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Lower Back Pain

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What is Lower Back Pain?

What is Lower Back Pain?

Lower back pain, also called low back pain, originates in the lumbar region of the spine or the part of the back that starts below the ribcage. About 72 million people living in the U.S. currently suffer from lower back pain. 

Usually, the most common cause of lower back pain is a lumbar strain that results from injury to the muscles and ligaments in the back that support the spinal column. Activities like incorrectly lifting heavy objects or performing an exercise incorrectly dramatically increase the risk of pain in the lower back region. 

Another common cause of lower back pain is lumbar spine osteoarthritis, resulting in long-term wear and tear on spinal disks. This painful condition causes stiffness, making stooping, bending, and twisting very difficult. 

Types of Lower Back Pain

Types

There are three primary forms of lower back pain. Once your healthcare provider determines which of the three types of lower back pain you’re currently suffering from, proper treatment will follow.

  • Non-specific muscular pain: This type of lower back pain is the most common cause of back pain. One primary symptom is non-specific and intense pain in the lower back muscles. Causes include: twisting, lifting, and other movements that stress the lower back. 
  • Muscle spasms: The result of involuntary muscle contraction in the back. Muscle spasms result from bending or lifting heavy items.
  • Radicular pain:  A type of lower back pain caused by either a degenerating disc or pinching of one or more nerves in the back.
  • Sciatic Nerve Pain: Caused by pain affecting the sciatic nerve, a large nerve that runs from the lower back down the back of both legs. Pain associated with sciatica can be severe enough to cause leg weakness or even bowel or bladder changes, requiring surgery.

What Causes Lower Back Pain?

Causes

Eighty percent of people will experience lower back pain at some point. Lower back pain is often characterized by the time it may take. Acute lower back pain is sudden and short-lived. Subacute lower back pain may come and go based on activities. Chronic lower back pain can persist over a longer period.

  • Acute lower back pain usually occurs suddenly and may last up to a month
  • Subacute lower back pain may last between 4 and 12 weeks
  • Chronic lower back pain lasts more than 12 weeks

Lower back pain can also be characterized by where it is experienced and the pain severity. The pain may be limited to one back area or radiate into the hips, buttocks, and legs. Lower back pain can range from mild to debilitating and vary from person to person.

Lower back pain is a leading cause of disability and absenteeism from work and can interfere with your ability to enjoy your daily activities. Learning what is causing it is one of the first steps toward successful lower back pain management.

Strain, tension, and injury

Many cases of lower back pain are caused by forces that can stress the muscles, ligaments, and discs, such as:

  • Muscle stress and strain. This discomfort may result from poor posture, obesity, weak muscle tone, not lifting correctly, or overuse. Picking up a heavy object incorrectly just once can cause acute lower back pain. Heavy physical labor on a regular basis, sitting at a desk all day or bending over a workspace and even caring for a small child can result in muscle strain.
  • Accidents. An injury sustained during sports, a fall, or a car accident can cause lower back pain.

Spine conditions affecting the lower back

In some people, lower back pain is caused by certain lumbar spine conditions. Treating the condition can relieve the discomfort. These medical conditions may include:

  • Disc degeneration in the lumbar spine can occur with normal aging, the discs in the lower back tend to wear out, and joints and muscles can lose their ability to extend and contract as well as they used to.
  • Compression fractures in the lumbar vertebrae from trauma or due to osteoporosis in older adults.
  • Spinal deformity. A curve in the spine creates muscle imbalances and places stress on spinal structures.
  • Spondylolisthesis, where one of the vertebrae in the spine slips out of the proper position and slightly out of line with the vertebra below or above.
  • Arthritis, including osteoarthritis and ankylosing spondylitis (a kind of inflammatory arthritis that affects the spine).
  • Spinal stenosis that may place pressure on the spinal cord or spinal nerves. It is most often caused by degenerative changes of the spine.
  • A tumor, A spine tumor may arise in the spinal cord or nerves, such as schwannoma, or the bones of the spine. In some cases, tumors may metastasize to the spine due to cancer elsewhere in the body, such as prostate or lung cancer.
  • Other conditions outside the spine—such as an enlarging abdominal aorta, kidney stones, or gynecologic disorders such as endometriosis or ovarian cancer—can cause pain in the lower back region.

