- Low back pain
Are there different types of low back pain?<sup>1</sup>
There are two types of low back pain: acute and chronic
Acute low back pain can last for a few days to a few weeks. It usually goes away with self-care and does not cause any long-term issues. Acute low back pain is usually caused by sudden injury to muscles or ligaments that support the back (due to falls or heavy lifting).
Chronic low back pain lasts for 12 weeks or longer—even after the cause of the acute low back pain has been treated. About 2 out of every 10 people who have acute low back pain develop chronic low back pain.
What causes low back pain?<sup>1,2</sup>
There are many causes of low back pain, as well as factors that can lead to it. These include:
- Strains/Sprains: A strain is a stretched or torn muscle or tendon (tissues that connect muscle to bone). A sprain is a stretched or torn ligament (tissues that connect bones at a joint).
- Disc Degeneration: This happens when the rubbery discs in the spine lose their cushioning ability.
- Herniated/Ruptured Discs: This occurs when discs become compressed and bulge outward (herniation) or rupture.
- Sciatica: This refers to pain caused by compression of the sciatic nerve, a large nerve that runs from the buttocks and down the back of the leg.
- Spinal Stenosis: A narrowing of the spinal column that can lead to pain and numbness when walking and eventually to a loss of feeling.
- Trauma/Injury: Playing sports, falling, or being in a car accident can injure the muscles, tendons, or ligaments in the lower back. Trauma/injury can also lead to herniated or ruptured discs.
- Skeletal Irregularities: This can be due to curvature of the spine (called scoliosis) or severe arch in the lower back (called lordosis).
- Underlying Medical Conditions: This includes osteoporosis (loss of bone density and strength), endometriosis (a buildup of uterine tissue outside the uterus), and fibromyalgia (chronic muscle pain and fatigue).
What are the risk factors for low back pain?<sup>1</sup>
As people age, they lose bone strength, muscle tone and elasticity. In addition, the discs in the spine do not adequately cushion the vertebrae (bones in the spine that protect the spinal cord and nerves, and that support the body).
People who are overweight or who gain a lot of weight quickly put extra stress on the back.
Poor physical fitness
Back pain is more common in people who are not physically fit. This happens because weaker back and stomach muscles may not support the spine properly.
Doing physically demanding work
People whose jobs require heavy pushing, pulling, or lifting are at risk for back injury and pain.
Having a desk job
Sitting at a desk all day can lead to back pain, especially in people who have poor posture or whose chair does not provide enough support.
Many pregnant women have acute low back pain. This happens because of changes in the pelvis and weight distribution of the body. This type of low back pain usually goes away after child birth.
What are the treatment options for low back pain?
Acute low back pain usually gets better with an over-the-counter pain reliever to ease the pain. A healthcare provider can recommend over-the-counter medicines and a course of action, as well as the possible benefits of treatments such as heat or cold therapy and massage therapy.1
People with acute low back pain should stop their normal physical activities for the first few days, but only after talking to your healthcare provider about the specific care plan you should follow. When resuming your normal activities, slowly ease into them. For example, begin with activities like walking, riding a stationary bike, and swimming. Talk to your healthcare provider about the types of stretching and strengthening exercises that you can do for your back.2
Treatment options for chronic low back pain include:1,2,3
It’s important for some people who suffer from chronic low back pain to have a realistic expectation of the level of pain relief and activity they will get from pain management. If you have chronic low back pain, it may be helpful for you and your healthcare provider to talk about treatment goals. Be sure to review your goals periodically.4
When should someone with low back pain see a doctor?<sup>2,5,6</sup>
It may not be necessary for you to see a doctor for a minor backache right away, but you should call your doctor if:
- The pain doesn’t start to go away after 72 hours of self-care
- The pain gets worse
- You have any numbness, tingling, or difficulty moving
However, see your healthcare provider as soon as possible if your back pain is from a severe fall or injury; or if you have back pain together with trouble urinating; weakness, pain, or numbness in the legs; fever; or sudden weight loss.
- Low Back Pain Fact Sheet [Internet]. National Institute of Health, National Institute of Neurological Disorders and Stroke. 2014 [Cited 05 July 2019]. Available from https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/low-back-pain-fact-sheet#3102_4
- Low Back Pain–Acute [Internet]. National Institute of Health/U.S. National Library of Medicine. MedlinePlus. 2018 [Cited 05 July 2019]. Available from https://medlineplus.gov/ency/article/007425.htm
- Chronic Low-Back Pain and Complementary Health Approaches [Internet]. National Institutes of Health, National Center for Complementary and Integrative Health. 2014 [Cited 05 July 2019]. Available from https://nccih.nih.gov/health/providers/digest/chronic-low-back-pain
- Last AR, Hulbert K. Chronic low back pain: evaluation and management. Am Fam Physician. 2009;79(12):1067-1074.
- What can cause lower back pain? [Internet]. MedicalNewsToday. 2019 [Cited 05 July 2019]. Available from https://www.medicalnewstoday.com/articles/325381.php
- Back Pain Information Page [Internet]. National Institute of Health, National Institute of Neurological Disorders and Stroke. 2019 [Cited 05 July 2019]. Available from https://www.ninds.nih.gov/disorders/All-Disorders/Back-Pain-Information-Page