What causes sharp back pain. How to identify acute low back pain. When to seek medical attention for back pain. What are the best treatments for acute back pain. How to prevent recurring episodes of low back pain.

Understanding Acute Low Back Pain: Causes and Risk Factors

Acute low back pain is a common condition that affects millions of people worldwide. It’s characterized by sudden onset pain in the lower back region, often accompanied by stiffness and reduced mobility. But what exactly causes this type of pain?

The most frequent causes of acute low back pain include:

• Muscle strain or ligament sprain
• Sudden injury or accident
• Lifting heavy objects improperly
• Prolonged sitting in one position
• Sudden movements

In some cases, more serious conditions may be responsible for acute low back pain:

• Herniated or ruptured disks
• Compression fractures due to osteoporosis
• Spinal stenosis
• Sciatica
• Spine curvatures (e.g., scoliosis or kyphosis)

Are certain individuals more prone to experiencing acute low back pain? Indeed, several risk factors can increase one’s susceptibility:

• Age (pain is more common as we get older)
• Poor physical fitness
• Obesity
• Occupations requiring heavy lifting or repetitive motions
• Smoking
• Pregnancy

Recognizing the Symptoms of Acute Low Back Pain

How can you tell if you’re experiencing acute low back pain? The symptoms can vary from person to person, but typically include:

• Sharp or dull pain in the lower back region
• Stiffness and difficulty moving
• Muscle spasms
• Pain that worsens with movement
• Difficulty standing up straight

In some cases, the pain may radiate to other areas of the body. Do you feel tingling or numbness in your legs? This could be a sign of nerve involvement, such as sciatica. Are you experiencing weakness in your legs or feet? This might indicate a more serious condition that requires immediate medical attention.

When to Seek Medical Help

While most cases of acute low back pain resolve on their own within a few weeks, certain symptoms warrant immediate medical attention:

• Loss of bowel or bladder control
• Severe, persistent pain that doesn’t improve with rest
• Pain accompanied by fever
• Unexplained weight loss
• Weakness or numbness in the legs

Diagnosing Acute Low Back Pain: What to Expect

How do healthcare providers diagnose acute low back pain? The process typically begins with a thorough medical history and physical examination. Your doctor will ask about the onset of pain, its severity, and any activities that worsen or alleviate the discomfort.

During the physical exam, your provider will assess:

• The location and distribution of pain
• Your range of motion
• Muscle strength and reflexes
• Signs of nerve involvement

In most cases, imaging tests are not necessary for acute low back pain. However, if your doctor suspects a more serious underlying condition, they may order:

• X-rays to check for bone problems
• CT scans for a detailed view of bone and soft tissues
• MRI scans to evaluate disks, nerves, and other soft tissues

Effective Treatment Strategies for Acute Low Back Pain

What are the most effective ways to manage acute low back pain? The good news is that most cases improve with conservative treatment within 4 to 6 weeks. Here are some strategies to help alleviate pain and promote healing:

1. Rest and Activity Modification

Contrary to popular belief, prolonged bed rest is not recommended for acute low back pain. Instead, aim for a balance between rest and gentle activity:

• Limit normal physical activity for the first few days
• Gradually return to your usual activities after 2-3 days
• Avoid heavy lifting or twisting movements for 6 weeks

2. Ice and Heat Therapy

Applying ice or heat to the affected area can help reduce pain and inflammation:

• Use ice for the first 48-72 hours to reduce swelling
• Switch to heat therapy after the initial period to relax muscles and increase blood flow

3. Over-the-Counter Pain Medications

Non-prescription pain relievers can be effective in managing acute low back pain:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen
• Acetaminophen for pain relief without anti-inflammatory effects

Always follow the recommended dosage and consult your healthcare provider if you have any concerns.