More to explore

Signs & Symptoms of Lower Back Pain

Symptoms

Lower back pain can make everyday activities challenging and uncomfortable. Getting out of bed or a chair, bending over to tie your shoes, or walking comfortably can be challenging.

Your lower back pain symptoms may include:

  • Sharp pain often described as a burning sensation or knife-like pain, often limited to one spot. It may become radiating pain that travels along a nerve to other areas.
  • General achiness or dull pain in a region that may spread to a nearby area
  • Stiffness resulting from reduced mobility in your lower back is caused by pain or achiness
  • Tingling (pins and needles), numbness, or weakness may be felt if a nerve is being compressed
  • Pelvic pain symptoms such as sharp or dull pain in the lower abdomen that radiates to the lower back. It may be constant, or it may come and go. Examples of pelvic pain causes include cancer (such as ovarian, bladder, or digestive cancer) and urinary tract infections. The pelvic discomfort caused by these disorders can also cause lower back pain.
  • Sacrum pain symptoms such as sharp pain or a dull ache on the side of the back of your hip. Sacrum pain may be caused by arthritis, trauma, or repetitive stress on the sacroiliac joint—where the bottom of your spine (sacrum) connects with your hips. Sacrum pain can sometimes extend down the back of the thigh and feel worse when standing up, climbing stairs, or lying on that side.

Who Is at Risk for Lower Back Pain?

Risk Factors

You may be at risk for lower back pain if you:

  • Are older, since there is normal wear and tear on the spine as you age
  • Are overweight, which places more stress on the lower back
  • Have a genetic condition that predisposes you to lower back pain, such as ankylosing spondylitis
  • Work in a job that requires heavy lifting regularly
  • Are a “weekend warrior,” an athlete who doesn’t work out regularly and then does too much at one time
  • Sit in front of a computer screen or mobile device for many hours per day
  • Stand for long periods, particularly with improper posture or poor footwear
  • Have weak abdominal (core) or back muscles
  • Are chronically stressed

Complications

Complications

Severe back pain can profoundly affect your physical health because you’re not likely to be as active. If left untreated lower back pain can lead to a lack of physical activity and increase the risk of developing severe health conditions such as:

Chronic back pain can compromise mental and emotional health. More than 60 percent and 55 percent of individuals with chronic low back pain also suffer from depression and anxiety, respectively

Preventing Lower Back Pain

Prevention

Lumbar spine deformities or certain diseases that cause lower back pain cannot be prevented. There are, however, steps you can take to keep your spine healthy and reduce the chance of developing lower back pain.

  • Maintain good posture when you are sitting, standing, and moving
  • Get regular physical activity, including cardiovascular workouts and strength training
  • Watch your weight, make sure to eat a healthy diet, and get regular exercise to achieve and maintain a healthy weight
  • Avoid smoking, which causes damage to the blood vessels and can increase the risk of degenerative diseases of the spine
  • Lift using your leg muscles rather than your lower back and avoid lifting while bending or twisting
  • Set up a spine-friendly workspace, with the top of your computer monitor at eye level and your knees slightly lower than your hips when sitting. Use a desk chair with a seat that supports your back.
  • Change positions frequently when working or sitting for prolonged periods
  • Find ways to reduce stress in your life, such as meditation, yoga, walking, or psychotherapy

When to Seek Help for Lower Back Pain

When to Seek Help

Lower back pain that persists, worsens, or limits your daily activities may require a visit to a specialist. Some lower back pain symptoms may signal that something serious, even a life-threatening condition, is happening in your body and require medical attention.

Make an appointment to see a physician very soon if you have:

  • Severe lower back pain after an accident
  • Numbness, weakness, or tingling, including discomfort that travels down into your buttocks, hips, and legs
  • Difficulty walking or balancing
  • Unexplained loss of bladder or bowel control
 

This content has been reviewed by the following medical editors.

Neel Mehta, MD

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Get Lower Back Pain Relief at Och Spine at NewYork-Presbyterian

There’s no reason to live with lower back pain. Find out where your severe pain is coming from and what the trained specialists at Och Spine can do to help you start feeling better.

We are very experienced at caring for people from all backgrounds with all types of lower back pain. We’ll assess your symptoms and devise a plan of care just for you.

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