Pain in the lower back is one of the most common reasons behind doctor visits. As stated by the NINDS or the National Institute of Neurological Disorders and Stroke, the lower back pain is usually the main cause of job-related disabilities. About 80% of the US population experiences lower back pain at some point in their life.
Some of the most common causes behind the lower back pain are injuries which include muscle strains or sprains resulting from poor body mechanisms and sudden movement when lifting heavy objects. Lower back pain can also be due to certain illnesses, such as arthritis, herniated disc, cancer of the spinal cord, and kidney infections. Acute pain in the back can last from a few days to several weeks, while chronic back pain can last up to three months.
Lower back pain usually occurs among individuals who are 30 to 50 years old. This is mainly due to the changes that take place in the body as a result of aging. As you age, the fluid content that’s in between your spine and vertebrae reduces. As a result, the discs in your spine get irritated so easily. You’ll also lose some muscle tone, putting your back at high risk of injury. By strengthening your back muscles and applying good body mechanisms, you’ll be able to successfully prevent lower back pain.
Low Back Pain Causes
Strains
The ligaments and muscles in your back could tear up and stretch after excess activity. Some of the symptoms include stiffness and pain in the lower back and muscle spasms. Getting enough rest and undergoing physical therapy are some of the best remedies to cure these symptoms.
Disc Injury
The discs at your back are at high at high risk of injury and the risk increases, as you get older. The outside part of the discs could tear or become herniated. Herniated disc, also known as ruptured or slipped disc happens if the cartilage that surrounds the disc will push against the nerve roots or the spinal cord.
If you suffer from a disc injury, the cushion that’s sitting in between the spinal vertebrae will extend outside its usual position. This will result in the compression of the nerve root as it gets out of the spinal cord and into the vertebral bones. Disc injury usually occurs after suddenly lifting a heavy object or after twisting the back. The pain resulting from disc injury usually lasts for more than 72 hours.
Sciatica
Sciatica happens along with a herniated disc and this usually takes place when the disc presses into the sciatic nerve. The sciatic nerve is connected to the spine of the legs and this is why you’ll feel pain in your feet and legs if you have sciatica. The pain feels like a burning sensation or getting pricked by needles or pins.
Spinal Stenosis
Spinal stenosis refers to a condition where the spinal column narrows and will apply too much pressure against the spinal cord and the nerves. This condition usually happens as a result of the degeneration of discs in between the vertebrae. Pressure on the spinal nerves can lead to certain symptoms like cramping, weakness, and numbness. You could suffer from these symptoms anywhere in your body. Those who suffer from spinal stenosis may notice that their symptoms get worse when they are walking or standing.
Abnormal Spine Curvatures
Lordosis, kyphosis, and scoliosis, are all conditions that result in abnormal curvatures of the spine. All three are congenital conditions that are first diagnosed at childhood and during the teenage years. The abnormal curvature is a condition that places pressure at the tendons, muscles, ligaments, and the vertebrae leading to poor posture and pain.
Other Conditions
There are several other conditions that could trigger pain in the lower back. These include fibromyalgia, arthritis, spondylitis, and spondylitis. Although aging is often the main reason behind spondylitis, the rate and location of the degeneration are usually individual.
Bladder and kidney problems, endometriosis, pregnancy, ovarian cyst, cancer, and uterine fibroids, are also some of the causes behind the lower back pain.
What Can Go Wrong with the Lumbar Spine
It is the lower back that provides support to the overall weight of the upper body. Furthermore, it also provides mobility for everyday motions that include twisting and bending. These muscles are also responsible for the rotating and flexing of the hips when walking and provide main support to the spinal column. The nerves at the lower back supplies sensation and provide power to the muscles at the legs, feet, and pelvis region.
The worst form of lower back pain results from an injury to the ligaments, muscles, joints, and discs. This is because the body tends to react to the injury by mobilizing, which leads to inflammatory healing response. And although the inflammation might seem like minor, this could generate severe pain.
