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Low Back Pain
Low back pain is an ache or discomfort in the lower part of the spine. This area has many small bones and muscles that surround and protect the spinal cord and nerves.
|Bones of the Lower Back|
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Many things can cause low back pain. Some causes are:
This problem is more common in older adults.
General risk factors are:
- Certain activities, such as lifting, bending, or twisting
- Lack of activity
- Prior back injury
- Prior back surgery
Health problems, such as:
- Herniated disc —the cushions between the bones of the spine develop a bulge
- Degenerative diseases, such as arthritis
- Fractures due to trauma and osteoporosis
- Spinal stenosis —narrowing of the spinal canal
- Spondylolisthesis —slippage of a bone in the lower back
- Ankylosing spondylitis —an autoimmune disease involving the spine
- Cauda equina syndrome —compression of nerve roots at the base of the spinal cord
Job-related factors, such as:
- Bending, twisting, or reaching
- Heavy manual labor
Psychosocial factors, such as:
The main problem is pain in the low back. It may be worse with motion, sitting, standing, bending, and twisting. If a nerve is irritated, the pain may spread into the buttock or leg on the affected side. Muscle weakness or numbness may also occur.
When Should I Call My Doctor?
Often, back pain improves with home care. Some problems may need care right away. Call the doctor if you have:
- Severe or worsening pain
- Pain that lasts longer than one week
- Problems walking, standing, or moving
- Pain that is worse at night or when you lie down
- Pain that spreads down your legs
- Pain or throbbing in your belly
Bain pain with:
- Numbness, weakness, or tingling in the buttocks, genitals, or legs
- Loss of bowel or bladder control
- Problems urinating
- Fever, unexplained weight loss, or other signs of illness
The doctor will ask about your symptoms and health history. A physical exam will be done. The exam will focus on the back, hips, and legs.
Imaging tests are rarely needed. They may be done for pain that is severe or does not get better with treatment. They may be taken with:
Other tests may be done. It depends on what the doctor thinks may be causing the pain.
The goal of treatment is to ease pain. Choices are:
- Supportive care, such as resting the area for no more than 1 to 2 days, applying cold compresses, and avoiding things that may the pain worse
- Medicines, such as:
- Over the counter and prescription pain relievers
- Topical pain relievers that are applied to the skin
- Muscle relaxants to ease spasms
- Physical therapy to improve strength, flexibility, and range of motion
- Cognitive behavioral therapy to learn how to manage pain
There are no known guidelines to prevent this health problem. Some things that may help are:
- Exercising regularly
- Practicing good posture
- Not sitting or standing in one position for too long
- Use proper techniques when playing sports, exercising, or lifting heavy objects
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Acute low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-low-back-pain. Accessed January 28, 2021.
Chronic low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-low-back-pain. Accessed January 28, 2021.
National Guideline Centre. Low back pain and sciatica in over 16s: assessment and management. London (UK): National Institute for Health and Care Excellence (NICE); 2016 Nov 30. 18 p.
12/14/2016 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/condition/chronic-low-back-pain: Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA 2016;315(12):1240-1249.
- Reviewer: EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
- Review Date: 12/2020
- Update Date: 01/28/2021