Lower Back Pain (Lumbago): Causes, Symptoms, Diagnosis and Treatment Options

Lower back pain (also called lumbago) is a common condition that affects millions of people worldwide. It can range from a mild ache to a severe and disabling pain that interferes with daily activities and quality of life. Low back pain can have various causes, such as injury, overuse, degeneration, or disease. It can also be acute or chronic, depending on how long it lasts and how often it recurs.

Lower Back Pain Causes

Low back pain can have many different causes, depending on the location, type, and severity of the pain. The most common lower back pain causes include:

• Muscle or ligament strain
• Herniated or bulging disk
• Spinal stenosis
• Spondylolisthesis
• Osteoarthritis
• Scoliosis
• Other causes

Muscle or ligament strain: This is a condition that affects the soft tissues that support the spine, such as the muscles, tendons, and ligaments. It can cause pain, stiffness, and inflammation in the lower back. It is often caused by overuse, improper lifting, poor posture, or sudden movement.

Herniated or bulging disk: This is a condition that affects the disks, which are the cushions between the vertebrae (the bones of the spine). A disk can herniate or bulge out of its normal position and press on a nerve, causing pain, numbness, or weakness in the lower back or leg. It is often caused by aging, injury, or degeneration of the disk.

Spinal stenosis: This is a condition that affects the spinal canal, which is the space where the spinal cord and nerves pass through. The spinal canal can narrow due to bone spurs, arthritis, or thickened ligaments, causing pressure on the spinal cord or nerves. This can cause pain, numbness, or weakness in the lower back or leg. It is often caused by aging, injury, or degeneration of the spine.

Spondylolisthesis: This is a condition that affects the alignment of the vertebrae. A vertebra can slip forward over the one below it, causing instability and pain in the lower back. It can also compress a nerve, causing pain, numbness, or weakness in the lower back or leg. It is often caused by a congenital defect, injury, or degeneration of the spine.

Osteoarthritis: This is a condition that affects the joints, such as the facet joints that connect the vertebrae. Osteoarthritis causes the cartilage that covers the joints to wear away, causing pain, stiffness, and inflammation in the lower back. It can also cause bone spurs, which can narrow the spinal canal or compress a nerve. It is often caused by aging, injury, or overuse of the joints.

Scoliosis: This is a condition that affects the curvature of the spine. The spine can curve sideways, causing pain, stiffness, and deformity in the lower back. It can also affect the alignment and function of the organs, such as the lungs and heart. It is often caused by a congenital defect, injury, or disease of the spine.

Other causes: Low back pain can also result from other conditions, such as infection, tumor, fracture, kidney stones, endometriosis, fibromyalgia, or ankylosing spondylitis. These conditions can affect the structures or organs in or near the lower back, causing pain, inflammation, or compression of the nerves.

Lower Back Pain Symptoms

The symptoms of low back pain can vary depending on the cause, location, and severity of the pain. The common lower back pain symptoms include:

• Pain in the lower back, which can be sharp, dull, throbbing, burning, or shooting
• Stiffness or reduced range of motion in the lower back or hips
• Difficulty standing, sitting, walking, or bending
• Muscle spasms or tightness in the lower back
• Numbness, tingling, or weakness in the lower back or leg
• Fever, chills, or signs of infection, such as redness, warmth, or pus in the lower back
• Weight loss, night sweats, or signs of tumor, such as a lump or mass in the lower back
• Problems with bladder or bowel control, sexual function, or sensation in the groin or buttocks, which can indicate nerve damage or compression

How Is Low Back Pain Diagnosed?

To diagnose low back pain, a doctor will ask about the symptoms, medical history, and activities that may cause or aggravate the pain. The doctor will also examine the lower back and perform some tests to check the function and sensation of the spine, nerves, and muscles. The doctor may also order some imaging tests, such as X-rays, MRI, CT scan, or ultrasound, to confirm the diagnosis and rule out other possible causes of low back pain.

Some of the tests that the doctor may use to diagnose low back pain include:

• Straight leg raise test
• Spinal tap
• Bone scan
• Blood test

Straight leg raise test: The doctor will ask the patient to lie down and raise one leg at a time, keeping the knee straight. If this causes pain in the lower back or leg, it may indicate a herniated or bulging disk or nerve compression.

Spinal tap: The doctor will insert a needle into the lower back and draw some fluid from the spinal canal. This can help to detect infection, inflammation, or bleeding in the spinal cord or nerves.

Bone scan: The doctor will inject a radioactive substance into the bloodstream and use a special camera to create images of the bones. This can help to detect fractures, tumors, or infections in the spine.

Blood test: The doctor will take a sample of blood and measure the levels of certain substances, such as white blood cells, erythrocyte sedimentation rate, or C-reactive protein. This can help to detect infection, inflammation, or autoimmune disorders that may affect the lower back.

