower back pain be caused by UTI?

A urinary tract infection ( UTI) can cause lower back pain. Because of the location of the bladder, a UTI may spread to the kidneys, and pain can radiate to the lower back. Usually, lower back pain is not the only symptom of a UTI. Lower back pain may occur along with other UTI symptoms, such as:

• Pain when urinating
• Cloudy urine
• A frequent need to urinate

Can gas cause lower back pain?

Gas in the lower abdomen can cause discomfort that radiates to the lower back. Usually, if abdominal gas is the cause of lower back pain, additional symptoms are present, such as:

• Abdominal pain
• Bloating
• Abdominal distension

Conclusion

Lower back pain can include discomfort in any area of the lower back, including the muscles, tendons, or vertebrae. Common causes of lower back pain include muscle strain, arthritis, and a herniated disc. In addition to pain, associated symptoms of lower back pain include numbness and tingling.

Treatment options for lower back pain include self-care measures such as rest, ice, and heat therapy. When self-care measures are not enough, other options include physical therapy and injections. Surgery is typically only used when other conservative treatments have not helped.

When it comes to lower back pain, prevention is your best bet. Regular exercise, maintaining a healthy weight, and good posture all play a role in preventing lower back pain.

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