Nearly everyone will experience some form of back pain in their lifetime.
Lumbar back pain is a common condition, leading to lower productivity, missed work, and a lower quality of life.
It usually develops due to a minor injury or muscle overuse, but sometimes there may be no obvious cause.
Lower back pain can also be a symptom of an underlying medical condition.
The pain can appear suddenly or gradually and can range from a dull ache to intense, sharp pain.
In some people, the pain may be chronic.
In this article, we look at some of the possible causes of lumbar back pain and lumbar back pain relief. We also cover when to see a doctor.
What is Lumbar Back Pain?
The low back, also called the lumbar region, is the area of the back that starts below the ribcage.
Almost everyone has lumbar back pain at some point in life.
Fortunately, it often gets better on its own. When it doesn’t, your doctor may be able to help with several effective treatments.
Anatomy of the Lumbar Region.
The lumbar spine (lower back) consists of five vertebrae (bones) in the lower part of the spine between the ribs and the pelvis.
The vertebrae that form the spine in the back are cushioned by small discs, which are located between each of the vertebrae and act as shock absorbers for the spinal bones.
These discs are flat and round, with a tough, outer layer (annulus) that surrounds a jelly-like material called the nucleus.
Thick ligaments attached to the vertebrae hold the pulpy disc material in place.
Of the 31 pairs of spinal nerves and roots, five lumbar (L1–L5) and five sacral (S1–S5) nerve pairs connect beginning in the lower back area.
Categories of Lumbar Back Pain
Lumbar back pain may be categorized as either mechanical or compressive.
- Mechanical Lower Back Pain. Mechanical lower back pain is caused by inflammation. It is usually a consequence of injury or irritation to the:
- Facet joints
- Intervertebral disc (disc degeneration, annular tear, or disc prolapse)
- Ligaments or the muscles of the back (musculoligamentous back pain)
- Or, as a result of spondylolisthesis (a slip of one vertebra on another).
Less common, but extremely important, causes of mechanical lower back pain include:
- Infection (discitis, epidural abscess, osteomyelitis)
- Traumatic fractures and/or dislocations
- Tumors which have spread to the spine (metastases)
Typically, mechanical lower back pain starts in or near the midline and may spread to the buttocks and thighs.
It is unusual for this type of pain to extend below the knee.
Sometimes, hip problems may mimic mechanical lower back pain.
- Compressive Lower Back Pain. Compressive lower back pain occurs when one or more nerve roots are either pinched or irritated. A herniated intervertebral disc is a common cause of compressive pain. Often, compressive back pain is associated with pain extending down the leg (sciatica) and sometimes into the foot. This leg pain may be associated with numbness or weakness.
Causes of Lumbar Back Pain
Most commonly, mechanical issues and soft-tissue injuries are the common causes of lumbar back pain.
These injuries can include compression of nerve roots, damage to the intervertebral discs, and improper movement of the spinal joints.
However, the most common cause of lower back pain is a torn or pulled muscle and/or ligament.
- Muscle Strain and Ligament Sprain. A low back sprain or strain can happen suddenly or can develop gradually over time due to repetitive movements. Strains occur when a muscle is stretched too far and tears, damaging the muscle itself. Sprains happen when over-stretching and tearing affect ligaments, which connect the bones together.
Common causes of sprain and strain include:
- Poor posture over time
- Lifting a heavy object
- Twisting the spine while lifting
- Sudden movements that place too much stress on the low back (i.e. a fall)
- Sports injuries
- Herniated Discs. A disc may herniate gradually as a part of general wear and tear or suddenly due to injury or heavy lifting. During disc herniation, the soft inner contents of the disc (nucleus pulposus) push against its outer covering (annulus fibrosus). The nucleus pulposus may also leak out in severe cases by tearing the fibrous layers of the annulus.
- Osteoarthritis. Osteoarthritis results from wear and tear of the disc and facet joints. It causes inflammation, instability, pain, and stenosis to a variable degree, and can occur at a single level or multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly progressive. It is also referred to as spondylosis or degenerative joint disease.
- Spinal stenosis. Spinal stenosis causes pain through the narrowing of the spinal canal where the nerve roots are located. The narrowing can be central, foraminal, or both, and can be at a single level or multiple levels in the lower back.
