6 Things That Could Be Causing Your Lower Back Pain, Based on How It Feels
Article Published by: self.com
To paraphrase Forrest Gump, lower back pain is like a box of chocolates: You never know what you’re going to get. This kind of pain can be sharp and stabbing, dull and achy, or even radiate into other parts of your body. It can last for a few hours, months, or years. Unfortunately, it also happens to be shockingly common—great when you’re talking about chocolate, not so much when you’re discussing pain.
According to the National Institutes of Health (NIH), around 80 percent of adults will experience lower back pain at some point in their lives. If you’re one of them, you’ve probably been desperate to know the cause of your pain so you can treat it. But before we get into what might be causing your aches, it’s important to understand the basic components of your back first.
Let’s start with your spine. This all-important column of interlocking bones known as vertebrae runs down the middle of your back and protects your spinal cord, according to the NIH. “That’s where all the nerve fibers that control your body go,” Lara Morgan Oberle, M.D. a primary care sports and exercise medicine specialist at Cleveland Clinic’s Sports Health, tells SELF.
In between your vertebrae are rubbery cushions called spinal discs. These discs, which act as shock absorbers, are a little bit like jelly donuts. They have a softer inside with a tougher exterior. There are also a number of ligaments attached to your spine, connecting those stacking vertebrae to each other and to other bones. Beyond that, there are tendons attaching bones to surrounding muscles. Then there are the muscles of your back themselves.
Because there are so many parts in your back, lower back pain could be coming from a variety of sources. With that said, experts name the following issues as some of the most likely to result in lower back pain.
1. If your back pain is dull and persistent, it could be poor posture.
Working a sedentary job can do a number on your body. “Sitting at your desk all day long with a poor ergonomic workstation is one of the worst things for your general health overall, including your lower back,” Dr. Oberle says.
An ergonomic workstation is designed to put the least amount of stress on your body. For the purposes of lower back comfort, that includes using an office chair that supports the curve of your spine, according to the Mayo Clinic. Objects you use often, like your telephone and notepad, should be comfortably within reach so you don’t have to strain each time you need them. And your computer monitor should be right in front of you, with the top of the screen either at or slightly below eye level so you don’t need to hunch over as you work.
Setting up an ergonomic work space might seem like a pain, but it’s better than the soreness you might experience without one. Sitting in a slumped or unsupported position puts a lot of pressure on your back, especially the lower region, Alpesh Patel M.D., the director of orthopedic spine surgery at Northwestern University’s Feinberg School of Medicine, tells SELF. Over time, that pressure can lead to a dull, persistent ache. Plus, sitting all day can shorten your hip flexors, causing them to pull on your lower back. This might make your lower back and butt feel tight and sore, Dr. Patel says.
If you can’t set up an ergonomic workstation, Dr. Oberle recommends taking regular breaks to stretch and move around. Though this of course varies by individual, she suggests doing so every 15 minutes. (This is her recommendation for generally healthy people—if you have health issues that don’t make this feasible, check in with your doctor for specific guidelines.) Even if you can’t actually move this often, you should be checking your posture regularly and adjusting accordingly.
2. If your back pain is sharp and you have muscle spasms or stiffness, it could be improper workout form or over-exercise.
If your lower back hurts the day after you exercise, it could be delayed onset muscle soreness (DOMS). This kind of post-workout pain happens as a normal result of your body repairing muscle fibers you tear during exercise. It typically sets in 12 to 24 hours after you’ve exercised and lasts for a maximum of 72 hours, according to the American College of Sports Medicine. But if your pain lasts beyond that or is more extreme than your usual post-exercise soreness, your workout could be doing your back more harm than good.
This can be especially likely if you’ve been trying new exercises, Dr. Patel says. Obviously, this doesn’t mean you shouldn’t broaden your exercise horizons, just that you should prepare yourself properly first.
If you’re excited to take on a new workout or sport, make sure to read up on it, try to find informative YouTube videos from certified trainers or similar experts, or ask a knowledgeable buddy to join you. If you’re trying new moves at the gym, see if they have any trainers on hand to provide guidance. If you’re taking a new class, let the instructor know, so they can look out for your form. Above all, take it slowly and listen to your body—if something suddenly hurts, stop.
Using the wrong form or overexerting yourself can strain muscles or tendons in your back, or sprain one of your ligaments, according to the Cleveland Clinic. That essentially means those components have been twisted, stretched, or torn. These kinds of injuries can present as abrupt pain that worsens with activity, muscles cramps or spasms, and stiffness or limited movement.