What Are the Treatment Options for Low Back Pain?

The treatment for low back pain depends on the cause, location, and severity of the pain, the patient's preferences, and the doctor's recommendations. The main goals of lower back pain treatment are to relieve pain, reduce inflammation, promote healing, restore function, and prevent recurrence. The treatment options for low back pain include conservative treatment, interventional treatment, and surgical treatment.

Conservative treatment

Conservative treatment is the first line of treatment for most cases of low back pain, and it involves non-surgical methods, such as:

• Rest
• Ice and heat
• Medication
• Physical therapy

Rest: The patient should avoid or limit activities that cause or worsen the pain, and allow the lower back to heal. The patient may also use a brace, belt, or pillow to support and stabilize the lower back.

Ice and heat: The patient should apply ice or a cold pack to the affected area for 15 to 20 minutes every four to six hours for the first few days, to reduce pain and inflammation. The patient should wrap the ice or cold pack in a towel or cloth, and avoid direct contact with the skin. After the first few days, the patient may switch to heat or a hot pack, to relax the muscles and improve blood flow to the lower back. The patient should not use heat if there is swelling, infection, or bleeding in the lower back.

Medication: The patient may take over-the-counter or prescription pain relievers, such as ibuprofen, naproxen, aspirin, or acetaminophen, to reduce pain and inflammation. The patient should follow the dosage and instructions on the label, and consult the doctor if the pain persists or worsens. The patient should also be aware of the possible side effects and interactions of these medications, such as stomach ulcers, bleeding, liver damage, and kidney problems. The doctor may also prescribe muscle relaxants, antidepressants, or anticonvulsants, to ease muscle spasms, nerve pain, or chronic pain in the lower back.

Physical therapy: The patient may see a physical therapist, who can design a customized exercise program to strengthen and stretch the muscles and ligaments of the lower back and abdomen, and improve the posture and alignment of the spine. The physical therapist may also use other modalities, such as massage, ultrasound, electrical stimulation, or traction, to enhance the healing process and reduce pain and inflammation.

Interventional treatment

The doctor may perform some procedures to deliver medication or stimulate the nerves in the lower back, such as:

• Epidural steroid injection: The doctor will inject a corticosteroid, a powerful anti-inflammatory drug, into the epidural space, which is the area around the spinal cord and nerves. This can help to reduce pain and inflammation in the lower back and leg, and improve mobility and function. The effect of the injection can last from a few weeks to a few months, depending on the patient's condition and response.
• Nerve block: The doctor will inject a local anesthetic, a drug that numbs the area, into a specific nerve or group of nerves in the lower back. This can help to block the pain signals from reaching the brain, and provide temporary relief from pain and inflammation. The effect of the injection can last from a few hours to a few days, depending on the patient's condition and response.
• Radiofrequency ablation: The doctor will insert a needle into the lower back and use an electric current to heat up and destroy a small portion of the nerve tissue that carries the pain signals. This can help to interrupt the pain signals from reaching the brain, and provide long-term relief from pain and inflammation. The effect of the procedure can last from six months to a year, depending on the patient's condition and response.

Surgical treatment

Surgical treatment is the last resort for cases of low back pain that do not improve after six to 12 weeks of conservative treatment, or that cause severe pain and disability. The surgery involves repairing or removing the damaged or inflamed tissues, such as the disks, joints, bones, or nerves, and restoring the normal function and alignment of the spine. The surgery can be done through an open incision, or through a minimally invasive technique, such as microdiscectomy, laminectomy, or spinal fusion. The surgery can relieve pain and restore function, but it may also have some risks and complications, such as infection, bleeding, nerve damage, or failure of the fusion. The surgery requires general or regional anesthesia, and a hospital stay of one to five days. The recovery time may vary from three months to a year, depending on the type of surgery, the patient's condition, and the rehabilitation program.

How to Prevent Low Back Pain from Happening or Recurring?

The best way to prevent low back pain from happening or recurring is to avoid or modify the activities that cause or aggravate the condition, and to take care of your spine, muscles, and nerves. Some of the preventive measures that you can take are:

