Pain in the lower back area can be caused by an irritation or problem with tendons, muscles, nerves, nerve roots, joints, and spinal discs found in the lumbar region (lower back area). The cause of this pain is dependent on the complication or underlying issue in the back. There are several different causes of lower back pain.
INSTANT BOOKINGIn This Comprehensive Guide You'll Discover What's Causing Your Lower Back Pain, What It Means For Your Health, And The Various Options You Can Take To Guarantee Success In Healing
80% of the world's population will experience back pain at some point in their lives
3.4 million Australians live with chronic lower back pain
Lower back pain is the leading cause of disability in working adults, costing the Australian economy $3 billion in GDP growth.
I’m not just throwing random figures at you; these are hard facts and the sad truth about this lumbar plague.
The lower back is the connection between your upper and lower body. It bears most of the body's weight and, as such, can be prone to experience complications that result in mild to unbearable pain.
Lower back pain, as the name suggests, is characterised by a throbbing pain, tension, or stiffness in the lumbar region (low back) which often radiates to other parts of the back, the neck, and even all the way down to the legs. It can be caused by a host of factors and comes with several symptoms. These symptoms differ from person to person, depending on the cause of the complication.
Lower back pain can either be acute or chronic. Acute lower back complications are usually mild and only last for a few days or weeks. In fact, in most cases, they go away on their own or with the aid of some sort of self-care (massage, exercises, resting, etc.).
The chronic symptoms, however, last much longer (1 month or more) and can cause future complications if not appropriately handled. It’s usually advised to see professionals in this case as self-care will have minimal or no effect.
Lower back pain can be treated in two major ways - the conservative approach that utilises over-the-counter and prescription medication, and a holistic approach that works with the body to restore it to its original state.
Pain in the lower back area can be caused by an irritation or problem with tendons, muscles, nerves, nerve roots, joints, and spinal discs found in the lumbar region (lower back area). The cause of this pain is dependent on the complication or underlying issue in the back.
There are several different causes of lower back pain, but generally, the reasons are classified under three broad categories - muscle strain, sciatica, and degenerative and inflammatory diseases.
This is a common cause of lower back pain because the back houses the structure (the spinal cord) that supports our overall weight. Even when doing normal everyday things we sometimes place too much stress on the muscles and ligaments in the back. This then leads to what is known as mechanical back pain.
Asides placing undue weights on your back, other things like bad posture, incorrect lifting and bending habits, and poor ergonomics can result in mechanical back pain.
Another cause of mechanical lower back pain is a sprain. A sprain is basically the stretching and tearing of the fibrous tissues that connect the bones in the joints. It is also caused by stress as a result of the numerous activities we do with our backs. Another cause could be due to impact injuries such as falling from great heights and accidents.
Sciatica refers to the condition where the sciatic nerve is placed under significant pressure which results in sharp radiating pain from the lower back all the way down to the legs and feet. It can be caused by a host of issues like stenosis, spondylolisthesis, and herniated discs.
Lumbar spinal stenosis refers to the condition where the spinal canal narrows significantly, thereby putting pressure on the nerves travelling along the back- including the sciatic nerve. Age is a major cause of this complication; however, young adults can suffer from stenosis as well.
Spondylolisthesis is a complication where one of the individual vertebrae in the lower back slips onto the one below. It can occur due to strenuous activities like playing football, gymnastics, some field events like throwing shot puts, and dead weight lifting. These activities put stress on the back, which can cause the vertebrae to slip forward.
Disc herniation is a condition that affects the rubbery intervertebral discs that connect two vertebrae bones. This disc is made up of a harder exterior casing, and a soft interior tissue. Disc herniation occurs when the soft tissue pushes through the crack on the exterior casing, causing an intense feeling of pain. It is caused by excess body weight, inappropriate lifting habits - lifting objects with your lower back instead of your leg and thigh muscles - and age.