There’s usually a significant overlap of the nerve supply to most of the muscles, discs, ligaments, and some other spinal structures, and it can be hard for the brain to sense what really caused the pain. For instance, a degenerated and torn lumbar disc could feel the same as that of a pulled muscle, both of which creates painful muscle spasm and inflammation in the same area. Ligaments and muscles rapidly heal, but a torn disc may not. The course of pain and the time it heals can help to determine the cause
How is Low Back Pain Diagnosed?
When diagnosing low back pain, most doctors would start by conducting a thorough physical examination in order to figure out where you are feeling the pain. The physical exam can also help to determine if the pain affects your range of motion. Your doctor might also check your reflexes as well as how you respond to different sensations. This also helps your doctor to determine if your lower back pain is affecting your nerves. Except if you are suffering from some debilitating symptoms, your doctor might need to closely observe your condition for a certain period of time before you will be asked to undergo a test. This is because most cases of the low back pain get resolved after applying some simple self-care treatments.
Certain symptoms, such as weakness, lack of bowel control, weight loss, and fever may need furthermore testing. In the same way, if the pain will persist despite continuous after-home treatment, you could be asked to undergo certain tests. It’s important that you seek immediate medical attention the moment you notice any of these symptoms, aside from the pain in your lower back.
Imaging tests that include CT scans, X-rays, MRI, and ultrasound are also necessary as these tests allow your doctor to check if you got any disc problems, bone problems, or problems relating to your ligaments and tendons.
The moment your doctor notices some problem with the bones of your back, he might send you to undergo a bone density test or a bone scan. EMG or Electromyography is a nerve conduction test that can help to detect if you have some issues with your nerves.
Physical Exam
The main purpose of the physical exam is to narrow down some of the possible causes of the pain in your lower back. A typical physical exam will require the following steps:
Your doctor will check your lower back by hand to locate any muscle tightness or spasms, or detect any joint abnormalities and areas of tenderness.
Neurologic Exam. This diagnosis will most likely include a motor exam, which requires manual movement of the knee, hip, and big toe extension, as well as flexion (backward and forward movement). The exam may also include testing your reaction against pinprick, light touch, and other senses involving the buttocks, legs, and the lower trunk.
A range of Motion T You will be asked to twist or bend your body in order to look for certain positions that could recreate or worsen the pain. This is for your doctor to determine if certain movements are limited due to discomfort.
Reflex Test. For this test, your reflexes on your legs will be evaluated and check to determine any weakened reflexes and a decrease in the muscle strength. If your reflexes have diminished, this could mean that your nerve roots are not responding the way it’s supposed to.
Leg Raise Test. For this test, you’ll be asked to lie on your back and raise one of your legs as high and straight as possible. If this test recreates the pain, then there’s a possibility that you could be suffering from a herniated disc.
Your doctor should be able to diagnose your low back pain based on your physical exam, medical history, and further testing.
Treatment Options for Low Back Pain
Home Care
Self-care methods are very helpful on the first 72 hours since the pain in your lower back started. If the pain will not improve after 72 hours despite the home treatment you applied, you must call your doctor immediately.
You may need to stop doing any physical activities for a couple of days and apply ice-cold compress on the affected area. Doctors would normally advise using ice compress for the first 72 hours and then switch to hot compress after that. Alternating ice and cold can help to relax the muscles.
To relieve the pain, you can take OTC medications like Ibuprofen or Acetaminophen.
Lying on your back may sometimes lead to more discomfort. In this case, try lying on your side while bending your knees and placing a pillow in between your legs. If you’re comfortable with lying on your back, place a rolled up towel or pillow beneath your thigh so as to minimize the pressure on your lower back.
Taking a warm bath and getting a relaxing massage may also help to relax the pained muscles in your back.