4. Proper Sleep Positioning

How you sleep can significantly impact your back pain. Try these positions for better comfort:

• Sleep in a fetal position with a pillow between your knees
• If you prefer sleeping on your back, place a pillow under your knees to reduce pressure on your spine

5. Gentle Exercises and Stretches

Once the initial pain subsides, incorporating gentle exercises can help strengthen your back and prevent future episodes:

• Start with light aerobic activities like walking or swimming
• Gradually introduce low-impact exercises to strengthen core and back muscles
• Consider yoga or Pilates to improve flexibility and posture

Preventing Recurrence: Long-Term Strategies for Back Health

How can you prevent future episodes of acute low back pain? Implementing these long-term strategies can help maintain a healthy back:

1. Maintain good posture: Be mindful of your posture when sitting, standing, and lifting objects.
2. Exercise regularly: Focus on strengthening core and back muscles to support your spine.
3. Maintain a healthy weight: Excess weight puts additional strain on your back.
4. Use proper lifting techniques: Bend at the knees and keep the object close to your body when lifting.
5. Quit smoking: Smoking can reduce blood flow to the spine and increase the risk of osteoporosis.
6. Manage stress: Stress can lead to muscle tension and exacerbate back pain.
7. Invest in a supportive mattress: A good mattress can help maintain proper spinal alignment during sleep.

Alternative Therapies for Acute Low Back Pain

While conventional treatments are often effective, some individuals find relief through alternative therapies. What are some alternative approaches to managing acute low back pain?

1. Chiropractic Care

Chiropractic adjustments may help alleviate pain and improve spinal function. A chiropractor uses manual techniques to manipulate the spine and surrounding tissues.

2. Acupuncture

This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. Some studies suggest acupuncture may be effective for certain types of back pain.

3. Massage Therapy

Massage can help relax tense muscles and improve circulation, potentially reducing pain and stiffness in the lower back.

4. Mindfulness and Meditation

Practicing mindfulness techniques or meditation may help manage pain perception and reduce stress-related muscle tension.

5. Herbal Remedies

Some herbal supplements, such as devil’s claw or white willow bark, have shown potential in managing back pain. However, always consult with a healthcare provider before trying any new supplements.

When Surgery Might Be Necessary for Acute Low Back Pain

In rare cases, acute low back pain may require surgical intervention. When might surgery be considered as a treatment option?

• Persistent pain that doesn’t respond to conservative treatments
• Severe nerve compression causing significant weakness or loss of function
• Spinal instability due to injury or degenerative conditions
• Cauda equina syndrome, a rare but serious condition affecting nerve roots in the lower spine

What types of surgical procedures are commonly used for acute low back pain?

• Microdiscectomy: Removal of herniated disk material pressing on a nerve root
• Laminectomy: Removal of bone spurs or ligaments to relieve pressure on nerves
• Spinal fusion: Joining two or more vertebrae to stabilize the spine

It’s important to note that surgery is typically considered a last resort for acute low back pain. The decision to undergo surgery should be made in consultation with a spine specialist, weighing the potential benefits against the risks.

The Impact of Lifestyle Factors on Acute Low Back Pain

How do our daily habits and lifestyle choices influence the occurrence and severity of acute low back pain? Several factors can play a significant role:

1. Physical Activity Levels

Both too little and too much physical activity can contribute to back pain. A sedentary lifestyle can lead to weak core muscles and poor posture, while overexertion can cause strains and injuries. Finding the right balance is key to maintaining a healthy back.

2. Workplace Ergonomics

Poor ergonomics at work, especially for those who sit for long periods, can contribute to back pain. Ensuring proper desk and chair height, using ergonomic equipment, and taking regular breaks to move and stretch can help prevent workplace-related back issues.

3. Sleep Habits

The quality and quantity of sleep can impact back health. Poor sleep posture or an unsupportive mattress can lead to or exacerbate back pain. Additionally, lack of sleep can lower pain tolerance and increase muscle tension.

4. Stress Management

Chronic stress can lead to muscle tension, particularly in the back and neck. Learning effective stress management techniques, such as deep breathing exercises or regular relaxation practices, can help reduce the risk of stress-related back pain.

5. Nutrition

While the link between diet and back pain is not always direct, maintaining a healthy diet can contribute to overall spine health. A balanced diet rich in anti-inflammatory foods and nutrients essential for bone and muscle health may help prevent or manage back pain.

6. Hydration

Proper hydration is crucial for maintaining the health of intervertebral disks. Dehydration can lead to decreased disk height and increased risk of herniation. Ensuring adequate water intake throughout the day can support spinal health.

By addressing these lifestyle factors, individuals can take proactive steps to reduce their risk of acute low back pain and promote overall spine health. Remember, small changes in daily habits can lead to significant improvements in back health over time.