Another cause of lower back pain are diseases that commonly affect the back. Degenerative diseases, like spondylosis, and inflammatory conditions, like ankylosing spondylosis, all contribute to back pain complications.
Spondylosis is an age-related disease that affects the entirety of the spine - vertebrae and intervertebral discs. It occurs when the bones, cartilages, and ligaments of the spine become old and stiff. As a result, they break down and cause spurs.
Ankylosing spondylitis, also referred to as Bechterew's disease is a form of inflammatory arthritis that affects the spine causing stiffness and low back pain. There isn't any scientifically proven cause of this disease; at best, all we know is that it affects certain people with specific genes. If you have a family history of this disease, the chances that you'd also have one is high.
Just like any other complication in the body, lower back pain also comes with its own characterising symptoms. If you have any or a combination of these red flags highlighted below, you’re likely have lower back problems.
This is a classic symptom of sciatica. The thing is, the sciatic nerve travels from the lumbar region, through the thighs and terminates at the feet and any form of irritation or pressure on the nerve will result in pulsating pain that can be felt in these three areas.
This is another sign that you have back pain. Unlike the radiating pain that comes with sciatica, this pain is more localised and is accompanied by muscle spasms and stiffness.
If you wake up with sharp pain and stiffness in your lower back, it could be an indication you have lower back complications. This is a telling sign of ankylosing spondylitis.
It is caused by pressure on the sciatic nerve resulting in stiffness, numbness, and a tingly sensation in the affected area. It can also be felt in the legs and feet.
Depending on the cause of the lower back pain, some activities like sitting in a spot for a while or moving around can cause discomfort and a significant amount of pain.
Some lower back complications come with the loss of bowel and sometimes, bladder control.
Although rare, lower back pain could be a sign of cancer.
Cancer affects all parts of the body, including the spinal cord, and when they do, it could result in lower back pain. Besides the primary bone cancer tumour that affects the spine, cancers in other areas can spread to the spine as well through the bloodstream or lymph system. The major cancer types that cause lower back pain include the following:
Spinal cancer
Lung cancer
Breast cancer
Blood cancer
Tissue cancer
Gastrointestinal tract cancer
Ovarian cancer
Prostate cancer
Spinal cancer, as the name implies, is a tumour growth on the vertebrae or other components of the spinal cord, thereby resulting in pain.
The other forms of cancer take a more indirect approach. The cancer cells in these points of origin (breast, lungs, ovary, etc.) break down, metastasise, and form tumours in other parts of the body, including the spine.
It rarely occurs in other forms of cancer but is a common occurrence in lung cancer patients. As a matter of fact, the Dana-Farber reports that about 25% of people with lung cancer experience back pain.
However, generally you should not be alarmed. Lower back pain isn't the first or primary indication of cancer. In fact, most times, it is as a result of something less life-threatening like sciatica or spondylosis. But in situations where other symptoms accompany the pain, then further investigation needs to be conducted. These symptoms include:
Back pain that does not seem to have a cause or origin
Unexplainable weight gain or loss
Fatigue
Loss of appetite
Indigestion and difficulty swallowing
Abdominal pain
Inexplicable and frequent night sweats
Changes in bowel habits
One or a combination of these symptoms together with lower back pain could mean cancer. But on its own, lower back pain very rarely indicates cancer.
Asides nausea and weird food cravings, lower back pain is also a common occurrence in pregnant women. Pain in the lower back occurs during pregnancy when the pelvis moves from its original position and meets the spine at the sacroiliac joint, thereby causing pain. It occurs for a variety of reasons with the obvious ones being additional weight gain and change in posture.
Pregnant women can gain as much as 10-15 kg, which puts a lot of extra pressure and weight on the spine. This, in turn, causes lower back pain.
As far as posture is concerned, with pregnancy, comes a shift in your centre of gravity. So you are forced to adjust to this new posture imposed on your body structure. Doing that places stress on the joints and muscles in the lower back and with time, will lead to back pain.
