13. Sprains and Strains
Sudden, acute low back pain is most often caused by sprains and strains.
How can someone strain or sprain their back?
This type of acute low back pain tends to be mechanical in nature and involves a disruption in how the spine, nerves, muscles and intervertebral discs work together and move. That means that back strains can occur when the muscles, ligaments, or tendons in the lower back tear.
Some ways these injuries occur include:
- Overstretching
- Lifting something that is too heavy
- Lifting with improper technique
- Twisting too suddenly
How long does the pain last?
This type of pain tends to only last a few days or a couple of weeks, depending on the severity of the injury.
How is this pain managed?
While this type of injury can be painful, with a little self-care it usually resolves itself and tends not to result in any long-term loss of function. In most cases, the person can simply take some pain killers and rest their back for a few days.
When should someone see the doctor?
If pain is so severe that it impedes daily life or it doesn’t go away, though, it’s time to see a doctor. This next condition also often requires medical attention for resolution…
12. Intervertebral Disc Degeneration
Intervertebral disc degeneration is a common cause of back pain. In fact, some estimate that it affects roughly 5% of the U.S. adult population each year.
How does it happen?
It takes place when normally rubbery discs in the spine begin to lose their flexibility and integrity as people age.
Namely, when the back is young and healthy, the intervertebral discs are spongy and flexible. These qualities support someone’s full height and allow the lower back to bend, flex, and twist freely and painlessly.
As the person ages, however, these discs begin to deteriorate. This deterioration means less flexibility and less cushioning for the joints in the back. The result? A drop in height, a decrease in flexibility, and pain.
When does it happen?
Intervertebral disc degeneration takes place over a long period of time; it is not a sudden condition that develops overnight.
Who is at risk?
Risk factors for this condition include:
- Being overweight or obese
- Aging
- Living a sedentary lifestyle
How is this condition managed?
Common treatments for this type of lower back pain includes:
- Losing weight
- Doing occupational therapy
- Attending physical therapy
- Practicing special exercises
Pain relief may come in the form of:
- Medication
- Injections of local anesthetics
- Steroids
- Surgery
Feeling pinched?
It’s not just discs that can cause pain. Sometimes all it takes is a pinched nerve…
11. Radiculopathy (Pinched Nerve)
Radiculopathy is the medical term for a pinched nerve or, more specifically, a disease that affects a nerve’s root.
How does a pinched nerve cause pain?
This condition occurs when a spinal nerve root is injured, inflamed or compressed. This results in pressure on the spinal nerve root. The result? Numbness, pain, or a tingling sensation, all of which can radiate to the different places.
How do nerves become pinched?
Causes of radiculopathy (specifically, the compression of the nerve root) include:
- Spinal stenosis (narrowing of the spinal canal)
- Herniated discs bulging and rupturing
- Tumors
How is this condition managed?
There are a number of treatments available to people suffering with radiculopathy. They include:
- Nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen)
- Corticosteroids (oral or injection)
- Physical therapy exercises
- Immobilization of the affected area
- Specialized stretches
- Orthopedic surgery
- Carpal tunnel surgery
More nerve pain to follow.
The next condition also involves nerve pain…
10. Sciatica
Sciatica refers to pain resulting from the pinching of the sciatic nerve, which runs along the lower back down the backs of both legs.
How does the pinching happen?
There are several ways the sciatic nerve can become pinched. They include:
- When a disc or bone in the spine dislocates
- When a cyst or tumor emerges and presses on the nerve
How common is sciatica?
This condition is incredibly common. In fact, some estimate that 40% of people can experience sciatica at some point in their lifetime. In the United States, over 3 million people are estimated to suffer from this condition on an annual basis.
What does sciatica feel like?
This condition results in:
- A burning sensation
- Shock-like pain
- Numbness
- Weakness
These sensations typically occur on one side of the body in the lower back, buttocks, leg, and sometimes the foot.
How is sciatica managed?
There are several effective therapies for relieving low back pain caused by sciatica.
- Cold pack and ice packs
- A few days of rest on a firm surface
- Stretching
- Exercise
- Physical therapy to improve posture
- Massage
- Yoga
- Acupuncture
- Medications like ibuprofen, aspirin, naproxen, acetominophen
- Muscle relaxants
- Tricyclic antidepressants
- Anti-seizure medications
- Steroid injection
- Surgery (last resort)
Not all lower back pain is caused by something as specific as sciatica.