- Trauma. Acute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a fall or a motor vehicle accident, should be medically evaluated.
- Compression fracture. A compression fracture occurs in the cylindrical vertebra, in which the bone essentially caves in on itself, and can cause sudden pain. This type of fracture is most common due to weak bones, such as osteoporosis, and is more common in older people.
Note: Having one or more of these conditions does not necessarily mean that is the cause of your lumbar back pain. Always consult your doctor for proper diagnosis and for help on how to achieve lumbar back pain relief.
Symptoms of Lumbar Back Pain
The symptoms of lumbar back pain often present as pain in the low back that can include pain that goes into the hips, glutes (buttocks), or legs. The pain can be dull, aching, burning, sharp, or a combination of all of these. It can be intermittent, constant, or activity-related.
- Dull, aching pain. Pain that remains within the low back is often described as dull and aching rather than stinging, burning, or sharp. This kind of pain can be accompanied by mild or severe limited mobility, muscle spasms, and aches in the hips and pelvis.
- Pain that travels to the buttocks, legs, and feet. Occasionally, lumbar back pain includes a stinging, sharp, tingling, or numb sensation that moves down the thighs and into the low legs and feet, also known as sciatica. Sciatica is caused by irritation of the sciatic nerve and is usually only felt on one side of the body.
- Pain that’s worse after waking up and better after moving around. Many people who experience lumbar back pain report symptoms that are worse first thing in the morning. However, after getting up and moving around, symptoms are relieved. Pain in the morning is due to decreased blood flow with sleep, stiffness caused by long periods of rest, and possibly the quality of mattresses and pillows used.
- Pain that’s worse after prolonged sitting. Sitting puts pressure on the discs, which can cause low back pain to worsen after sitting for long periods of time. Stretching and walking can alleviate low back pain quickly, but returning to a sitting position may cause symptoms to return.
- Pain that feels better when changing positions. Depending on the underlying cause of lumbar back pain, some positions will be more comfortable than others. For instance, with spinal stenosis, walking normally may be difficult and painful, but leaning forward onto something, (i.e. a shopping cart), may reduce pain. How symptoms change with shifting positions can help identify the source of pain.
Onset of Low Back Pain Symptoms. Depending on the cause of lumbar back pain, the onset of symptoms can vary widely. The onset of symptoms may:
- Develop slowly over time. Symptoms caused by stress-inducing positions or repetitive motions tend to come on slowly and get worse progressively. Pain may develop after certain activities or at the end of a long day, and may feel like a constant ache.
- Come and go, but worsens over time. Lumbar back pain caused by degenerative disc disease can be felt off and on, but pain flare-ups get progressively more severe over a long period of time.
- Immediate pain after an injury. Sudden movements (i.e. such as during a motor vehicle accident) can damage the spine and its supportive muscles, causing immediate, acute pain.
- Delayed symptoms after an injury. Sometimes, symptoms may develop or get worse a few hours or days after an accident or injury. Delayed pain is generally thought of as a side effect of the natural healing processes of muscles.
Diagnosis of Lumbar Back Pain
Although lumbar back pain is fairly common, it still warrants evaluation by a medical professional.
It is particularly crucial if you experience persistent or worsening back pain; neurologic symptoms, including weakness, numbness, or tingling; or changes in bowel or bladder function.
Diagnosis is made by a neurosurgeon based on your history, physical examination, symptoms, and results of diagnostic studies.
Some patients may be treated conservatively; if conservative treatment is ineffective, the physician may order imaging studies of the lower back and other tests, which may include:
- X-rays
- Computed Tomography Scan (CT or CAT scan)
- Magnetic Resonance Imaging (MRI)
- Electromyography (EMG)
- Myelogram
- Nerve Conduction Studies (NCS)
Treatment Options: Lumbar Back Pain Relief
Lumbar back pain relief treatment options include back exercises, weight reduction, physical therapy, steroid injections (epidural steroids), nonsteroidal anti-inflammatory medications, rehabilitation, and limited activity.
All of these treatment options are aimed at relieving inflammation in the back and irritation of nerve roots.
Physicians usually recommend 4 to 6 weeks of conservative therapy before considering surgery.