Other causes could be hormonal changes and irregular sleeping positions due to the pregnancy. Conservative medication can be taken to ease the pain. However, there are home remedies for pregnancy-related lower back pain that are just as effective. It is even advised to go the homemade route to avoid pregnancy complications as a result of using certain medication.
Lower back pain during menstruation - dysmenorrhea - is a common occurrence. As a matter of fact, the American College of Obstetricians and Gynaecologists reports that about 50% of menstruating women will experience dysmenorrhea.
The primary cause of dysmenorrhea is a hormone known as prostaglandins. This hormone causes the uterus muscles to contract more so as to push out the tissue in the uterus lining. These contractions cause cramps which then lead to lower back pains.
In addition, reports show that increased levels of prostaglandins increase your perception of pain.
Asides contractions induced by prostaglandins, there are other causes of period lower back pain. These cases are referred to as secondary dysmenorrhea and can be caused by endometriosis, or benign growths in the womb such as fibroid.
Menstrual lower back pain does not usually indicate underlying conditions. The pain can be treated by conservative medications like Nonsteroidal anti-inflammatory drugs (NSAIDs), and progesterone which reduces the level of the prostaglandins, thereby reducing the pain.
In addition to medication, some home remedies for period back pain can also do wonders to alleviate the discomfort.
In addition to the many things that cause lower back pain, bad sitting posture is one of them. This is a common occurrence in the corporate world and accounts for a huge chunk of worker's compensation in Australia.
Improper ergonomics, such as slouching, can put pressure on the intervertebral discs that cushion the joints in the spinal cord. This pressure affects the joints and nerves in the lumbar region, which then result in pain.
It is especially pronounced if the lumbar muscles are not strong enough to support that undue pressure, and that is why regular lower back exercises and stretches are recommended first thing in the morning before you get to work on your desk.
Bad sitting posture can also aggravate underlying lower back complications like sciatica, stenosis, increasing pain by several thresholds. So if you have any of these conditions, it is important to know the best sitting position for lower back pain that will reduce discomfort and stop further complications to the underlying condition.
A lot of people ask us why they always wake up with excruciating back pain that tends to go away as the day progresses, only to come back again during the night. Now, there are several causes of this, from how you sleep at night, to the kind of mattress you sleep in, or it could even be as a result of inflammatory diseases like ankylosing spondylitis.
Ankylosing spondylitis is most likely the cause of this back pain symptom because it is an inflammatory disease. And with inflammatory diseases, resting in one position makes the pain worse because of those inflammatory chemicals build-up and localise at the affected area, thereby increasing the magnitude of the pain.
How you sleep at night can also be a cause of lower back pain. This is usually so when there is an underlying lower back problem like sciatica, spondylosis or disc herniation, as inappropriate sleeping habits can trigger and alleviate discomforts. If you have any of these conditions, knowing the proper sleeping positions will go a long way in mitigating the symptoms of your lower back pain.
Back pain on one side is caused by what is known as sacroiliac (SI) joint dysfunction. The SI joint is a very complex joint that connects the hips to the lumbar spine via a triangle-shaped bone called the sacrum. It provides support and stability when you walk or run.
When there is damage to the joints or inflammation of the ligaments surrounding and supporting the joint, it can result in pain that is often felt on one side of the lower back. The pain radiates to the leg on the side experiencing the pain, and sometimes, to the groin and buttocks.
SI dysfunction can occur as a result of a work injury, a fall, hypermobility in the pelvic area, pregnancy, childbirth, or as a side effect of spine surgeries.
The following provide relief to SI-related lower back pain
Physiotherapy
Spinal injections (cortisone shots)
Prolotherapy - The injecting of saline solutions and numbing drugs to tighten loose and inflamed ligaments that are causing joint pain.
Asides these procedures, there are exercises for SI joint pain relief that you can do at home.