Sciatica is an incredibly specific cause of back pain, unlike the following…
9. A Traumatic Injury
An injury is the most obvious cause of back pain, whether it be from a car accident or sports collision.
What do traumatic injuries commonly cause back pain?
Every traumatic event will be different, which means each injury can be different and cause pain in different ways. However, impact injuries commonly cause the following pain-related issues:
- Herniated or ruptured disc
- Dislocations that result in pinched nerves
- Inflammation
- Irritation and compression of spinal nerves
- Tearing of ligaments, muscles, and tendons
The pain from these injuries can make it difficult to walk, twist, or simply get out of a bed.
How are these injuries managed?
Treatments for traumatic injuries to ligaments, muscles, and tendons resulting in low back pain can vary widely depending on their severity.
For minor injuries, the following may help:
- A few days of rest
- Ice packs followed by heat rubs
- Compression wraps
- Over-the-counter pain relievers
More severe injuries may require:
- Stronger medications
- Physical therapy
In the most severe cases, the person may need surgery.
Unfortunately, the next cause of back pain is incredibly difficult to manage…
8. Skeletal Irregularities
Skeletal irregularities simply refer to abnormal curves and positioning of the skeleton. Those that affect the spine can result in back pain.
What are some types of skeletal irregularities?
There are a number of skeletal irregularities that can cause low back pain. They include:
- Scoliosis, an unusual curvature of the spine
- Lordosis, a low back arch that’s abnormally accentuated
- Spinal arthritis, swelling and pain in the back bones
- Facet joint syndrome, painful and swollen facet joints
- Kyphosis, a curved spine
- Congenital (at birth) spinal abnormalities
What is the pain like and when does it occur?
These conditions tend to cause mild or moderate low back pain. This pain can become more pronounced as people age, they become more sedentary, or certain joints and cartilage break down. For congenital cases, however, the pain-causing conditions are present since birth.
How are these irregularities managed?
Physicians have a number of ways that they commonly treat low back pain. These treatments will vary on the specific type of abnormality is present. Often, though, treatment includes:
- Manual therapy
- Nonsteroidal anti-inflammatory medication
- Special exercises and stretching
- Physical therapy
- Massage
- Acupuncture and acupressure
- Injections
Treatment widely varies.
Since the causes of skeletal irregularities vary, their treatments vary. The same is also true of the following pain-causer…
7. Infections
Infections are another reason people sometimes suffer from lumbar pain. This is particularly true when the infections involve the vertebrae.
What types of infections cause back pain?
Bacteria and fungal organisms usually cause these types of infections, which can be in the vertebral column, spinal canal, intervertebral disc space, or even the adjacent soft tissues. Specific infections that can cause severe pain in the back include:
- Osteomyelitis (infection of the bone)
- Discitis (infection of the intervertebral disc space)
- Sarcoilitis (affects the sacroiliac joints that connect the spine to the pelvis)
How are these infections managed?
Finding pain relief will mean treating the underlying infection. That means treatment will vary depending on what the infection is. For minor cases, simple painkillers may help. In other cases, treatment could mean antifungal therapy or intravaenous antibiotics.
For severe cases, the following might be in order:
- An extended hospital visit
- Rest and immobilization, if the spine can become unstable
- Antibiotic administration
- Surgery
While surgery is typically needed in only the most severe cases here, that cannot be said of the following, where an immediate hospital room visit is necessary…
6. Cauda Equina Syndrome (CES)
Another serious condition that can cause pain in the lower back is cauda equina syndrome (CES). This rare condition means there is damage to the cauda equina, a nerve bundle under the spinal cord’s end.
What causes CES?
Commonly, a herniated disc is to blame. Specifically, when a disc in the lower back herniates, it thereby pushes itself into the spinal canal. This movement can compress various nerve bundles and nerve roots in the lumbar area.
What does CES feel like?
Besides low back pain, CES can also cause there to be radiating pain down the legs. The pain can be so severe that people lose control of their bladder and bowels. In some cases, the anus may also numb.
What are the complications of CES?
If left untreated, CES can lead to permanent damage. This permanent damage can include:
- Sexual dysfunction
- Numbness
- Bladder and bowel problems
How is CES managed?
Surgery is needed right away.
When does the surgery happen?
