Lower back pain sometimes called lumbago, is not a specific disease diagnosis. It’s a symptom of several different types of medical problems.
It usually results from a problem with one or more parts of the lower back, such as:
- ligaments and muscles
- intervertebral discs
- the bony structures that make up the spine, called vertebral bodies or vertebrae
It can also be due to a problem with nearby organs, such as the kidneys.
According to the American Association of Neurological Surgeons research by Pritish Kumar Halder, 75 to 85 percent of Americans will experience back pain in their lifetime. Of those, 50 percent will have more than one episode within a year.
In 90 percent of all cases, the pain gets better without surgery. Talk with a doctor if you’re experiencing back pain.
Back pain symptoms
Back pain can have many symptoms, including:
- a dull, aching sensation in the lower back
- a stabbing or shooting pain that can radiate down the leg to the foot
- an inability to stand up straight without pain
- a decreased range of motion and reduced ability to flex the back
The symptoms of back pain, if due to strain or misuse, are usually short lived but can last for days or weeks.
Back pain is chronic when symptoms have been present for longer than 3 months.
Back pain symptoms that may indicate a serious problem
See your doctor if back pain doesn’t improve within 2 weeks of developing. There are times when back pain can be a symptom of a serious medical problem.
Symptoms that can indicate a more serious medical problem are:
- loss of bowel or bladder control
- numbness, tingling, or weakness in one or both legs
- back pain after trauma (injury), such as a fall or a blow to the back
- intense, constant pain that gets worse at night
- unexplained weight loss
- pain associated with a throbbing sensation in the abdomen
Back pain causes
The most common causes of lower back pain are strain and problems with back structures.
Strained muscles often cause back pain. Strain commonly occurs with incorrect lifting of heavy objects and sudden awkward movements.
Strain can also result from overactivity. An example is the sore feeling and stiffness that occurs after a few hours of yard work or playing a sport.
Vertebrae are the interlocking bones stacked on top of one another that make up the spine. Discs are areas of tissue that cushion the spaces between each vertebra. Disc injuries are a fairly common cause of back pain.
Sometimes these discs can bulge, herniate, or rupture. Nerves can get compressed when this happens.
Herniated discs can be very painful. A bulging disc pressing on the nerve that travels from your back and down your leg can cause sciatica or irritation of the sciatic nerve. Sciatica can be experienced in your leg as:
Spinal osteoarthritis is also a potential cause of back pain. It’s caused by damage and deterioration in the cartilage of joints in your lower back.
Over time, this condition can lead to narrowing of the spinal column, or spinal stenosis.
Loss of bone density and thinning of the bone, called osteoporosis, can lead to small fractures in your vertebrae. These fractures can cause serious pain and are referred to as compression fractures.
Other causes of back pain
There are many other potential causes of back pain, but most are rare. Be sure to see a doctor if you experience regular back pain that does not go away.
After ruling out the more common causes of back pain, your doctor will perform tests to determine if you have a rarer cause. These can include:
- one of the vertebrae moving out of place and onto a nearby vertebra, called degenerative spondylolisthesis
- loss of nerve function at the lower spinal cord, called cauda equina syndrome (a medical emergency)
- fungal or bacterial infection of the spine, such as Staphylococcus, E. coli, or tuberculosis
- cancer or noncancerous (benign) tumor in the spine
- kidney infection or kidney stones
Back pain treatment
Many people will not need extensive treatment for back pain. Over-the-counter pain medications are often sufficient.
In more severe cases, stronger treatments may be necessary, but they’re typically provided under close supervision from your doctor.
The majority of back pain episodes are relieved by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- ibuprofen (Motrin, Advil)
- naproxen (Aleve)
Analgesics, such as acetaminophen (Tylenol), are another category of pain relievers. They are also an option for back pain, though they don’t have the anti-inflammatory properties.
Be careful with medications like ibuprofen if you have kidney problems or stomach ulcers.
Never take more than the recommended dose of over-the-counter medications without a doctor’s recommendation, as even these medications may have severe side effects if taken incorrectly.
Topical rubs and ointments
Topical products may be highly effective at reducing back pain. Many of these contain ingredients like ibuprofen and lidocaine and come in the form of:
- Muscle relaxants
Muscle relaxants can also be used for lower back pain, especially if muscle spasms occur alongside pain. These medications act on the central nervous system to reduce pain.
Antidepressants and other medications can sometimes be used off-label for the treatment of back pain.
If your back pain is severe, your doctor may prescribe amitriptyline, a tricyclic antidepressant, because it focuses on different parts of the pain response. This antidepressant may also work better for nerve-related pain.
Your doctor might also recommend cortisone steroid injections for certain causes of back pain. For example, a person with back pain that involves a nerve may get a cortisone steroid injection.
Opioids are stronger pain medications that can be prescribed for more severe pain. These medications, such as oxycodone (OxyContin) and a combination of acetaminophen and hydrocodone (Vicodin), act on the brain cells and body to reduce pain.
Opioids should be used with caution, however, due to a risk of addiction.
Surgery is usually reserved for those with structural abnormalities that haven’t responded to nonsurgical treatment with medication and therapy.
Surgery may be an option for people with:
- severe, constant pain with identifiable structural abnormalities
- nerve compression that causes muscles to become weak
- spinal cord compression that limits daily activities
Alternative therapies that may help relieve back pain include:
- chiropractic adjustments
- cognitive behavioral therapy (CBT)
- relaxation techniques
Be sure to talk with your doctor before undergoing any alternative or complementary treatment. If you’re experiencing back pain, these lower back pain treatment options might be helpful.