Medical Treatment
The pain in the lower back could occur in different conditions and this includes muscle weakness and strain, spinal cord misalignment, pinched nerves, etc. Thus, there are several different medical treatments that can be used to treat your lower back pain, and this includes undergoing physical therapy and using certain medical appliances. Your doctor can also help to determine the proper application and dosage of medications depending on your symptoms.
Some of the medications that your doctor will prescribe may include NSAID or non-steroidal anti-inflammatory drugs, muscle relaxants, corticosteroid injections, and steroids to help minimize inflammation.
You may also be asked to undergo physical therapy, which includes stretching, massage, strengthening exercises, and spinal manipulation.
Surgery
For extreme cases of lower back pain, your doctor may ask you to undergo a surgery, especially if all other treatments did not turn out well for you. A discectomy is a surgical treatment that helps to relieve pressure from the root of the nerve, which was pressed by a bone spur or bulging disc. For this treatment, the surgeon will take away a small component of the lamina. This is a body part of your spinal canal.
Foraminotomy is another surgery that’s performed to those suffering from low back pain. For this procedure, the surgeon will open up the foramen, which is the bony hole at the spinal canal where the nerve root would exit.
IDET or Intradiscal electrothermal therapy is a treatment that requires inserting a needle into a catheter and towards a disc then heating it for up to 20 minutes. This treatment can help to make the disc wall to become thicker and will cut down the inner disc’s bulging and minimize the irritation of the nerve.
A nucleoplasty is a type of surgery that makes use of a wand-like device that’s inserted through a needle within the disc. This is to remove the inner disc material. The device then makes use of radio waves in heating and shrinking the tissue.
Ablation or radiofrequency lesioning is a treatment that makes use of radio waves in interrupting the manner in which the nerves connect with each other. The doctor will insert a special type of needle in your nerves and then heats the needle in order to destroy the nerves.
Spinal fusion is a treatment that can make your spine stronger thereby minimizing the painful motion. This procedure requires removing discs in between two or more vertebrae. The surgeon will then fuse the vertebrae with each other using special metal screws or bone graft.
The spinal laminectomy, also called the spinal decompression, is another surgery for the low back pain that involves removing the lamina in order for the spinal canal to become bigger. This can help to relieve pressure on the nerves and the spinal cord.
How to Prevent Low Back Pain?
There are various ways in which the low back pain can be prevented. These prevention techniques can somehow help to lessen the severity of symptoms especially if you have gone through a lower back injury. Prevention usually requires exercising the muscles in the back and abdomen, losing weight, and lifting items properly. Maintaining proper posture can also help.
Home Remedies for Back Pain
Ice and Heat
Ice can certainly work wonders when it comes to minimizing the pain in your lower back. Simply wrap the ice cubes in a plastic bag to come up with an ice pack. Wrap it with a towel and apply on the affected area for up to 20 min. Repeat the process several times and after 48 hours, switch to the heat compress. To prepare the heat compress, simply dip a towel in warm water. Flatten the towel and fold it well before applying on your lower back. Apply a heating pad while placing a plastic cover in between the heating pad and the towel. Leave for up to 20 min. Do this same process several times as it helps to relax your nerves and reduce the swelling, which causes the pain.
Rest
Get enough rest. Avoid exhausting yourself further if you’re suffering from low back pain. When you sleep, change your positions often. When lying on your back, place a pillow below your knees. In the same way, if you lie on your side, lift your knees towards your chest and place a pillow in between.
Right Posture
The manner you sit and stand is very important when it comes to keeping your back pain at bay. Try to avoid sitting or standing in a bending position for too long. Avoid slouching or sitting at the edge of a chair. Your office chair should have an angle of 110 degrees.
Lemon Juice
Lemon juice is another effective home remedy to treat back pain. Drinking the juice for at least twice a day can lead to better results.
Yoga
Yoga has been proven to be effective in treating back pain. In fact, it has helped millions of people from around the world in treating different kinds of health problems and back pain is one of these. There are lots of yoga postures that could specifically treat back pains.
