Low back pain is a common problem and a major reason for missed work, chronic pain and long-term disability. Understanding the underlying causes of back pain can help people avoid unnecessary risk factors and seek prompt treatment to minimize the impact of back pain.
What Causes Lower Back Pain?
Conditions or injuries that affect the musculoskeletal system are the most common reasons for lower back pain. A “slipped” or herniated disc can occur after an injury to the spine. Since the disc bulges, it can compress surrounding nerves or the spinal cord. When the nerves become compressed, the condition is often referred to as a “pinched nerve.” The effects of nerve compression can be mild or severe, depending on which nerve is affected. If major nerves that are responsible for motor coordination or the function of organs are compressed, paralysis or loss of bodily functions can result.
Similarly, when a herniated disc is located in the low back, the disc can compress the sciatic nerve. This is the major nerve leading from the lower back to the feet. In addition to back pain, sciatica causes pain and numbness that can affect one or both of the lower extremities. Some forms of inflammatory arthritis that affect the spine or spinal stenosis can cause compression of the sciatic nerve. Low back pain with nerve involvement often benefits from epidural steroid injections. Steroid injections allow for direct placement of medication to reduce pain and inflammation.
Acute back injuries from falls or automobile accidents, or injuries caused by heavy lifting are contributing factors for back pain. Overuse of the back muscles from repetitive lifting or sudden movements that cause hyperextension can cause muscle strain, which can affect the muscle itself or tendons. Milder strains may present with soreness and muscle pain, while substantial injuries can cause muscle spasms. Although muscle spasms are usually attributed to injury or tension, underlying problems with erratic nerve signals can cause spasms.
Due to the location of the reproductive organs in women, many common gynecological concerns can present with pain in the lower back. Women who experience painful and heavy periods often have back pain in addition to abdominal cramps, especially in women who have a uterus that tilts toward the back. Unexplained back pain is often the first sign in conditions that specifically affect the ovaries such as cysts, ovarian cancer or polycystic ovarian syndrome.
Significant low back pain during the early stages of pregnancy can be an indicator of an impending miscarriage or ectopic pregnancy. During the last trimester of pregnancy, back pain is a common problem because the fetus is rapidly growing larger, and the weight is concentrated in the abdominal region, adding strain to the low back. Maternity belts can be helpful by providing back and pelvic support. As a woman nears the end of her pregnancy, experiencing “back labor” is not uncommon and can be the first signs that contractions will begin.
Stomach and intestinal irritation are concerns that most people will experience and can be an underlying cause of sudden back pain. The buildup of gas, often from lactose intolerance or eating gas-producing foods such as beans, characteristically causes abdominal pain, which can radiate to the back. Typically, the pain comes with sudden bloating and fullness, even nausea and diarrhea. Once the gas is expelled, the severity of the pain will subside.
Chronic or severe constipation can produce substantial pain and bloating. As waste stays inside the intestines and hardens, it causes the intestines to become distended. This increases pressure in the abdominal cavity, which can result in back, stomach and pelvic pain.
Other Serious Illness
Since there are many organs that are located in the abdominopelvic cavity, problems with chronic back pain can be a primary or secondary feature of serious conditions. Urinary conditions such as kidney stones or bladder infections may radiate pain to the lower back. Although uncommon, conditions such as pancreatic cancer will cause back pain as the tumor progresses. Pain in cancerous or benign inflammation of the pancreas is not the only symptom. Nausea, light-colored stool and stomach pain are common symptoms that occur when the pancreas is affected.
How to Alleviate Low Back Pain Naturally
Heat can quickly alleviate back pain, especially when the pain is from spasms or sore muscles. The easiest way to incorporate heat therapy is during a bath or shower. Soaking in a warm bath or allowing hot water from the shower to run on your back can help soothe the area. A heating pad can be used while seated or lying down and give the person an opportunity to rest their back while reducing pain.
Pain that is more consistent can benefit from heat wraps. The wrap stays warm for several hours and can be worn while at work or during activities. Some people find that the consistent use of heat throughout the day allows them to prevent limitations from back pain.
