If you have been suffering with low back pain, I wrote this guide on the causes of low back pain to help you better understand what could be causing your pain.
Low back pain can be very complex, which is why surgery to solve low back pain is only about 50% successful. Sometimes it's hard to identify the exact structure causing pain. However, we do know a lot about the presentation of low back pain so here are some of the most common causes of low back, how they present, and some of the relieving factors.
Muscle or Ligament Strain:
Symptoms: Acute, sharp or dull pain in the lower back that may radiate into the buttocks but not typically down the leg.
Activities Causing Pain: Physical activities such as lifting heavy objects, bending or twisting at the waist, or sudden movements that place too much stress on the lower back muscles and ligaments.
Demographics: Can affect anyone who does physically demanding work, or those who have sudden, awkward movements. However, people aged over 30 are more likely to experience this type of pain.
Quality of Pain: The pain often starts suddenly, can be severe and may become constant or intermittent. Usually worse in the morning or after physical activity, with improvement during rest periods.
Relieving Factors: Rest, over-the-counter pain relievers, light stretching and movement, and lying down.
Degenerative Disc Disease (DDD):
Symptoms: Chronic low back pain sometimes radiating to the hips.
Activities Causing Pain: Pain is often worse when sitting, as this position puts more load on the disc. Lifting, bending, or twisting can also worsen the pain.
Demographics: DDD is more common in older adults, typically over the age of 40, as it's often a result of aging.
Quality of Pain: The pain is often described as aching or dull, may be constant or intermittent, and can vary in intensity from nagging to severe or disabling.
Relieving Factors: Physical therapy, heat or ice therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and certain positions that take pressure off the disc can help alleviate pain.
Symptoms: In addition to lower back pain, a herniated disc can cause numbness, weakness, or a tingling sensation that runs down your leg. The pain usually feels “nervy” or burning. The pain can shoot from the back out along the belt line. If the herniation is bad enough that is when it will travel into the butt and down into the leg and even the foot.
Activities Causing Pain: Herniated discs are usually worse with forward bending to lift something,twisting the spine, and sitting. This can be tough though because if the herniation is bad enough, sitting can actually relieve the symptoms in the short term but will usually be worse with a longer period of sitting.
Demographics: Most common in adults aged 20-55. 2x more men than women.
Quality of Pain: The onset of pain may be sudden or gradual and is often described as sharp or shooting, especially if it follows the path of a nerve. The pain is often worse with movement.
Relieving Factors: Rest, gentle exercises, physical therapy, heat or cold therapy, and medications can help manage the pain. Some people also find relief in certain positions, like lying flat on the back or lying on the stomach.
Symptoms: Symptoms of spinal stenosis can include lower back pain, numbness or weakness in your legs, and a decreased physical endurance. Some people also experience a "pins and needles" sensation or a loss of bladder or bowel control.
Activities Causing Pain: The pain from spinal stenosis is usually positional, often brought on by activities that involve standing or walking for prolonged periods.
Demographics: This condition is most commonly seen in men and women over 50 years of age. It's often the result of wear-and-tear changes in the spine related to osteoarthritis.
Quality of Pain: The pain typically starts gradually and is a dull ache or a radiating pain. It's usually worse when standing or walking and improves when the patient bends forward or sits down. It can be worst in the morning and late in the day.
Relieving Factors: Rest, physical therapy, medications for pain management, and certain positions (like leaning forward) may help relieve the pain. In some severe cases, surgery may be necessary.
Sacroiliac Joint Dysfunction:
Symptoms: Pain that is typically felt in the lower back and/or hip, and may radiate into the groin area. Some people may also experience a sensation of leg instability.
Activities Causing Pain: This condition can be exacerbated by a variety of activities, including prolonged standing, climbing stairs, running or walking for long distances, and bearing more weight on one leg than the other. Split stance positions also tend to cause discomfort of the SI joint.
Demographics: Women are more likely to experience this condition, possibly due to hormonal fluctuations that can lead to ligament laxity. However, it can also affect men, particularly if they have a history of lifting heavy weights or have experienced a direct trauma to the sacroiliac joint.
Quality of Pain: The pain from sacroiliac joint dysfunction can be sharp or dull, and may be constant or intermittent. It can vary from moderate to severe.
Relieving Factors: Decreased movement
Symptoms: Lower back pain that may feel like a muscle strain, with stiffness in the area. If the slipped vertebra is pressing on a nerve, there might be pain radiating down one or both legs, or numbness and tingling in the legs or feet.
Activities Causing Pain: The pain often gets worse with physical activity and improves with rest. Certain movements like bending or twisting at the waist might exacerbate the pain.
Demographics: This condition is most commonly seen in children and adolescents who are involved in sports that put repeated stress on the lower back, like gymnastics and football, but can also occur due to the degenerative changes with aging.
Quality of Pain: The pain is often described as a dull ache that may be constant or intermittent, and can vary in intensity from mild to severe.
Relieving Factors: Flexed position such as sitting or bending over. Lying down on your back, especially with knees bent.
The one thing I have to mention before we move any further are red flags. This may be confusing but sometimes your low back pain is not coming from your low back. Pain in the organs can cause referral of pain to the lower back.
This includes kidney, colon, ovary, uterus, and rectum. It can also be caused by things like cancer.
These pains are usually more severe and are not impacted by movement or position. If you don’t know what caused your back pain and you can’t tell what makes it worse or better you should stop right now and see a doctor or physical therapist in person.
Signs to look out for:
Bowel or bladder changes / problems
Loss of sensation around your reproductive organs
Severe loss of strength or sensation of the legs
Unexplained weight loss
Pain unchanged by rest or change of positions
If you think you should see a doctor, you should. You know your body better than anyone. If you think something is off it’s best to get a professional opinion.
If you are struggling with low back pain and would like to get it checked out click below for a free injury assessment.