Poppy Seeds
Another home remedy is the mixture of rock candy and poppy seeds. Prepare 100 grams of each and grind them together. Drink this mixture twice a day along with a glass of milk and eventually, you’ll find relief in your back pain.
Massage with Olive Oil
Massaging with olive oil can help to reduce your level of stress since it relaxes your tensed muscles. Massage also helps to release the stiffness in your joints and relieves pain in your upper back.
Stretching
Stretching is by far, the easiest method to treat low back pain. If your job would require standing or sitting for a longer period of time, try to take a break for at least 5 min each hour and take a walk while stretching your body in order to avoid pain in your back.
Wheat
Wheat contains pain-reducing components that can somehow help to ease your back pain. Simply mix coriander and cuscus grass with wheat and soak them overnight. Add a cup of milk and bring to a boil. Drink this mixture at least twice in a day.
Garlic
Eat 2 to 3 pieces of garlic cloves in an empty stomach every morning. This should help you to get relief from the pain in your back. You may also massage garlic oil in the affected area in your back. After the massage, cover your back with a warm blanket and gently lie down. After 20 minutes, take a warm bath.
Ginger
Ginger contains anti-inflammatory properties making it an ideal remedy for back pain. Simply add 1 tsp. ginger powder, ½ tsp. of black peppercorns, and ½ tsp. of garlic cloves in boiling water. Drink this concoction 2 to 3 times each day.
Alternately, you can grate some ginger and make it into a paste. Apply the paste directly to the affected area in your back and then massage with eucalyptus oil.
Another option is to place thin slices of ginger in a pan of boiling water. Simmer for up to 15 min. Strain and leave to cool down at room temperature. Add honey as a sweetener and drink this 2 – 3 times a day.
Milk
We all know that milk is a great source of calcium. Thus, it’s highly beneficial for achieving strong bones and preventing pain in the back. Both kids and adults could benefit from drinking milk. For better relief, add some drops of honey to your milk and some turmeric.
Epsom Salt
Epsom salt is a natural healer since the salt helps to reduce the swelling. This salt contains sulfate and magnesium, which allows the muscles to be able to function well, thereby providing relief from pain. You can simply add 2 cups of the Epsom salt to the warm water in your tub and soak your body for 30 min.
Rice
Rice is another effective home remedy to treat back pain. Place a cup of uncooked rice in a thick sock and microwave for up to a minute. Then apply it directly to the affected area in your back.
Oats
Simply mix cooked oats with vinegar and apply it directly on your back while it’s still hot. This should help to soothe your aching lower back.
Potatoes
Peel a bunch of potatoes and boil them. Leave the potatoes to cool and apply directly on your back. You’ll eventually experience relief from pain.
Acupuncture
Acupuncture is one of the most effective remedies for lower back pain. Several people have experienced significant improvement in their back pain after undergoing acupuncture therapy.
Coconut Oil
Simply mix camphor in the coconut oil and boil for up to 7 minutes. Leave it to cool and store in a bottle. Massage your back with this oil for at least twice a day in order to relieve you of your back pain.
Capsaicin Cream
Capsaicin is one of the most important ingredients found in chilies. Simply apply the capsaicin cream directly on the affected area of your back. That should help to minimize the production of chemicals that are responsible for transmitting pain signals to your brain.
Willow Bark
The bark of a white willow tree is a great herbal remedy for back pain. It contains pain-relieving properties similar to aspirin and should help to ease your back pain.
Basil Leaves
Basil is known for its many medicinal benefits and its leaves can help in treating lower back pain. Simply boil the fresh basil leaves in a cup of water. Add a pinch of salt and drink this for up to twice a day, depending on how severe the pain is.
Herbal Oils
Herbal oils like eucalyptus oil, almond oil, and coconut oil are all very effective in treating back pain. Massaging with warm oils on the painful part of your back can help to relax the nerves on the area, which could ease the pain.