The Role of Physical Therapy in Treating Acute Low Back Pain

How can physical therapy benefit those suffering from acute low back pain? Physical therapy plays a crucial role in both the treatment and prevention of back pain. Here’s how it can help:

1. Pain Management

Physical therapists use various techniques to alleviate pain, including:

• Manual therapy (massage, mobilization)
• Heat and cold therapy
• Electrical stimulation
• Ultrasound therapy

2. Improving Mobility

Through targeted exercises and stretches, physical therapy can help improve flexibility and range of motion in the back and surrounding areas.

3. Strengthening Exercises

A key component of physical therapy for back pain is strengthening the core and back muscles to provide better support for the spine.

4. Posture Correction

Physical therapists can identify postural issues contributing to back pain and provide guidance on proper posture and body mechanics.

5. Education

Patients learn about their condition, proper body mechanics, and strategies to prevent future episodes of back pain.

6. Customized Treatment Plans

Physical therapists develop personalized treatment plans based on the individual’s specific condition, lifestyle, and goals.

What can you expect during a physical therapy session for acute low back pain?

1. Initial assessment: The therapist will evaluate your condition, pain levels, and functional limitations.
2. Treatment: This may include manual therapy, exercises, and other modalities to address pain and improve function.
3. Home exercise program: You’ll receive instructions for exercises to perform at home to support your recovery.
4. Progress monitoring: Regular check-ins to assess improvement and adjust the treatment plan as needed.

How long does physical therapy typically last for acute low back pain? The duration can vary depending on the severity of the condition and individual response to treatment. Many patients see improvement within 4-6 weeks, but some may require longer-term therapy.

By incorporating physical therapy into the treatment plan for acute low back pain, patients can often achieve faster recovery, improved function, and learn strategies to prevent future episodes of pain.

Low back pain – acute: MedlinePlus Medical Encyclopedia

Low back pain refers to pain that you feel in your lower back. You may also have back stiffness, decreased movement of the lower back, and difficulty standing straight.

Acute back pain can last for a few days to a few weeks.

Most people have at least one backache in their life. Although this pain or discomfort can happen anywhere in your back, the most common area affected is your lower back. This is because the lower back supports most of your body’s weight.

Low back pain is the number two reason that Americans see their health care provider. It is second only to colds and flu.

You will usually first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an injury or accident.

Acute low back pain is most often caused by a sudden injury to the muscles and ligaments supporting the back. The pain may be caused by muscle spasms or a strain or tear in the muscles and ligaments.

Causes of sudden low back pain include:

• Compression fractures to the spine from osteoporosis
• Cancer involving the spine
• Fracture of a spine bone
• Muscle spasm (very tense muscles)
• Ruptured or herniated disk
• Sciatica
• Spinal stenosis (narrowing of the spinal canal)
• Spine curvatures (like scoliosis or kyphosis), which may be inherited and seen in children or teens
• Strain or tears to the muscles or ligaments supporting the back

Low back pain may also be due to:

• An abdominal aortic aneurysm that is leaking.
• Arthritis conditions, such as osteoarthritis, psoriatic arthritis, and rheumatoid arthritis.
• Infection of the spine (osteomyelitis, diskitis, abscess).
• Kidney infection or kidney stones.
• Problems related to pregnancy.
• Problems with your gall bladder or pancreas may cause back pain.
• Medical conditions that affect the female reproductive organs, including endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids.
• Pain around the back of your pelvis, or sacroiliac (SI) joint.

You may feel a variety of symptoms if you have hurt your back. You may have a tingling or burning sensation, a dull achy feeling, or sharp pain. The pain may be mild, or it can be so severe that you are unable to move.

Depending on the cause of your back pain, you may also have pain in your leg, hip, or the bottom of your foot. You may also have weakness in your legs and feet.

When you first see your provider, you will be asked about your back pain, including how often it happens and how severe it is.

Your provider will try to determine the cause of your back pain and whether it is likely to quickly get better with simple measures such as ice, mild painkillers, physical therapy, and proper exercises. Most of the time, back pain will get better using these methods.

During the physical exam, your provider will try to pinpoint the location of the pain and figure out how it affects your movement.

Most people with back pain improve or recover within 4 to 6 weeks. Your provider may not order any tests during the first visit or for 4 to 6 weeks unless you have certain symptoms.

Tests that might be ordered include:

• X-ray
• CT scan of the lower spine
• MRI of the lower spine

To get better quickly, take the right measures when you first feel pain.