3. If your back pain is sharp and travels into your legs or arms, it could be a herniated disc.
If the tough exterior of one of your spinal discs tears, some of the soft stuff on the inside can bulge outward. This condition is called a herniated, slipped, or ruptured disc, and it can cause sharp pain that might travel down your legs or up into your arms, Dr. Patel says. You may experience numbness or weakness in those body parts, too.
A herniated disc usually happens due to normal, age-related wear and tear, according to the Mayo Clinic. Your spinal discs lose water as you get older, making them less flexible and more prone to rupturing after a minor strain or twist. But this can happen at any age if you experience a sudden impact or injury; Dr. Patel says he usually sees disc herniations in patients who play high-impact sports, like basketball or football.
If you do wind up with a herniated disc, it can aggravate nearby nerves that affect other parts of your body, which is why you might experience those seemingly random leg or arm symptoms in addition to back pain. If you experience sudden numbness, weakness, or even a loss of bladder or bowel control, seek medical assistance right away—these can be a sign of serious spine injury, Dr. Oberle says.
4. If your back pain is either dull or sharp and extends into only one hip or leg, it could be sciatica.
Your sciatic nerve branches from your lower back into your hip and leg on each side of your body, according to the Mayo Clinic. Trouble can arise when the nerve becomes compressed. This can happen due to something like a bone spur (that’s a sharp projection that develops on the edge of a bone) or a herniated disc, and it can lead to nerve pain called sciatica. The pain can be dull or sharp and may be focused in one spot or travel down the nerve into your hip and leg, but usually only one side of your body at a time, according to the Mayo Clinic.
5. If your back pain comes along with abdominal pain and heavy periods, it could be endometriosis.
You’ve probably heard a lot about endometriosis, a reproductive health condition that can cause incredibly debilitating pelvic pain. Some experts believe it’s caused by endometrial tissue—which makes up the uterine lining—migrating from the uterus to other organs. Others say that the tissue is not made up of endometrial cells, but something similar that can create its own estrogen. Either way, these cells cause inflammation that can affect the lower back.
“Endometriosis certainly can press on the pelvic nerves, giving pain referred to the back—and [the pain] can be stabbing, achy, or can radiate down the legs,” Mary Jane Minkin, M.D., a clinical professor in the department of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine, tells SELF. This tissue may also produce prostaglandins, hormone-like chemicals that cause cramping, further exacerbating the problem.
This condition can also cause painful sex, pain when using the bathroom, excessively heavy vaginal bleeding whether or not you have your period, and issues like diarrhea and constipation.
6. If your back pain is sharp, stabbing, and accompanied by issues like nausea and vomiting, it could be a kidney stone.
If you’ve ever had a kidney stone, it might feel like your body’s betrayed you. These small, hard deposits of minerals and salts can form in your kidneys and wreak complete havoc, causing sharp, stabbing pain in your back or side along with other symptoms like nausea and vomiting. You might also experience pain when you try to pee, and see a pink, red, or brown tint once you finally eke out some urine.
Of course, the best treatment for your lower back pain will depend on what’s causing it.
Both Dr. Oberle and Dr. Patel agree that if your lower back pain stems from relatively minor issues like your office chair or too much exercise, you can target it with nonsteroidal anti-inflammatory drugs, heat or ice packs, physical therapy, and special exercises or stretches as advised by your doctor.
Things get a little more complicated if one of the other issues on this list is causing your back pain, because they all come with a wealth of treatment options. They include cortisone injections to calm disc-related inflammation to laparoscopic surgery to remove endometrial lesions to shock wave therapy that can smash a kidney stone into smaller pieces so you can pee them out. If you suspect one of these issues is at the root of your lower back pain, you’re not going to be able to tackle it on your own. Loop in your doctor so you can create an expert-approved treatment plan that will get you back on your feet.
ABOUT IFFIE OKORONKWO, M.D.
Iffie Okoronkwo, M.D. is a Spine and Sports Rehabilitation Medicine and Pain Management physician at Manhattan Spine and Sports Medicine (http://www.manhattanmd.com/), a private practice based in New York City with 40 years of experience providing the finest expert medical care and services to patients around the world.
Dr. Iffie is board certified in Physical Medicine and Rehabilitation and, as a physiatrist, utilizes ultrasound guided injections, fluoroscopy guided injections, PRP, regenerative medicine, and more to evaluate and treat a variety of conditions affecting muscles, joints, ligaments, and nerves.