Chamomile
Gather some chamomile flowers and steep them in boiling water for up to 20 minutes. Drink this for 2 to 3 times in a day. This can help to relax your tense muscles away, which could cure your backache.
Back Problems During Pregnancy
There are many reasons behind back pain during pregnancy and this includes abnormal or compromised posture, weight gain, etc. All these could trigger lumbar back problems, which explains the pain.
Another reason behind lumbar pain in pregnancy is the Sacroiliac Joint Dysfunction. The sciatic nerve could trigger back problems right after pregnancy. In this case, a back brace should help one to go through the final months of pregnancy. When a woman becomes pregnant, hormones will be released, which improves the laxity of the joints for childbirth. Thus, the joints will be relatively immobile and by moving them more than they typically should, you could suffer from pain and inflammation. Compounding this issue with excess weight that an expectant mom carries, this could understandably lead to injury.
Aside from the pain on any side of the spine at your lower back, some other signs of back injury at the Sacroiliac Joint may include pain in the leg, groin, or hips.
Putting on a sacroiliac joint belt is one of the best ways to soothe this area of your back and help you to recover from a back injury. Taking anti-inflammatory medication, engaging in SI joint exercises, and applying ice can also help expectant moms with their back problems.
Traumatic Back Injury and Middle Back Problems
Men are also at high risk of certain injuries. Statistics show that back injuries are four times more likely to affect men than women, especially the fracture of vertebrae in the thoracic spine or lumbar. Certain situations could trigger back injury among men, such as sports injury, car crash, etc.
Some signs of acute back injury include moderate to severe pain heightened by movement. If the spinal cord is also affected, the back pain may also come with some other symptoms such as tingling, numbness, and weakness, and a possible dysfunction of the bowels or bladder.
Treatment of thoracic or lumbar injury will mainly depend on how the fracture came to be and if there are any other injuries that exist. Some back injury fractures may heal on their own by immobilizing a low or mid back brace and by performing some rehabilitation exercises for the back injury.
However, unstable fractures resulting from a traumatic back injury should be repaired through surgery. Follow-up surgery to repair severe back problems, including a thoracic brace, may also be necessary, along with rehabilitation, in order to return the flexibility and strength.
Back Skin Problems
Psoriasis is an autoimmune disease affecting the skin. If you’re suffering from psoriasis, your body will send out messages to your skin in order to speed up the growth cycle of the skin cells even if there’s no such need. A lot of times, psoriasis can show up at the back, feet, hands, mouth, eyelids, ears, and pretty much anywhere in the body.
The condition is also linked to some other health conditions, such as diabetes, heart disease, and depression. Unfortunately, there’s no cure for psoriasis, however, there are some ways on how these symptoms can be managed. There are also several medications that can be used in treating different kinds of back problems resulting from psoriasis.
Psoriatic arthritis is another condition that tends to appear along with psoriasis in almost a third of the sufferers. The condition affects individuals between the age of 30 and 50 years old and its onset is often gradual, where mild symptoms start appearing until you’ll eventually experience acute back injury.
Psoriatic backbone problems affect almost all of the joints in your body and this could lead to swelling, pain, tenderness, and throbbing sensation. Psoriatic arthritis can also trigger stiffness of the joint, including the spine, and a reduced range of motion. Fatigue, as well as changes in the nails and redness of the eyes, is also among the most common symptoms of back arthritis.
It’s important that psoriatic arthritis is diagnosed early and treatment is immediately administered in order to prevent permanent damage of the joint. Your doctor can prescribe certain medications to help control the inflammation and the pain on the joints. Applying ice compress and alternating with heat is also beneficial for treating back problems.
Altering the manner one would go about doing certain tasks and using arthritic aids can also make a huge difference in how one’s joints would feel.
Maintaining a healthy weight is also a great way to minimize strain in the joints. Performing low-impact and regular exercises like swimming and biking are also beneficial for the muscles and joints.