The use of certain products may also offer some lumbar back pain relief. Some of our top recommendations include:
The FEATOL back brace for men’s lower back is effective in relieving the pains caused by disc herniation, sciatica, scoliosis, and other spine problems. This lower back brace allows you to enjoy your life without the bother of lower back pain.
The ergonomic design safely supports your back. It brings acupuncture effects through deep pressing on specific acupoints and promotes circulation, helping you to relax the tension in the lumbar and back after a long day and relieve those aching muscles.
Spinal therapists recommend using heat and cold packs for therapy as the best way to reduce inflammation. The Magic Gel pad and strap provide compression designed specifically for upper and lower back injuries.
Lumbar Back Pain Relief Exercises. Aside from using these products, you can also do some exercises for lumbar back pain relief. Here are some exercises to consider:
- Stretching. Almost everyone can benefit from stretching muscles in the lower back, hips, buttocks, and legs (especially the hamstring muscles). These muscles support the weight of the upper body. The more mobile these muscles are the more the back can move without injury. Typically, it is advised to start small – stretch for 20 to 30 seconds and stop a stretch if it causes pain.
- Strengthening exercises. Strengthening the abdominal, hip, and gluteus muscles that support the spine, also called the core muscles, can help relieve lumbar back pain. Two common programs are the Dynamic Lumbar Stabilization and McKenzie Method.
- Low impact aerobics. Low-impact aerobic exercise increases the flow of blood and supports healing from an injury without jarring the spine. Low-impact aerobics can include walking, water therapy, and using stationary bikes, ellipticals, or step machines. People with low back pain who regularly do aerobic exercise report fewer recurring pain episodes and are more likely to stay active and functional when pain flares.
You may also consider massage therapy for lumbar back pain relief.
Applied to the low back, massage therapy can relieve the muscle spasms that usually contribute to low back pain.
Massage also increases blood flow to the low back, which speeds up healing by bringing nutrients and oxygen to damaged muscles.
Lumbar Back Pain Relief: When Surgery Is Necessary
When conservative treatments for lumbar back pain do not provide relief or symptoms are worsening or severe, surgery may be needed.
Some surgeries are considerably more invasive than others and include lengthier healing periods, more or less significant pain during recovery, and varying inpatient hospital stays.
However, with modern surgical approaches and an experienced surgeon, many types of spine surgery can now be done on an outpatient basis with a shorter recovery period.
Surgery options may include:
- Decompression Surgeries. A decompression surgery removes whatever is pressing on a nerve root from the spinal column, which might include a herniated portion of a disc or a bone spur. There are two primary types of decompression for low back pain: microdiscectomy or laminectomy.
Decompression surgery can be performed with minimally invasive techniques with relatively small incisions, minimal discomfort, and shorter recovery times.
Most of these procedures are now being done as day surgery or with one overnight stay.
- Lumbar Spinal Fusion Options. Removing the soft tissues between two or more adjacent vertebral bones and replacing them with bone or metal is known as fusion surgery. This procedure allows the bones to grow together over time – around 6 to 12 months – and fuse into one long bone to stabilize and eliminate motion at those spinal segments.
The recovery period after low back surgery depends on several factors, including the patient’s condition before the surgery and the extent of the surgery.
The Bottom Line
Lumbar back pain is a common condition, leading to lower productivity, missed work, and a lower quality of life.
It usually develops due to a minor injury or muscle overuse, but sometimes there may be no obvious cause.
Lower back pain can also be a symptom of an underlying medical condition.
The pain can appear suddenly or gradually and can range from a dull ache to intense, sharp pain.
In some people, the pain may be chronic.
Symptoms of lumbar back pain may include dull, aching pain; pain that comes and goes, but worsens over time; immediate pain after an injury, as well as delayed symptoms after an injury.
Lumbar back pain relief treatment options include back exercises, weight reduction, physical therapy, steroid injections (epidural steroids), nonsteroidal anti-inflammatory medications, rehabilitation, and limited activity.
The use of lumbar back pain relief products is also usually recommended.
When conservative treatments for lumbar back pain do not provide relief or symptoms are worsening or severe, surgery may be needed.
Disclaimer: The information on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. All information contained on this website is for general information purposes only.
