OVERVIEW
Low back pain can range from mild discomfort to severe, chronic pain, and treatment depends on its cause, severity, and duration. Below are common approaches to managing and treating low back pain:
What is lower back pain?
Lower back pain affects the lumbar region of your spine or back. It can result from many different injuries and conditions. Most often, the cause is an injury to muscles or tendons in your back.
Nearly everyone experiences lower back pain at some point in their lives. The pain can range from mild to severe. For most, it’s temporary. But long-lasting (chronic) lower back pain is also common — up to 23% of adults worldwide have chronic lower back pain. In extreme cases, lower back pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
Given how common it is, it may be hard to tell if you should be worried about your lower back pain. Trust your gut and reach out to a healthcare provider if something feels off — or if the pain keeps you from going about your usual activities.
Symptoms of Low Back Pain
Low back pain can manifest in various ways, depending on the underlying cause. Common symptoms include:
- Pain Characteristics
- Dull, Aching Pain: Often constant and localized in the lower back.
- Sharp or Stabbing Pain: May occur during movement or in specific positions.
- Radiating Pain: Pain that spreads to the hips, buttocks, or down the legs (sciatica).
- Stiffness
- Difficulty moving or bending due to stiffness in the lower back.
- Muscle Spasms
- Sudden, involuntary tightening of back muscles.
- Limited Range of Motion
- Reduced ability to twist, bend, or flex the spine.
- Numbness or Tingling
- Sensations in the legs or feet, often indicating nerve involvement.
- Weakness
- Difficulty standing, walking, or maintaining posture.
Causes of Low Back Pain
- Muscle or Ligament Strain: Lifting heavy objects, sudden movements, or overuse can strain muscles or ligaments.
- Herniated or Bulging Discs: Discs between the vertebrae may rupture or protrude, putting pressure on nearby nerves.
- Arthritis: Osteoarthritis or rheumatoid arthritis can lead to joint inflammation and back pain.
- Sciatica: Compression of the sciatic nerve causes pain radiating from the lower back down to the legs.
- Spinal Stenosis: Narrowing of the spinal canal can compress nerves and cause pain or weakness.
- Osteoporosis: Weak and brittle bones can result in compression fractures in the spine.
- Scoliosis: Abnormal curvature of the spine may contribute to back pain.
- Infections or Tumors: Rarely, infections or tumors in the spine or surrounding tissues can cause pain.
- Injury or Trauma: Falls, accidents, or sports injuries can lead to acute back pain.
- Poor Posture or Ergonomics: Sitting, standing, or sleeping in awkward positions can strain the lower back.
What are the risk factors for low back pain?
Some people are more likely to have lower back pain than others. Risk factors for lower back pain include:
- Age: People over 30 are more likely to experience back pain. Vertebral disks wear away with age. As the disks weaken and wear down, pain and stiffness can result.
- Weight: People who have a body mass index (BMI) greater than 25 (have overweight or obesity) are more likely to have back pain. Excess weight puts pressure on joints and disks. Increasing weight in pregnancy can also put pressure on your lower back.
- Poor core strength: Weakened abdominal muscles can’t properly support your spine, which can lead to back strains and sprains.
- Overall health: People who smoke, drink excess alcohol and/or get limited physical activity have a higher risk of back pain.
- Occupation and hobbies: Jobs and activities that require heavy lifting or frequent bending can increase your risk of a back injury. Lower back pain is also very common in athletes.
- Mental health conditions: Studies show there’s a connection between depression and back pain. But it’s difficult to tell for sure if depression can cause back pain.
Diagnosis and Tests
How is lower back pain diagnosed?
Your healthcare provider will ask about your symptoms and medical history and do a physical exam. Your provider may recommend a variety of tests to check your spine for injuries and assess your health in other ways. Tests may include:
- Spine X-ray: This test uses radiation to produce images of your bones.
- MRI: This test uses a magnet and radio waves to create pictures of your bones, muscles, tendons and other soft tissues.
- CT scan: This test uses X-rays and a computer to create 3D images of your bones and soft tissues.
- Electromyography (EMG): This test assesses the function of your nerves and muscles. It checks for neuropathy (nerve damage), which can cause pain, tingling and numbness.
- Blood tests or urine tests: Blood tests can detect genetic markers for some conditions that cause back pain (like ankylosing spondylitis). Urine tests check for kidney stones, which cause pain in your flank (the sides of your lower back).
Because there are so many possible causes of low back pain, it may take time to find the correct diagnosis.
Management and Treatment of Lower Back Pain
Lower back pain can be effectively managed through a combination of approaches tailored to the individual’s needs. Conservative treatments often include rest, lifestyle modifications, and medications such as ibuprofen or acetaminophen to alleviate discomfort. Physical therapy focuses on strengthening core muscles, improving flexibility, and supporting the spine. Chiropractic care and techniques like heat or cold therapy can also provide relief.
In more severe cases, medical interventions such as corticosteroid injections or nerve blocks may be recommended to target inflammation or nerve pain. Minimally invasive procedures like radiofrequency ablation or surgical options such as discectomy, spinal fusion, or laminectomy are considered when conservative treatments are ineffective.
Self-care strategies, including weight management and low-impact exercises like swimming, help maintain mobility and reduce strain on the spine. Alternative therapies, such as acupuncture or yoga, may also complement traditional treatments. Tailored management plans ensure effective pain relief and improved quality of life.