If you suffer from lower back pain, you’re not alone — approximately 80 percent of adults feel lower back pain at some point. Unfortunately, lower back pain is quite a broad category. It can encompass everything from a slight twinge after a tough workout to the extreme pain of sciatica.
The key to successfully treating lower back pain is understanding what is causing it in the first place. In this article, Dr. Brandon Claflin advises on the common causes of lower back pain and discusses possible treatment options.
Common Causes of Lower Back Pain
Lower back pain exists on a wide spectrum, and there could be many possible causes of back pain, depending on how severe your pain is. Understanding what is causing lower back pain can also help doctors or pain management specialists recommend appropriate treatment options.
Common causes of lower back pain include the following:
- Muscle or Ligament Strains: These can occur after lifting heavy objects, making sudden movements, or spending time with poor posture.
- Herniated Discs: Discs act as cushions between vertebrae. When a disc begins to herniate, this cushion thins out and can contribute to lower back pain.
- Spinal Arthritis: If your spine sees a lot of wear due to repetitive movements and age, you may develop spinal arthritis.
- Sciatica: Sciatica occurs due to compression of the sciatic nerve. It manifests as a sharp pain that radiates through the lower back down into the leg.
- Spinal Stenosis: This condition describes a narrowing of the spinal column, which puts pressure on the nerves inside and can cause intense back pain.
- Pregnancy: Lower back pain is a common symptom of pregnancy (especially in the third trimester as the baby gets heavier).
- Lifestyle Factors: Some factors like weight gain, stress, poor posture, and an inactive lifestyle can contribute to back pain.
How Is Lower Back Pain Diagnosed?
Lower back pain is a symptom that can help guide your doctor to whatever condition is causing it. To start, your doctor might ask you a series of questions to help them better understand the nature of your pain.
These questions could include the following:
- When did your pain start?
- On a scale of one to 10, how would you rate your pain?
- Does anything make your pain better or worse?
- What were the events leading up to your pain?
Next, your doctor may perform a physical exam to see if there’s anything out of the ordinary. If they still need more information, then they may order some imaging tests like X-rays, MRIs, or CT scans.
How Is Lower Back Pain Treated?
Just like lower back pain exists on a scale of mild to severe, treatment options for lower back pain exist on a similar scale. On the lower end, lifestyle modifications may help mild cases of lower back pain that can be caused by everyday wear or muscle strain. On the upper end, surgery may be required for serious causes like herniated discs or pelvic fractures.
Lifestyle Modifications
If the pain is on the lower end of the spectrum, your doctor may recommend that you start out with lifestyle modifications. For instance, if the back pain is likely caused by poor posture, a doctor may recommend buying an ergonomic desk chair or engaging in some posture-correcting exercises.
Dr. Claflin adds that moderate exercise can also help strengthen back and core muscles. Just make sure you choose low-impact activities like walking, swimming, or yoga. If you work a job that requires a lot of sitting, try to stretch and walk around every 30 minutes to an hour to relieve pressure on your back. Ask your doctor which stretches are best for you.
Finally, maintaining a healthy weight can help reduce strain on the lower back. A doctor may recommend working with a nutritionist or personal trainer to help come up with a targeted weight management plan and anti-inflammatory diet to relieve pain.
Non-Surgical Treatments
In addition to making lifestyle changes, there are also some at-home remedies to try to temporarily relieve lower back pain. For instance, patients can take over-the-counter pain relievers like ibuprofen or acetaminophen to lower inflammation (ask your doctor first). They can also try alternating heat and cold therapy, which can also reduce inflammation and provide some relief.
If you’d like to add another layer of treatment, alternative therapies can help. For instance, physical therapy can help strengthen the muscles in your core and lower back. Massage can also help relieve muscle spasms, while acupuncture can reduce muscle tension and increase circulation.
Interventional Pain Management
If you’re further up on the pain scale, more heavy-duty interventions may be needed. While your back pain might not warrant surgical intervention, your pain management specialist may recommend epidural steroid injections (ESIs) to reduce inflammation around the nerves. This is especially helpful for herniated discs or sciatica. Nerve blocks are also an option your doctor might suggest.
Surgical Options
Finally, if your pain is severe and isn’t responding to any other interventions, you might need to consider surgery. Certain causes of lower back pain, like herniated discs and spinal stenosis, might require surgery straight away if they’ve progressed enough. Depending on the cause of your lower back pain, your doctor may recommend a discectomy or spinal fusion.
Back Pain and Treatment: Final Thoughts
Lower back pain is extremely common and, in many cases, is the result of everyday wear and tear. In these cases, the pain can often be treated with simple lifestyle modifications and at-home remedies.
However, extreme back pain can be a warning sign of a severe issue like a herniated disc, spinal stenosis, or even a fracture. Those may require more serious treatments like injections and surgical procedures. Speak to your primary care provider or pain specialist about what path could lead to pain relief.
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