• Exercise regularly: Exercise can help to strengthen and stretch the muscles and ligaments of the lower back and abdomen, and improve the posture and alignment of the spine. Exercise can also help to maintain a healthy weight, reduce stress, and improve blood flow to the spine. You should aim for at least 30 minutes of moderate exercise, such as walking, swimming, or cycling, three times a week. You should also include some specific exercises for the lower back, such as pelvic tilts, bridges, or planks, as recommended by your doctor or physical therapist. You should avoid exercises that involve twisting, bending, or lifting heavy objects, as they can worsen the pain or cause injury.
• Use proper posture and technique: You should use proper posture and technique for your daily activities, such as standing, sitting, walking, or lifting. You should keep your spine in a neutral position, with your ears, shoulders, and hips aligned. You should avoid slouching, hunching, or leaning forward, as they can strain the muscles and ligaments of the lower back. You should also use proper technique for lifting, such as bending your knees, keeping your back straight, and holding the object close to your body. You should avoid lifting objects that are too heavy, too large, or too far from your body, as they can cause injury or pain.
• Use ergonomic equipment and furniture: You should use ergonomic equipment and furniture for your work or home environment, such as chairs, desks, keyboards, mice, and mattresses. They should be adjustable, comfortable, and fit your body size and shape. They should also support and stabilize your spine, and allow you to change your position or posture frequently. You should avoid using equipment or furniture that are too high, too low, too hard, or too soft, as they can cause pain or discomfort in the lower back.
• Wear supportive shoes and clothing: You should wear supportive shoes and clothing for your activities, such as walking, running, or working. They should be comfortable, fit well, and provide cushioning and stability for your feet and ankles. They should also avoid putting too much pressure or friction on your lower back, such as high heels, tight belts, or heavy backpacks. You should avoid wearing shoes or clothing that are too loose, too tight, or too worn out, as they can cause pain or injury in the lower back.
• Manage stress and emotions: Stress and emotions can affect the muscles and nerves of the lower back, and cause pain, spasms, or inflammation. You should try to manage your stress and emotions, and cope with them in healthy ways, such as relaxation techniques, meditation, yoga, or counseling. You should avoid coping with stress and emotions in unhealthy ways, such as smoking, drinking, or overeating, as they can worsen the pain or cause other health problems.

Frequently Asked Questions About Low Back Pain

Here are some frequently asked questions about low back pain, and their answers.

Can low back pain be a sign of a serious condition?

Low back pain can be a sign of a serious condition, in some cases. This can happen if the pain is accompanied by other symptoms, such as fever, chills, weight loss, night sweats, or signs of infection, such as redness, warmth, or pus in the lower back. This can indicate a condition such as spinal infection, spinal tumor, or spinal fracture. Low back pain can also be a sign of a serious condition if it affects the function or sensation of the bladder, bowel, sexual organs, or legs. This can indicate a condition such as cauda equina syndrome, which is a medical emergency that requires immediate attention. If you experience any of these symptoms, you should call 911 or seek emergency medical attention immediately.

Can low back pain be caused by stress?

Low back pain can be caused by stress, in some cases. This can happen if the stress causes muscle tension, spasms, or knots in the lower back, which can affect the nerves and cause pain, numbness, or weakness. Stress can also affect the immune system, and make the body more susceptible to infection or inflammation in the lower back. To reduce stress, you can try some relaxation techniques, such as breathing exercises, meditation, yoga, or massage.

Should I sit or lay down with lower back pain?

Neither sitting nor lying down for long periods is good for low back pain, as both can increase the pressure on the spine and worsen the pain. The best position for low back pain is to lie on your back with a pillow under your knees, or on your side with a pillow between your knees. This can help to maintain the natural curve of your spine and reduce the strain on your muscles and ligaments. However, you should not stay in bed for more than a few hours, as this can lead to stiffness, weakness, and depression. You should try to get up and move around as soon as possible, and gradually resume your normal activities.

Is walking good for bad lower back pain?

Walking is a good exercise for low back pain, as it can help to reduce pain, inflammation, and stiffness, and improve blood flow, muscle strength, and posture. Walking can also stimulate the release of endorphins, which are natural painkillers, and improve mood and quality of life. However, walking should be done in moderation, with proper warm-up and stretching, and with supportive shoes and clothing. Walking too much, too fast, or on uneven surfaces can worsen the pain or cause injury.

Summary

Low back pain is a common condition that affects millions of people worldwide. It can range from a mild ache to a severe and disabling pain that interferes with daily activities and quality of life. Low back pain can have various causes, such as injury, overuse, degeneration, or disease. It can also be acute or chronic, depending on how long it lasts and how often it recurs.

Low back pain can be treated with rest, ice, pain relievers, physical therapy, injections, or surgery, depending on the cause, location, and severity of the pain, the patient's preferences, and the doctor's recommendations. The main goals of treatment are to relieve pain, reduce inflammation, promote healing, restore function, and prevent recurrence.

One of the most effective methods to prevent or manage low back pain is to wear a lower back brace, such as the Back Brace for Lower Back Pain from Zofore Sport. This brace can provide support, compression, and pain relief to the affected area, and help you recover faster and prevent further injury. You can also prevent low back pain by modifying your activities, improving your posture and technique, and doing some exercises and stretches.

References

1. WebMD “Low Back Pain Pictures: Symptoms, Causes, Treatments”
2. Healthline “Everything You Want to Know About Lower Back Pain”
3. American Association of Neurological Surgeons (AANS) “Low Back Pain”
4. World Health Organization “Low back pain”
5. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) “Back Pain”

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