Here are some tips for how to handle pain:

• Stop normal physical activity for the first few days. This will help relieve your symptoms and reduce any swelling in the area of the pain.
• Apply heat or ice to the painful area. One good method is to use ice for the first 48 to 72 hours and then use heat.
• Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). Follow package instructions on how much to take. Do not take more than the recommended amount.

While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.

A common misbelief about back pain is that you need to rest and avoid activity for a long time. In fact, bed rest is not recommended. If you have no sign of a serious cause for your back pain (such as loss of bowel or bladder control, weakness, weight loss, or fever), then you should stay as active as possible. It is important to prevent your back and abdominal muscles from becoming too weak.

You should reduce your activity only for the first couple of days. Then, slowly start your usual activities after that. Do not perform activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. After 2 to 3 weeks, you should gradually start exercising again.

• Begin with light aerobic activity. Walking, riding a stationary bicycle, and swimming are great examples. These activities can improve blood flow to your back and promote healing. They also strengthen muscles in your stomach and back.
• You may benefit from physical therapy. Your provider will determine whether you need to see a physical therapist and can refer you to one. The physical therapist will first use methods to reduce your pain. Then, the therapist will teach you ways to prevent getting back pain again.
• Stretching and strengthening exercises are important. But, starting these exercises too soon after an injury can make your pain worse. A physical therapist can tell you when to begin stretching and strengthening exercises and how to do them.

If your pain lasts longer than 1 month, your primary provider may send you to see a physiatrist (specialist in rehabilitation), an orthopedist (bone specialist) or neurologist (nerve specialist).

If your pain has not improved after use of medicines, physical therapy, and other treatments, your provider may recommend an epidural injection.

You may also see:

• A massage therapist
• Someone who performs acupuncture
• Someone who does spinal manipulation (a chiropractor, osteopathic doctor, or physical therapist)

Sometimes, a few visits to these specialists will help back pain.

Many people feel better within 1 week. After another 4 to 6 weeks, the back pain should be completely gone.

Contact your provider right away if you have:

• Back pain after a severe blow or fall
• Burning with urination or blood in your urine
• History of cancer
• Loss of control over urine or stool (incontinence)
• Pain traveling down your legs below the knee
• Pain that is worse when you lie down or pain that wakes you up at night
• Redness or swelling on the back or spine
• Severe pain that does not allow you to get comfortable
• Unexplained fever with back pain
• Weakness or numbness in your buttocks, thigh, leg, or pelvis

Also contact your provider if:

• You have been losing weight unintentionally
• You use steroids or intravenous drugs
• You have had back pain before, but this episode is different and feels worse
• This episode of back pain has lasted longer than 4 weeks

There are many things you can do to lower your chances of getting back pain. Exercise is important for preventing back pain. Through exercise you can:

• Improve your posture
• Strengthen your back and improve flexibility
• Lose weight
• Avoid falls

It is also very important to learn to lift and bend properly. Follow these tips:

• If an object is too heavy or awkward, get help.
• Spread your feet apart to give your body a wide base of support when lifting.
• Stand as close as possible to the object you are lifting.
• Bend at your knees, not at your waist.
• Tighten your stomach muscles as you lift the object or lower it down.
• Hold the object as close to your body as you can.
• Lift using your leg muscles.
• As you stand up with the object, do not bend forward.
• Do not twist while you are bending down for the object, lifting it up, or carrying it.

Other measures to prevent back pain include:

• Avoid standing for long periods. If you must stand for your work, alternate resting each foot on a stool.
• Do not wear high heels. Use cushioned soles when walking.
• When sitting for work, especially if you are using a computer, make sure your chair has a straight back with an adjustable seat and back, armrests, and a swivel seat.
• Use a stool under your feet while sitting so that your knees are higher than your hips.
• Place a small pillow or rolled towel behind your lower back while sitting or driving for long periods.
• If you drive a long distance, stop and walk around every hour. Bring your seat as far forward as possible to avoid bending. Do not lift heavy objects just after a ride.
• Quit smoking.
• Lose weight.
• Do exercises on a regular basis to strengthen your abdominal and core muscles. This will strengthen your core to decrease the risk for further injuries.
• Learn to relax. Try methods such as yoga, tai chi, or massage.