Anti-Inflammatory and Pain-Relieving Foods, Herbs and Supplements
There are many ways to incorporate natural products into your life that can help reduce inflammation and pain. Some people choose to adhere to an anti-inflammatory diet. In addition to reducing pain, anti-inflammatory diets eliminate processed and high-fat foods that are generally unhealthy. Eating lean proteins, especially fish, vegetables and whole grains can reduce inflammatory-based back pain caused by arthritis or irritated nerves.
Adding fish oil supplements is another natural method of reducing pain. Fish oil is high in Omega-3, and when taken on a regular basis can be especially beneficial to people with chronic pain. Ensuring that your vitamin intake is adequate can be important. Even with a proper diet, having the right levels of essential vitamins can be difficult. Adding a daily multivitamin is important for adequate levels of vitamin D, calcium and micronutrients that are essential to maintain a healthy musculoskeletal and nervous system.
Most people may not consider eating spicy food as a way of reducing back pain. However, the chemical component that makes peppers and herbs spicy also reduces pain. Incorporating curry, ginger and peppers into your diet can act as nature’s pain reliever. If you do not enjoy spicy foods, consider trying ginger tea or looking for mild peppers. Cayenne powder can be taken in pill form, which can be easier for some people to consume.
Relaxation and Massage
The impact of stress, anxiety and depression on the back cannot be understated. Daily stress and worry can often manifest as back pain because it causes the muscles to tense and spasm. Learning relaxation techniques can improve many forms of back pain, especially when the cause is not completely physical. Various forms of yoga incorporate breathing techniques in addition to improving flexibility. Listening to meditation tapes that are designed to help people learn to relax their muscles and decrease stress is another helpful relaxation technique.
Therapeutic massage can reduce muscle tension and strain on nearby nerves. The combination of physically manipulation of the back muscles and the mental aspects of massage can reduce pain and stress. If routine massages are not possible, investing in a massage chair or pad can be equally effective.
How to Prevent Lower Back Pain
People who have excess body weight, especially around the abdomen, can be more vulnerable to back pain and injuries. A larger stomach adds strain to the spine and back muscles. People who experience chronic back pain and are overweight may notice a dramatic difference in pain, even with small decreases in weight. Back pain can be a contributing factor in limiting activities. Starting slowly by going for a walk or participating in water aerobics, can help burn calories while limiting the direct impact on your back.
When possible, avoid lifting heavy objects and make use of dollies or ask for assistance. Improper lifting techniques can easily cause unnecessary back injuries. When lifting an object from the floor, you should squat and use your leg muscles to help with lifting. This minimizes the need to bend over at the waist and hyperextend the back muscles. Stretches before lifting can help loosen the back muscles. You should slowly bend forward and to each side to target the major muscles in your back and the sides of your abdomen.
Do not neglect the impact of a heavy purse or backpack. Many people carry around unnecessary items, which increase the strain on their back. Switching to a smaller bag will encourage you to bring essential items. When you must carry a heavy bag, changing the type of bag is equally important. Rolling bags have the least impact on the back muscles. However, backpacks worn by using both shoulder straps for equal weight distribution can reduce back strain. Women who carry heavy purses should consider styles that provide the best weight distribution across their body, such as messenger bags.
People who work in industries that require heavy lifting need to consistently wear back support. Supportive devices encourage proper lifting techniques, while engaging the core muscles. Back support is not limited to employment. Abdominal belts and corsets are commonly used by people during exercise, working at the computer or performing daily activities. People who have a previous back injury should be more vigilant about wearing back support. A previous injury can make the muscles and tendons in the back weaker, and more vulnerable to repetitive injuries.
Exercise and Strength Training
Engaging in a regular exercise program is one of the easiest ways to help prevent back pain. Strengthening the muscles of the back and abdomen will improve posture and reduce the likelihood of acquiring injuries from work and other daily activities. Exercises such as planks and stomach crunches help strengthen core muscles. Adding weights or resistance bands while doing core exercises can improve the effectiveness of exercises.
