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What is lower back pain?
Lower back pain is caused by injury to a muscle (strain), a ligament (sprain), or the spine or joints. It can lead to back spasms or travel down your legs and can cause leg numbness and weakness. Lower back pain is sometimes also called lumbago.
Your spine is composed of bones called vertebrae that stack on top of each other. These vertebrae are separated by discs that have a fibrous coating surrounding a spongy center. Healthy discs act as shock absorbers and provide flexibility.
The vertebral canal houses the spinal column, which contains the spinal cord. The actual spinal cord ends at the first lumbar vertebrae and nerve roots continue vertically down the spine. Nerve roots also branch off the spinal column and exit through holes called foramen.
The lamina is the bridged section that forms the back of the vertebral canal, and is important in spinal stability. The spinous process is the bony ridge you can feel when you run your hand down your spine. Strong and flexible muscles help support your back.
If any of these areas are affected, it can cause lower back pain.
What causes lower back pain?
Potential causes of lower back pain include:
- Aging
- Injury
- Spine trauma
- Lumbar spine disease
- Simple daily strain
More complicated causes for lumbar and lower back pain include:
Herniated discs
Wear on a disc can cause the outer layer to rupture, creating a herniated disc. The herniated disc can push on the spinal canal and nerve roots, causing pain, numbness, and weakness. Find out more about herniated discs here. A bulging disc also puts pressure on the nerve, but the disc does not actually rupture.
Bone spurs
Wear on the vertebrae can cause bone spurs, which are bony malformations that can put pressure on discs and inflame the nerves, causing pain. Bone spurs can also cause stenosis, which is a narrowing of the spinal column or foramen.
Instability
Spondylolisthesis, or spinal instability, happens when vertebrae slip from their natural position in the spine. This can cause problems and lead to pain.
How is lower back pain diagnosed?
Lower back pain is often diagnosed by x-ray or MRI scan.
Dr. Ahuja and staff perform radiological procedures at The Brain and Spine Imaging Center, our state-of-the-art imaging facility in Franklin, Wisconsin.
What are back spasms? What do back spasms feel like?
Back spasms are sudden contractions of the muscles in your back. They can feel like the muscles are twitching, tensing or throbbing. The pain from a back spasm can range from very mild to severe.
Actual back spasms are typically caused by arthritis or muscular issues, rather than spinal ones. However, spinal problems like a herniated disc or spinal stenosis can cause pain that feels very much like a back spasm. To isolate the cause of your back pain or spasming back muscles, you may need to be examined by a health professional.
When should I see a doctor for lower back pain?
When back pain becomes debilitating, and starts affecting your day-to-day life, and over-the-counter medications aren’t enough to manage the pain, consider visiting a doctor. A neurosurgeon can provide more advanced treatment options, including but not limited to surgical intervention.
Surgery is never our first choice for treating lower back pain. If Dr. Ahuja believes conservative treatments and therapies would be beneficial to try before considering surgery, there are a variety of options available. You can read more on our Lumbar and Thoracic Spine Surgery page. Our goal is to eliminate your pain or to get it to a level you can tolerate without surgery if possible.
What are non-surgical treatment options for lower back pain?
In this video, Luke, a certified personal trainer from the American Council of Exercise will show you some stretching exercises you can do at home to help ease lower back pain, improve hip mobility, and build core strength and stability:
Along with these conservative therapies, there are many things you can do on your own to help improve your symptoms without surgery.
Physical therapy
Dr. Ahuja will often prescribe physical therapy, which can be very beneficial to some patients. Physical therapists can teach patients exercises and ways to improve posture and reduce stress on their back. There are many different types of physical therapy that may be prescribed, ranging from water therapy to special massage techniques. Patients may be given home exercises that can help reduce stress on the spine and improve symptoms. Physical therapy can strengthen the muscles in your back, which can often improve your symptoms.
Lumbar Epidural Steroid Injections (ESIs)
ESIs are a set of 2-3 injections into the lumbar spine that can help reduce pain and strengthen the lower back.
Dr. Ahuja performs the injections himself, and the entire procedure only takes about a minute.
After two injections, Dr. Ahuja will see you back in his office to evaluate your symptoms and see what the next step in treatment should be.
For more information, visit our ESI page.
Medication
Medications are often an effective way to calm muscle spasms, reduce inflammation, and control pain. It is important to take medications exactly as prescribed by Dr. Ahuja to maximize the effect that they will have in improving symptoms. Some medication prescribed will only treat pain caused by inflamed tissue, while others will specifically target pain due to pinched nerves. Others will help relax muscle spasms.
Posture
Poor posture is often a root cause of back problems, so learning proper posture is essential to improving your symptoms.
When standing, try to align your ears, shoulders, hips, and ankles, and relax your shoulders, hips, and knees.
Remember, it as just as bad to be slouched forward as it is to be too arched backwards.
When sitting, align your ears with your hips and make sure to sit in a chair that supports your back. Your feet should be flat on the ground.
When in the shower, make sure you stand close enough to the showerhead so that you don’t have to slouch to be in the water.
It is important to have a good pair of glasses, if needed, which will prevent you from leaning forward when sitting at a computer.
Tilt your rearview mirror slightly upwards to prevent slouching when driving.
Sleep on your back or side. Sleeping on your stomach only worsens back pain. If you sleep on your side, place a pillow between your legs to prevent your legs from slipping and twisting your spine.
Proper body mechanics
Always bend at the knees and hips, and never bend at the waist.
Lift with the object close to you, and use your legs as the primary lifting muscles.
Try to keep your hips and shoulders aligned.
When turning, move your whole body so you don’t have to twist your back and spine. Lead your body with your feet.
Try to keep heavier objects between shoulder and hip level.
When reaching for objects, use a stool or other reaching tool if possible.
What exercises help back pain?
Here are a few helpful exercises that may aid in your recovery. Dr. Ahuja or your physical therapist may suggest different ones depending on your individual needs. Remember, these are just suggestions; you should always make sure to okay these exercises with Dr. Ahuja or your physical therapist first.
- Lumbar Arc: Lie down, tighten your abdomen and buttock muscles, and tilt your hips until your spine is flush with the floor.
- Hamstring: Gently pull your leg towards you and then straighten it.
- Half Sit-Up: Tighten your abdominal muscles and only raise your torso up high enough so your shoulder blades don’t touch the floor.
- Hip Flex: Tighten your abdominal muscles and gently lean forward, feeling a stretch in your hip and groin.
- Wall Sit: Place your feet a foot in front of you and keep them at shoulder length. Slide down into a sitting position, leaning against the wall for support.
- Back Flex: Push your upper body off the floor, keeping your hips touching the floor.