Another thing most people tend to overlook is the kind of mattress they sleep on. Being the surface you go to rest your back at night, the mattress must be appropriately suited to provide relief from stress for your entire body, including the lower back.
Your mattress should not be too soft because if it is, you will sink into it while you sleep, and this can force your body into bad postures that can lead to lower back pain. However, if too hard, it can place pressure on some points in the back, causing pain.
Deadlifting simply means lifting an immobile object from the ground. It is a fundamental human movement and can describe everyday activities like picking up your kids, moving furniture, changing car tires, or even lifting school bags. Some even use barbell deadlift to improve their physical appearance and body strength.
The real problem is not the movement itself; it is the way you carry out this primal activity. The spine is responsible for transferring energy from the legs and hip to the weight you want to lift. For this to happen efficiently, the spine has to maintain its neutral position and resist bending.
Deadlift lower back pain occurs when the proper position of the spine is not maintained during this lifting movement. At the first instance, it could be mechanical, but with continuous bad lifting habits, it can result in further complications like disc herniation or spondylolisthesis.
Lower back pain is very common in the running population, and it occurs for a variety of reasons. One reason is due to poor core control or core strength.
The core is very important for maintaining posture, and if you have bad core stability or strength, you will tend to arch in a position where the pelvis tilts forward while you run. This puts a lot of strain on the lower back, thereby causing pain.
In addition, the core muscles absorb the sudden shock wave impacts that come with running. If they are not strong enough, these shock waves will travel to the spine through the lower back, causing complications like disc herniation. There are some core strengthening exercises you can do that will improve your lower back structure.
Another common reason for back pain when running is poor glute activation. The gluteus maximus the main hip extensor muscle and is responsible for pulling our body through any time we are walking or running.
When the glute isn't strong enough, you tend to overuse your hamstring and lower back, which then results in pain. There are some exercises you can do to strengthen your glute muscles which will reduce your risk of suffering from lower back pain during your morning runs.
Even when you do the best stretches and exercises, lower back pain - especially the chronic type - can persist. So it is important to find relief that will mitigate the symptoms that come with this complication. Below are some of the things that offer relief to lower back pain
Heat and Cold Therapy
This practice helps alleviate lower back pains. It is especially effective for lower back complications that occur as a result of inflammation or soreness. The heat loosens the stiff muscles causing pain, and the cold soothes the inflammation.
Physical Therapy
These are a series of procedures employed by professional physiotherapists to help treat your lower back pain. These methods include electrotherapy, range of movement exercises (ROMs), massages, and so on.
Conservative Medication
This includes all the over-the-counter and prescription medication given to help with the pain and inflammation of the lower back.
Better Sleep
It is essential to know how to sleep when suffering from lower back pain as it will prevent morning stiffness and pain common to most lower back compilations.
Spinal Injections
This is a more active form of medication in case conservative measures are not producing desired results. Injections like cortisone shots can be administered to help ease the pain in the lower back and reduce the inflammation as well.
Besides conservative medications like opioids or hands-on treatments like massages, there are some stretches you can do on your own to relieve you of your lower back pain. The theory behind this relief method is rooted in the components that make up the structure that is your back.
The entire back comprises tendons, ligaments, tissues, joints, and most importantly, muscles. Most lower back pain occurs as a result of excess weight, high pressure, and the inflexibility of the joints and muscles. Strengthening these muscles and loosening these joints, with specific stretches and exercise, will significantly alleviate the symptoms that come with lower back pain.
Here are 7 great exercises and stretches you can do to relieve your lower back from pain.
Doing these stretches will significantly alleviate your lower back pain. In addition to these stretches, you can incorporate some lower back exercises you can do at home to strengthen your back muscles.
To treat, we first must diagnose. It is best to see an expert to give you an accurate diagnosis of your lower back problem from the onset of the pain. Most people try to get rid of the pain by doing some of the stretches or exercises that are effective against back pain without knowing the root cause of the pain. This is dangerous as some of these underlying conditions can get worse with rigorous movements. Your doctor will typically run a physical examination to try estimate the cause of the lower back pain, and then use X-rays, MRI or CT scans, blood tests, electromyography, and a bone scan to double-check and be absolutely sure of the actual underlying condition responsible for the back pain.