Most surgeons recommend proper surgery within 8 hours of symptoms beginning. However, most cases do not lead to permanent damage as long as surgery occurs within 48 hours of symptom onset.
What is the surgery like?
The aim of surgery is decompression, to reduce or eliminate pressure on the nerves in the back. The most common surgical procedure is a lumbar laminectomy, which removes part of a vertebral bone. Although, sometimes a lumbar microdiscectomy is necessary, which is a removal of the material that causes the pressure.
In the following, the root cause of back pain absolutely must be eliminated…
5. Kidney Stones
People who have kidney stones often experience sharp pain in their lower back. About 10% of Americans, primarily men, develop kidney stones and the resulting lower back pain at some point during their lives.
How do kidney form?
Kidney stones are the result of crystallization, or crystal formation. Specifically, they occur when there is a concentration of crystallizing substances—like calcium or uric acid—in the urine.
How do kidney stones cause pain?
Lumbar pain can occur when these stones migrate to the urinary tract or bladder. There, they can cause discomfort or even block the ureter, the narrow duct that connects the kidneys to the bladder.
What is kidney stone pain like?
These stones can cause mild to severe back pain, depending on their size. The pain tends to be slightly to one side or the other.
How are kidney stones treated?
The treatment for kidney stones and the lower back pain they can cause varies depending on the severity of the problem.
For mild cases, simple treatment can result in the problem resolving in a week or two. This treatment includes the following:
- Drinking lots of fluids
- Taking over-the-counter (OTC) medications for pain
- Getting a prescription for pain medications
People with large kidney stones may need more intense treatment, which can include:
- Shock-wave lithotripsy
- Ureteroscopy (to find the stones)
- Laser treatments
These treatments allow the kidney stones to break into small enough parts that the person can pass them on their own.
Surgery is sometimes the only option.
Abnormally large stones, however, may require removal surgery. The following cause of lower back pain may also need surgery…
4. Abdominal Aortic Aneurysms
Those who think they are experiencing an aneurysm should seek emergency medical attention right away.
An abdominal aortic aneurysm is another cause of low back pain. This condition develops when there is an enlargement of the big blood vessel (aorta) supplying blood to the pelvis, abdomen, and legs. This enlargement occurs as the artery walls weaken.
What are the complications of an aortic aneurysm?
Back pain is a sign that the aneurysm is becoming very large and should be assessed for the risk of rupture. At this point, life-saving emergency surgery is needed. That is why it is important to pay attention to sudden, severe back pain, as back pain is one of the few signs of this type of aneurysm.
Who is at risk?
Abdominal aortic aneurysms tend to happen to:
- People over age 65
- Men
- Cigarette smokers
How is this condition managed?
There are two primary ways to treat abdominal aortic aneurysms.
Option #1
This solution is for when the problem is identified early enough and it is at low risk of rupture. Typically, lifestyle changes may help. These changes can include:
- Quitting smoking
- Eating a healthy diet
- Exercising regularly
- Taking medications to reduce blood pressure and cholesterol levels
- Professional monitoring of the artery’s size and potential growth every 6-12 months via ultrasound
Option #2
This option is for extreme cases where rupturing occurs. In this instance, immediate surgery is the only safe solution.
While this condition primarily affects men, the opposite is true of the following…
3. Osteoporosis
This metabolic bone disease is characterized by progressive deterioration of bone density and strength. This deterioration can lead to painful vertebrae fractures and chronic low back pain.
How exactly does this condition cause lower back pain?
It’s not the osteoporosis itself that causes back pain, but its complications. Specifically, this condition means bones become fragile and weak. In and of itself, this weakening is not painful. However, the weakening can lead to painful problems.
For example, bones can break down much faster than they can reform. Fractures are common. One particularly painful fracture that can occur is spinal compression fracture, or when the spine is too weak to support itself and subsequently fractures in certain areas.
Who is at risk?
- Sex: Women are more likely to develop this condition.
- Age: Women aged 50 and up are more likely to develop osteoporosis.
- Hormonal changes: Postmenopausal individuals are at greater risk.
- Size: Those with smaller frames are more likely to suffer from this condition.
- Race: Those who are white or of Asian descent are at the greatest risk.
- Family history: Those with a family history of this condition are at greater risk.
How is this condition managed?
The most effective treatments for osteoporosis involve medication that slows down the rate at which bones break down and speeds up bone formation.