Backache; Low back pain; Lumbar pain; Pain – back; Acute back pain; Back pain – new; Back pain – short-term; Back strain – new

• Spine surgery – discharge

• Lumbar vertebrae
• Backaches
• Sciatic nerve

Corwell BN, Davis NL. Back pain. In: Walls RM, Hockberger RS, Gausche-Hill M, Erickson TB, Wilcox SR, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 31.

El Abd OH, Amadera JED. Low back strain or sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 48.

Grabowski G, Gilbert TM, Larson EP, Cornett CA. Degenerative conditions of the cervical and thoracolumbar spine. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller’s Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 130.

Malik K, Nelson A. Overview of low back pain disorders. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 24.

Murray EL, Misulis KE. Lower back and lower limb pain. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 33.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Spinal Stenosis | Spine Center | Condition

At UT Southwestern Medical Center, the expert team of doctors in the Spine Center specializes in all available evidence-based treatments for spinal stenosis – both medical and surgical.

Our multidisciplinary approach gives patients access to neurosurgeons, orthopaedic surgeons, pain management specialists, and physiatrists with one call. We strive to coordinate, facilitate, and expedite patient care and save our patients time.

Our Spine Center is one of only a few U.S. programs offering endoscopic surgery for the treatment of herniated discs – a potential cause of spinal stenosis.

About Spinal Stenosis

Spinal stenosis is a narrowing in the spine that puts pressure on the spinal cord and nerves. The condition can occur in the neck (cervical spinal stenosis), the middle of the spine (thoracic stenosis), or the lower spine (lumbar stenosis).

Spinal stenosis can be caused by injuries and diseases such as osteoarthritis and scoliosis.

Many people have no symptoms, but some people experience pain, numbness, or weakness in the neck or back.

The Spine Center offers our patients the most advanced diagnostic and treatment technologies and techniques for spinal stenosis, such as specialized spine imaging.

Diagnosing Spinal Stenosis

If we suspect spinal stenosis, we’ll conduct a physical examination and order additional testing. Tests, procedures, and spine imaging studies used to diagnose spinal stenosis can include:

• Bone scans
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Myelography
• Nerve conduction studies to measure electrical activity generated by muscles and nerves
• X-rays

Spinal Stenosis Treatments

After diagnosis, we’ll make sure patients see the right experts to treat their specific symptoms. Our Spine Center specialists treat spinal stenosis with therapies that include:

• Anti-inflammation drugs
• Biofeedback
• Cortisone injections
• Physical therapy
• Surgery

We’ll create a care plan that minimizes the number of visits a patient needs to make, while also providing all the support needed.

Research and Clinical Trials

UT Southwestern conducts clinical trials aimed at improving the treatment of spinal stenosis. Talk with our doctors to see if a clinical trial is available.

See More

Back and Spine;

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June 5, 2017

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Back pain – treatment, symptoms, causes, diagnosis

Back pain is often referred to by such terms as lumbago or lumbalgia. Lumbago or “lumbago” refers to an attack of acute pain in the lower back, which is usually associated with hypothermia and exercise. Lumbago occurs in many people and is often the cause of temporary disability. Often the cause of lumbago can be sports injuries or sprains, but sometimes the factor that provokes the onset of pain remains unknown. Lumbago is characterized by pain that does not radiate to the legs. Lower back pain (lumbago) may appear acutely and progress gradually over the course of the day. Often there is stiffness in the morning and gradually the stiffness turns into pain. It is also possible curvature of the spine (antalgic scoliosis) as a result of muscle spasm. The pain itself may be due to muscle spasm, which in turn is associated with other causes. It can be overuse or sprain, sports injuries, herniated disc, spondylarthrosis (spondylosis), kidney disease (infection or kidney stones). Sometimes the patient accurately determines the causal relationship between the appearance of malaise and exercise, hypothermia, but often the pain appears for no apparent reason. Sometimes lower back pain can occur even after sneezing, bending over, or putting on shoes. This can be facilitated by deforming diseases of the spine, such as scoliosis.

