Pain in the lower back is a very common problem which almost everyone faces at some point in time. There are several reasons why you might be having pain in your lower back. To name a few:
- Improper posture
- Poor Heavy Lifting
- Lack of exercise
Let us look at the causes of back pain in detail
Causes Of Back Pain
Muscle/Ligament – Pulled/Torn
This is one of the most common causes of back pain in people today. A muscle/ligament pull happens when it is overstretched. It can happen suddenly or over a period of time.
Some reason why the muscles/ligaments get damaged are:
- Abrupt shift in spine due to heavy lifting
- a sudden impact on the muscle/ligament, such as an accident or fall
- Improper Posture
These pain normally go away after a period of time due to the body’s natural healing process.However,if the pain persists beyond three months,then this might be a case of chronic back pain.
Reasons which may cause chronic pain in lower back
1.Herniated Disk in the Lower Back(Lumbar Spine):
- The spine consists of 24 bones or vertebrae and the 5 vertebrae that make the lower back is called the Lumbar Spine.
- A disk is said to herniate when due to a sudden shock or gradual wear and tear its jelly-like substance pushes against its outer ring, which in turn generates its chemicals that irritate the nerves or causes inflammation.
- This may spread to both the legs and this scenario is commonly known as ‘sciatica’
- Poor Lifting Posture: Lifting heavy objects with the help of back and not the legs contributes to it.
- Excessive Driving: Staying seating in the same position puts pressure on your back
- Weight: Excessive weight puts a lot of pressure on your lower disk.
- Lack of exercise: It is very important to keep yourself mobile to avoid any kind of health issue.
- Self Diagnosis for Sciatica refers to a sudden burst of pain starting from your hips to the end of one of the legs.
- Numbness/Weakness in Leg/Foot
- Medical Diagnosis can be by getting:
- MRI done
- Neurological tests done by checking the strength of your leg muscles
- Straight Leg Raise Test
- Resting: This is the most basic treatment, you should rest and not sit in the same position for a long duration.
- Physiotherapy: Specific exercises can help you maintain a stable core and lower back
- Nonsteroidal anti-inflammatory medications (NSAIDs): These are medications/steroids that can give a temporary relief to the pain
- Epidural Steroid Injection: Again, these can help in temporary relief of short term pain.
- Microdiscectomy: This is a surgical procedure where the specific injured disk is operated through a microscope.(This should be opted after all the above non-surgical processes have not given the optimum results)
- Having a painful back exercises are important, here are some listed below:
2.Degenerative disc disease
- Intervertebral discs provide the cushioning between the vertebrae in the spine and as we age this cushioning tends to deteriorate due to wear-tear and small pressures applied over the years.
- Since the vertebrae now have less cushioning between them, it make the spine unstable.
- Against these changes the body produces bone spurs which causes pain around the spine.
- Old age is the most common cause of degenerative disc disease
- Herniated Disk as explained above
- Spinal Stenosis
- Obesity can cause this as the spine has to bear extra pressure because of the weight.
- Sudden Impact like a fall, accident
- Muscle Check: These can be done in several ways by the doctor by asking you to move in specific positions, or by checking the response by tapping a hammer.
- MRI: Imaging scans can give a proper picture of the alignment
- There are several exercises one can do to improve the stability such as walking, swimming.
- Surgery is another option if there is no improvement due to non-surgical measures. Different types of surgeries one can perform are:
- Spinal Fusion: This includes the fusion of 2 vertebrae together
- Stem Cell Therapy: Still debatable, this means reversing the degeneration process of the spine
- Decompression: Here certain parts of the joint of the discs are removed to relieve the pain.
- Here is a detailed video of exercises for back pain and degenerative disc disease
3.Facet joint dysfunction
- Each Vertebrae comprises of a 3 part system-one disk in the front and two facet joints at the back
- Facet joint helps in avoiding overtwisting and are covered with a lubricating fluid in a capsule.
- Over time, the capsule’s fluid thins and it makes a scenario of our spine which is similar to arthritis in our knees.
- This leads to a rigid movement in the facet joints which in turn causes it to become inflamed and irritated. Hence causing the pain.
Picture Source: mayfieldclinic.com
- Old age and the pressure applied on the spine over the years
- Poor Posture
- The doctor will ask you to perform certain movements to ascertain the problem
- It is very important to identify the accurate diagnosis
- MRI, Xray
- Facet Joint injections might be injected at specific joints to accurately identify the specific joint with the issue. The pain is measured before and after 20-30 minutes the procedure is performed to identify the pain source.
- Steroid Injections: These are not advisable as it has its own side effects
- Medications: Certain anti-inflammatory medicines are being used to suppress the pain
- Nerve Radiofrequency ablation: Here the nerve is stopped from sending pain signals to the brain through radiofrequency…this is a highly effective procedure where the pain can be suppressed from 9-24 months.
- Physical Exercises: It is important you take care of yourselves with different back pain exercise shown below
4. Sacroiliac joint dysfunction
- Sacroiliac(SI) Joint as the name suggests are the joints that connect the sacrum with the iliac bones, placed just below the lumbar spine.
- Similar to other issues the SI joints have cartilage on it which protects as a shock absorbent and helps in the smooth functioning of the bones.
- As the cartilage decreases, there is friction between the bones which leads to degenerative arthritis
- This is also common among pregnant women as during pregnancy the body releases chemicals which relaxes the ligaments, coupled with the extra weight and different walking pattern which puts more pressure on the SI joints
- Wear-tear like always is the reason for this lower back pain.
- Pregnancy: The SI Joints have to loosen up to accommodate the birth of the child.
- Sudden Impact: A fall or an accident can cause damage to the SI Joints.