This medication is paired with lifestyle changes. These changes can include:
- Eating diets rich in protein, calcium, and vitamin D
- Exercising regularly for flexibility and strength
- Getting hormone therapy
People experiencing low back pain because of vertebral fractures are often candidates for kyphoplasty or vertebroplasty surgeries.
While osteoporosis is a specific cause of back pain, the following is an umbrella condition that can affect people of any age…
2. Inflammatory Diseases
Another cause of low back pain? Inflammatory disease.
What are some inflammatory diseases that cause lower back pain?
Some conditions that may generate or worsen lower back pain include:
- Osteoarthritis
- Rheumatoid arthritis
- Ankylosing spondylitis (AS)/Bechterew’s disease (a specific type of arthritis)
- Inflammatory bowel disease
How do these conditions cause pain?
Conditions that cause swelling and inflammation of the joints can naturally generate pain. When localized in the back, it can cause lumbar pain.
Other inflammatory conditions that don’t affect joints can also affect the back. This pain is often the by-product of swelling that presses down on organs, joints, and soft tissues. When these conditions limit mobility, the pain can worsen.
How are these conditions managed?
Treatment for osteoarthritis, rheumatoid arthritis, spondylitis, and other inflammatory diseases include:
- Rest
- Medication
- Exercise
- Surgery
Some of the medicines commonly prescribed for inflammatory diseases include:
- Nonsteroidal anti-inflammatory drugs
- Corticosteroids
- Antimalarial medications
- Disease-modifying antirheumatic drugs
- Biologic drugs
In many cases, changes to diet and adding supplements may help. Dietary supplements that may help include:
- Fish oil
- Curcumin
- Lipoic acid
- Spices like cayenne pepper, ginger, and garlic
Eating foods high in polyphenols and antioxidants can also help. Some of these foods include:
- Olive oil
- Leafy greens
- Tomatoes
- Fatty fish
- Nuts
- Fruits
Foods to avoid include:
- Refined carbohydrates
- Fried foods
- Red meat
- Processed meat
Back pain caused by inflammatory bowel disease may be helped by getting proper medical attention and avoiding the following:
- Alcohol
- Caffeine
- Dairy products
- Refined sugars
- Spicy food
Hard-to-spot causes?
Inflammatory diseases are relatively easy enough to diagnose, unlike the following condition…
1. Fibromyalgia
Fibromyalgia is a disorder where someone experiences pain and tenderness all over the body. It also often causes fatigue as well as issues with sleep, mood, and memory.
What is fibromyalgia?
Specifically, fibromyalgia is a health disorder called a central hypersensitivity syndrome. This condition simply means that the central nervous system—which controls pain—is overly sensitive, activating much more frequently and oftentimes more severely than what is considered normal.
What’s the link between fibromyalgia and lower back pain?
About 66% of people with fibromyalgia have chronic low back pain. In fact, the two are so closely linked that many doctors consider back pain when making a fibromyalgia diagnosis.
What causes firbomyalgia?
The truth is that no one knows exactly why this condition occurs. However, there do seem to be common triggers for it. These triggers can include:
- Psychological trauma
- Infection
- Injury
- Surgery
How is fibromyalgia managed?
Treating fibromyalgia and the associated back pain and tenderness usually requires a comprehensive pain management plan. This plan can include:
- OTC medications
- Prescription medication
- Mental health services
- Acupuncture
- Dietary changes
- Maintaining a healthy weight
- Exercise
- Physical therapy
- Education about the condition
What’s next?
When living with back pain, it’s important to remember…
Living With Back Pain
Millions of people will experience lower back pain in their lifetimes. Those pains can range from mild to moderate to severe. While back pain itself can be a serious and debilitating condition, it can also be a symptom of something else.
How is back pain treated?
Treatment for back pain naturally varies based on the individual and what is causing them pain. For example, the treatment for a strain is different than that of kidney stones. What’s most important whatever the cause may be is to seek medical attention when necessary.
When is a doctor necessary?
People who find themselves experiencing chronic, unexplained back pain or sudden and severe pain should not just take a painkiller and carry on. Instead, they should take the time to see a doctor to make sure their back pain isn’t due to a serious injury or illness.
Those who are unsure if their pain warrants a doctor’s visit should play it safe and seek professional help. After all, left untreated, some of these conditions can result in permanent injury or even death.