Now the good part, getting you better! Let's discuss a few options for treating your pain. Lower back pain affects 80% of the world's population, and more than half of that is as a result of degenerative diseases that come with age. In this situation, there is no actual "fixing" in a sense that would make it go away permanently. One can only employ procedures to mitigate the symptoms. This applies to several other back complications like ankylosing spondylitis, disc herniation and so on. Some lower back complications, however, can be corrected by surgery. Surgery procedures like laminectomy and spinal fusion can help fix lower back pain as a result of spondylolisthesis. Surgery should always be seen as a last resort however, and we recommend a natural approach first. You can read more here about my top 5 tips for fixing back pain at home with no drugs or surgery.
Pain in the lower back can be caused by inflammation or tightness of lower back muscles like the quadratus lumborum and latissimus dorsi. Massage is a very effective method of getting rid of this pain because it warms these muscles up, and improves blood and lymphatic circulation in the area. This relaxes the tensioned muscles and purges toxins from the affected area. There are several lower back massage techniques - cupping, acupressure, Myofascial release, etc. - used by professional physiotherapists to help relieve your back from pain and improve your lower back structure. I always recommend taking the natural route first, and massage is a great place to start.
If you want to go the conservative route, there are some medications you can use to relieve your lower back pain. There are several of them and are generally classified under 4 categories - Nonsteroidal anti-inflammatory drugs (NSAIDs), Opioids, Muscle relaxants, and Antidepressants.
NSAIDs
These are typical pain relievers that can be easily purchased over the counter. Some are prescribed, especially when it contains higher doses of the active ingredient. NSAIDs help to reduce the pain and inflammation in the muscles and joints of the affected area. Examples of NSAIDs include ibuprofen, aspirin, and piroxicam.
Opioids
These are prescribed drugs for chronic lower back pain. They reduce the body's perception of pain by intercepting sensory motors transmitting the pain signals to the brain. Oxycodone and acetaminophen are common opioids prescribed for lower back pain.
There is usually concern about addiction to opioids, and that is why other holistic methods are recommended to be used in combination with opioid medication so as to reduce the risk of dependency.
Muscle Relaxants
Muscle relaxants, as the name implies, relax tensions in the muscle that can be squeezing on sensitive nerves in the lower back, such as the sciatic nerve.
Antidepressants
Sometimes, doctors could prescribe antidepressants to help relieve chronic lower back pain. This is because there is evidence that some antidepressants like duloxetine are effective in treating pain. Much like Opiods, there is the risk of addiction which is why we always recommend a holistic approach and only resorting to medication as a last option.
Following your doctor’s initial consultation would be a series of treatments that will be tailored to mitigate the lower back pain. If you are on Medicare or otherwise visit your GP for an initial examination, they will likely put you in touch with a registered Physiotherapist for treatment.
If you are a private patient you can choose to come directly to the experts for assessment and treatment. Here at Align Motion Physio we treat Lower Back Pain with holistic, science backed methods with a focus on minimising the use of drugs and eliminating the need for surgery.
We are a fully licenced and insured provider of treatment, and welcome patients from all channels. Whether you are on Medicare, Private Insurance, or Workers Compensation/ CTP, we have the team to help rid you of your lower back pain.
Align Motion Physio is based in Western Sydney, and treats patients from all over Sydney. If you’re in the local area of Merrylands/Wentworthville/Warrwong, why not give my friendly team a call today on (02) 9849 2855 for a phone screening and to book a consultation. Alternatively, you can click the floating link below to book instantly.
Thank you for reading, and I wish you great health!
Varunan Ravikumaran
Founder & Head Physiotherapist
Align MotionPhysio
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