Of equal importance is the shoes you wear while you exercise. People who run or engage in other high-impact activities should have a professional fitting for athletic shoes. Shoes that fit well, and are designed to absorb some of the shock as your foot hits the ground, can lessen the amount of wear and tear on your back and joints.
Ergonomically designed chairs and desks are helpful in preventing back pain in people who frequently work at the computer. A proper desk chair is designed to follow the natural contours of the spine and provide adequate support from the neck to the lumbar area. Ergonomic chairs encourage the person to sit up straight. The height of the chair can be adjusted to accommodate different desks while ensure the person’s feet rest appropriately on the floor.
Your desk should be at an appropriate height that allows you to sit comfortably and not hunch forward to work. Using a standing desk is another alternative. Standing while working encourages good posture and helps strengthen both the back and abdominal muscles, because they are constantly engaged. The computer monitor should large enough and located at a height that makes viewing easy when sitting or standing.
Back support while sleeping is often overlooked, but many people wake up with back pain. The average person spends several hours each day in their bed and inadequate back support from a low-quality or old mattress can cause problems. The right mattress is often a matter of personal preference, but mattresses that are very soft or firm are both problematic. When a mattress is too soft, it provides inadequate back support, although it may feel comfortable initially. Highly firm mattresses are unable to mold to the contours of the body and can create uncomfortable pressure points.
Memory foam mattresses are a popular choice for the combination of comfort and support. When you lay down, the foam cradles the body and eliminates the pressure that can come from traditional innerspring mattresses. Mattress pads made from memory foam can be used on top of innerspring mattresses as an inexpensive alternative to purchasing a new mattress. Your mattress should be replaced every eight years and rotated frequently to allow the mattress to wear evenly. If the mattress springs begin to poke through the mattress or the foundation slats break, the mattress should be immediately replaced.
People who sleep on their side should consider using a pillow that is placed between the legs if they notice back pain. The pillow keeps the legs slightly apart and in a natural alignment, reducing back strain while sleeping. A roll pillow can be helpful for people with back problems who prefer to sleep on their back. The added support to the lumbar area can make resting more comfortable.
When Should I Visit a Doctor for Low Back Pain? and What Kind of Doctor Should I See?
Any instance of severe back pain should be promptly evaluated in an urgent care setting or emergency room. Pain with neurological symptoms such as numbness, tingling, or loss of bowel or bladder control signals nervous system involvement and requires medical intervention to avoid permanent damage. Back pain with nausea, vomiting, fever or unexplained bleeding should be considered an emergency.
Mild to Moderate Pain Lasting More Than a Few Days
Any mild or moderate back pain that is not alleviated with rest and at-home therapy warrants a visit to your primary care doctor. Your doctor can evaluate the location of the pain, whether it is primarily in the low back or is radiating from other areas, in addition to other symptoms. It is not uncommon for the doctor to want additional tests such as a urinalysis, blood tests and a pregnancy test for women. The results of laboratory tests can help determine if specific organs are contributing to back pain.
Diagnostic imaging is important in determining the underlying cause of back pain. X-rays can be used to identify many musculoskeletal conditions. When a doctor suspects conditions that affect the organs of the abdominopelvic region, a CT scan with contrast can help identify tumors or abnormalities.
Your doctor will make referrals based on the information from tests and imaging results. People who experience chronic back pain are often referred to a chiropractor. The use of chiropractic medicine can offer substantial advantages to people who do not achieve adequate relief from other forms of treatment.
Chiropractors use manual manipulation of the spine to improve alignment. A poorly aligned spine is a common underlying cause of back pain. With regular adjustments, people with chronic back pain often notice a decrease in their pain and find their pain is manageable without the use of medication or surgery.
There are various conditions that can contribute to low back pain, which can make problems difficult to diagnose. Seeking prompt medical care from an emergency room or your primary doctor can help determine if the underlying condition is serious, or will resolve with at-home treatment. Many routine back problems can be prevented or minimized by being proactive and avoiding high-risk activities that impact your back.
If back pain occurs, consider dietary and lifestyle changes in addition to natural treatments. Simple changes to your lifestyle and the way you perform daily activities can minimize pain, and reduce the likelihood of subsequent injuries.