In contrast to lumbago, the term lumbodynia refers to pain that is not acute, but subacute or chronic. As a rule, pain with lumbodynia appears gradually over several days. Pain can also occur in the morning and may decrease with physical activity. Lumbalgia is characterized by increased pain during prolonged static loads (sitting, uncomfortable body position). It is also characteristic of lumbodynia that the pain decreases in the supine position in a certain position. Patients with lumbodynia have difficulty performing normal activities such as washing or putting on shoes due to muscle spasm. Due to the disease, there is a decrease in the range of motion of the body (forward bends or, to a lesser extent, side bends or extension). Due to the pain syndrome, the patient often has to change position when it is necessary to sit or stand. Unlike lumbago, muscle spasm is less pronounced and, as a rule, does not cover the entire lower back, and there are often signs of spasm predominance on one side.

Causes of back pain

Back pain is a symptom. The most common causes of back pain are diseases (injuries) of muscles, bones, and intervertebral discs. Sometimes lower back pain may be due to diseases of the abdominal cavity, pelvis and chest. Such pains are called reflected. Abdominal disease (eg, appendicitis), aortic aneurysm, kidney disease (kidney stones, kidney infection, bladder infections), pelvic infections, ovarian infections can all present back pain . Even a normal pregnancy can lead to lower back pain due to sprains in the pelvic area, muscle spasm due to stress, irritation of the nerves.

The most common low back pain associated with the following diseases:

• Nerve root compression, which causes symptoms of sciatica and is most often due to disc herniation. As a rule, with compression of the nerve root, the pain is acute, has irradiation and sensitivity disturbances in the zone of innervation of the nerve root. A herniated disc occurs mainly as a result of degeneration of the disc. There is a protrusion of the gelatinous part of the disc from the central cavity and pressure on the nerve roots. Degenerative processes in the intervertebral discs begin at the age of 30 and older. But the very presence of a hernia does not always lead to an effect on the nervous structures.
• Spondylosis – degenerative changes occur in the vertebrae themselves, resulting in bone growths (osteophytes) that can affect nearby nerves, resulting in pain.
• Spinal stenosis can occur due to degenerative changes in the spine (spondylosis and osteochondrosis). A patient with spinal stenosis in the lumbar region may experience low back pain radiating to both legs. Lower back pain can occur as a result of standing or walking.
• Cauda equina syndrome. This is a condition requiring emergency medical attention. Cauda equina syndrome occurs as a result of compression of the elements of the cauda equina (terminal part of the spinal cord). A patient with cauda equina syndrome may experience pain and dysfunction of the intestines and bladder (incontinence and bladder atony). This syndrome requires emergency surgery.
• Pain syndromes such as myofascial pain syndrome or fibromyalgia. Myofascial pain syndrome is characterized by pain and tenderness at certain points (trigger points), decreased muscle movement in painful areas. The pain syndrome decreases with the relaxation of the muscles located in the painful zones. In fibromyalgia, pain and soreness is distributed throughout the body. Fibromyalgia is not characterized by tightness and pain in the muscles.
• Bone infections (osteomyelitis) of the spine are extremely rare.
• Non-communicable inflammatory diseases of the spine (ankylosing spondylitis) can cause stiffness and pain in the spine (including the lower back itself), which is especially worse in the morning.
• Tumors, most often metastases of cancer, can be a source of discomfort in the lower back.
• Inflammation of the nerves and, accordingly, pain manifestations (in the chest or in the lumbar region) may be due to damage to the nerves themselves (for example, with herpes zoster)
• Given the variety of causes of symptoms, such as acute or subacute low back pain, it is very important to fully evaluate the patient and perform all necessary diagnostic procedures.

Symptoms

Pain in the lumbosacral region is the main symptom of lumbago, lumbodynia, lumbar ischialgia.

• The pain may radiate down the front, side, or back of the leg (lumbar ischialgia), or it may be limited to the lower back (lumbago, lumbalgia).
• Feeling that the lower back hurts, may increase after exercise.
• Sometimes the pain may be worse at night or when sitting for a long time, such as during a long car ride.
• Possible numbness and weakness in the part of the leg that is in the zone of innervation of the compressed nerve.

