Low Back Pain

There are numerous causes of low back pain, the most common being discogenic pain, which is caused by degenerative changes in the spine (such as osteoporosis or degenerative disc disease) and mechanical pain, which is caused by an abnormal amount of strain or stress on the lumbar spine. 

Lower back pain can be caused by health conditions like stenosis, spondylolisthesis, disc herniation, scoliosis and compression fractures. It can also result from diseases that have metastatic processes, mental health issues such as depression and anxiety or from a traumatic event, such as a car accident or fall. 

Your pain could also result from poor posture or weak back muscles. Since our musculoskeletal system is highly interconnected, these issues can cause the muscles around your spine to overcompensate and even lead to spinal muscle strain. It can also be caused by too strenuous or too little exercise, poor mattress quality and certain health/lifestyle factors like being overweight, smoking, eating a lot of processed foods or having a job that requires a lot of bending or heavy lifting.

A spinal specialist will be able to identify what’s causing your lower back pain and, in turn, help you find the right solution.

Low back pain is characterized most, as the condition’s name implies, by pain in the lumbar region of your spine. It can range from a dull ache in just the lower back to an intense, burning pain that radiates into the back of your thighs, lower legs or feet. You may experience tightness, stiffness or muscle spasms in your back. In some cases, your pain might get worse when you walk or after sitting or standing for long periods of time.

There are three classifications of lower back pain: acute, sub-acute and chronic.

• Acute low back pain occurs suddenly, typically after an injury. It’s short-term pain that lasts from a few days to four weeks. 
• Sub-acute low back pain lasts for four to 12 weeks. This pain is typically due to joint pain or muscle strain.
• Chronic low back pain is classified as pain that persists for longer than 12 weeks. It’s typically severe, doesn’t get better with basic treatment methods and happens with no obvious cause.

In addition to pain, you may also experience other serious symptoms such as tingling or numbness in your legs, incontinence or fever, in which case you should seek medical attention immediately. If your pain is so severe it prevents you from completing daily tasks, occurs after a traumatic injury or persists for more than 12 weeks, consult with a healthcare professional. These could be signs of a deeper issue that needs a full medical workup.

Your sleeping habits can impact your level of lower back pain. Sleep deprivation and poor sleeping posture can impede healing and put a strain on your lower back. In some cases, poor sleeping posture and quality can exacerbate your low back pain. In others, it can cause it. 

Contorted sleeping positions that twist your torso can cause your back to feel stiff and tender when you wake up. If you sleep on your back, the weight of your legs pulls your spine out of its naturally-curved shape, creating unnecessary strain and pressure on your lower back. If you sleep on your stomach, you may find that your lower back sinks into a “U” shape. In addition, your neck may feel strained from sleeping with your head turned and elevated above your spine. So, what’s the solution? 

Pillows can help redistribute your weight and take pressure off of your spine.  Side-sleepers should place pillows strategically – with one pillow between your knees and a small one between your waist and the mattress if there’s a gap there. You should alternate between sides to avoid imbalance. If you sleep on your back, place a pillow under your knees to alleviate pressure on your lumbar spine. If you sleep on your stomach, use a thinner pillow under your head to minimize cervical spine curvature, and place a thicker one under your hips to maintain spinal alignment.

There are many non-surgical treatments you can try to relieve lower back pain. These will typically be recommended as the first course of action by your healthcare provider before more invasive treatment methods are pursued. 

Non-invasive lower back pain treatments include hot and cold therapy, prescription pain medications, anti-inflammatory medications, back braces, muscle relaxants, epidural steroid injections and/or physical therapy. Your healthcare provider may also recommend lifestyle changes, such as quitting smoking, dietary improvements, correcting your posture and exercising regularly. Alternative lower back pain treatment methods like chiropractic care, acupuncture and massage therapy may be recommended as treatment options, too.

If these at-home treatments don’t improve your lower back pain, your spinal specialist may suggest surgery to help you find relief. The surgery they recommend will heavily depend on the cause and your overall health status.

Whether you’re currently experiencing back pain or had it in the past, there are certain things you can do to make sure it doesn’t return or occur in the first place. 

• Maintain a healthy weight. Extra weight, especially in your torso, can put pressure on your spine. 
• Strengthen your core. Your abdominal muscles support your spine. Keep a well-rounded exercise regimen with workouts focused on building core strength. 
• Lift with your legs, not your back. Whether you’re exercising or lifting something heavy throughout the day, be sure to use your legs as you rise by bending at your knees instead of your lower back. Always hold things close to your chest when straightening and don’t twist your lower back. 

• Check your posture. Poor posture can put an extreme strain on your spine. Maintain proper posture as you stand and sit. 

• Stretch. Lower back pain could also be caused by tight muscles, especially in your back and hamstrings.

• Maintain a healthy lifestyle. Your overall mental and physical health has a direct impact on your lower back pain. Healthy lifestyle choices such as staying hydrated, getting enough good sleep, avoiding inflammatory foods, quitting smoking, maintaining good mental health and staying active can help mitigate or prevent it.