- The usual measures are used to identify the problems areas such as
- CT Scan
- Injections with steroids and anesthetic are used to accurately identify the pain point.
- The usual measures are used to identify the problems areas such as
- Injections can be helpful in reducing the pain for a considerable period of time as stated above.
- SI Joint belts are available to stabilize the spine.
- Oral Anti Inflammatory Medications are available if the patient is advised by the doctor.
- Lastly, for back pain, exercises are very important. Here are some back exercises for pain relief for the same
- Spinal stenosis refers to the scenario in which the pain is caused by the narrowing of the space within our spine.
- Spinal stenosis is categorically divided into
- Cervical stenosis: The narrowing of the neck
- Lumbar stenosis: The narrowing of the lower back
- There is numbness in the hands, feet, legs or neck
- Problem in walking and balancing
- There is back pain
- Cervical or neck pain
- Bone Spurs: Due to osteoarthritis the spine can develop bone spurs because of wear-tear and that can cause abnormal growth of the spine
- Herniated Disks: As the cartilage wears out with age which in turn causes the cracks in disk’s material, these cracks can let the inner material to escape and push the nerves.
- Stiffness in Ligaments: The ligaments that hold your spine can sometimes become stiff
- Injuries: High impact accident or a fall can cause it
- Tumors: Tumours can form between the spinal cord and vertebrae that can cause Spinal stenosis
- Ct Scan
- Doctors can recommend painkillers or antidepressants
- Exercises to back pain is like the good guy an introvert does not want to meet, he knows the benefits, still does not want to do it.Physiotherapy can help immensely
- Chiropractic treatment
- There are some surgical ways which can be opted in for:
- Decompression: This is for people having lumbar stenosis or thick ligaments. Needle-like equipment is used to remove the excess ligament.
- Laminotomy: Only a part of the thick lamina is removed in this.
- Laminoplasty: This is a surgery performed for the vertebrae on the neck by creating a hinge on the lamina, therefore space within the spinal canal
- Here are a few exercises for Cervical and Lumbar stenosis, one of the best back pain exercises.
- Spondylolisthesis is a scenario where the lower vertebrae slips forward onto the bone below it. It is most common in adolescents and adults.
- There are different types of Spondylolisthesis which are listed as below:
- 1: This refers to people who have this disease since birth or it develops during the developmental years.
- 2: This refers to the damage to the spine which is caused by sports or an accident or microfracture due to hyperextension
- 3:Thus refers to the normal wear-tear due to aging.
- 4: This a fracture that occurs anywhere in a vertebra except in the pars interarticularis region.
- 5: These refer to the tumors that can cause pain
- 6:These refers to the tweaking of the spine due to past surgeries/surgery.
- The most common cause is impact during an activity like playing sports or lifting weights.
- It has been present since birth or developed over time
- It can happen due to aging and regular wear-tear
- CT Scan
- Anti-inflammatory Medication
- Here are some exercise for back pain that can assist in curing it:
Video Credits: AskDoctorJo
- Osteoarthritis is the most common type of arthritis. It occurs due to general wear and tear of the cartilages. As the cartilages wears down, the shock absorption also wears down, which causes pain and irritation in the joints.
- Genes: Sometimes it is in the genes that cause a defect in the cartilage. Also people born with deformities tend to hand Osteoarthritis.
- Overstressing of a joint: Long working hours in one position can overstress the lower back or it can be taken as an example for any other body part that is overstressed over a period of time.
- Obesity: As discussed earlier, the more you weigh, the more pressure is applied to the joints.
- Injury: No surprises here, any impact or injury can seriously damage the joints and cause Osteoarthritis. Also people with a history of a specific joint injury are more prone to it.
- Even blood tests are done to determine the type of arthritis
- Treatment: Although it cannot be cured but certain measures can be taken to suppress the pain to some extent
- Weight Loss can help in the suppression of the effects
- Anti-inflammatory drugs can be useful
- Thermotherapy: Cold and Hot treatment can reduce its effects
- Physiotherapy: Some exercises will be shown below
- Transcutaneous electrical nerve stimulation (TENS): This is a way where electrical pain signals are stopped from being passed to the brain.
- An ‘S’ or ‘C’ curve in the spine or any unnatural curve refers to scoliosis.
- It is mostly found in adolescents and can be caused due to neurological issues or deformity issues at birth
- A nervous system disorder-cerebral palsy can lead to scoliosis.
- Defects at the time of birth
- An accident or injury to spine or infection
- CT Scan
- Bone Scan
- Bracing: This is a method used in kids whoa re still growing, it does not cure scoliosis but helps in controlling it.
- There are a certain number of diets, exercises, physical therapy that can be applied.
- Surgery is a step that should be taken if the curve is greater than 40 degrees.
- Some back exercise for pain due to scoliosis are
9. Vertebral Compression Fracture
- Vertebral Compression fracture (VCF)refers to a scenario when one or more bones in the spine crumble
- This occurs in mostly the lower part of the spine and can lead to deformity, pain, and loss of height.
- This generally occurs in old age as the spine has been worked on throughout a long period of time due to regular usage and wear-tear.
- In a healthy spine this scenario can occur due to an accident or sudden impact/fall.
- There is a 500% chance that the same person might have a second VCF who has had it once.
- CT Scan
- Bone Densitometry
- In some cases it can heal automatically within 2-3 months, while there is a high reduction in the density of pain fairly quickly.
- Certain Medicines and muscle relaxants can be prescribed by the doctor.
- Back Bracing can help in maintaining the stability of the spine.
- Surgical procedures like
- Here are a few exercises you can do at home for
Hope we were of help!
Videos of exercise of back pain:Credits: ASK DR JO