For timely diagnosis and treatment, a number of criteria (symptoms) deserve special attention:

• Presence in the recent past of injuries such as a fall from a height, a traffic accident or similar incidents.
• Presence of minor injuries in patients over 50 years of age (eg, falling from a small height as a result of sliding and landing on the buttocks).
• History of long-term use of steroids (for example, these are patients with bronchial asthma or rheumatological diseases).
• Any patient with osteoporosis (mostly elderly women).
• Any patient over 70 years of age: at this age, there is a high risk of cancer, infections and diseases of the abdominal organs, which can cause lower back pain.
• History of oncology
• Presence of infectious diseases in the recent past
• Temperature over 100F (37.7 C)
• Drug use: drug use increases the risk of infectious diseases.
• Pain in the lower back increases at rest: as a rule, this nature of pain is associated with oncology or infections, and such pain can also be with ankylosing spondylitis (Bekhterev’s disease).
• Significant weight loss (no apparent reason).
• The presence of any acute nerve dysfunction is a signal for urgent medical attention. For example, this is a walking disorder, foot dysfunctions are usually symptoms of acute nerve injury or compression. Under certain circumstances, such symptoms may require emergency neurosurgery.
• Impaired bowel or bladder function (both incontinence and urinary retention) may be a sign of an emergency requiring emergency care.
• Failure to respond to recommended treatment or increased pain may also require medical attention.

The presence of any of the above factors (symptoms) is a signal to seek medical help within 24 hours.

Diagnosis

The medical history is important for making an accurate diagnosis, as low back pain can be caused by a variety of conditions. The time of onset of pain, the relationship with physical activity, the presence of other symptoms, such as cough, fever, bladder or bowel dysfunction, the presence of seizures, etc. are important. A physical examination is carried out: identification of pain points, the presence of muscle spasm, a study of the neurological status is carried out. If there are suspicions of diseases of the abdominal cavity or pelvic organs, then an examination is carried out (ultrasound of the abdominal organs, ultrasound of the small and pelvic organs, urine blood tests).

If the somatic origin of low back pain is ruled out, then such instrumental research methods as radiography, CT or MRI can be prescribed.

Radiography is the initial method of examination and allows you to determine the presence of changes in bone tissues and indirect signs of changes in the intervertebral discs.

CT allows to visualize the presence of various changes, both in bone tissue and in soft stones (especially with contrast).

MRI is the most informative research method that allows diagnosing morphological changes in various tissues.

Densitometry is necessary in cases where there is suspicion of osteoporosis (usually in women over 50 years old)

EMG (ENMG) is used to determine conduction disturbances in nerve fibers.

Laboratory tests are ordered (blood, urine, blood biochemistry) mainly to exclude inflammatory processes in the body.

Treatment of pain

After the diagnosis and confirmation of vertebral origin in lumbago and lumbalgia, a specific treatment for back pain is prescribed.

In acute pain, rest for 1-2 days is necessary. Bed rest allows you to reduce the load on the muscles and reduce muscle spasm. In most cases, when the pain syndrome is due to muscle spasm, the pain syndrome decreases within a few days without the use of drugs, only due to rest.

Medical treatment. For pain syndrome, drugs of the NSAID group (movalis ibuprofen voltaren) are used. COX-2 inhibitors, such as celecoxib (Celebrex), have fewer side effects, but long-term use of these drugs also has certain risks. Considering that all drugs of this group have a lot of side effects, taking drugs of this group should be short and under the obligatory supervision of a doctor.

Muscle relaxants (mydocalm, sirdalud, baclofen) may be used to relieve spasm. But the use of these drugs is effective only in the presence of spasm.

Steroids may be used to treat pain, especially when there are signs of sciatica. But due to the presence of pronounced side effects, the use of steroids should be selective and short in time.

Manual therapy. This method can be very effective in the presence of muscle blocks or subluxations of the facet joints. Mobilization of motor segments can reduce both muscle spasm and lower back pain.

Physiotherapy. There are many modern physiotherapy procedures that can both reduce pain and reduce inflammation, improve microcirculation (for example, electrophoresis, cryotherapy, laser therapy, etc.).

exercise therapy. For acute pain in the lower back, exercises are not recommended. Connecting exercise therapy is possible after reducing the pain syndrome. In the presence of chronic pain, exercise can be very effective in strengthening the core muscles and improving spinal biomechanics. Exercises should be selected only with an exercise therapy doctor, since often independent exercises can lead to increased pain manifestations. Systematic exercises of exercise therapy, especially in the presence of degenerative changes in the spine (osteochondrosis, spondylosis), can preserve the functionality of the spine and significantly reduce the risk of pain syndromes.

Lower back pain – what to do, causes in men and women

What can be pain in the lower back

Back pain can be sharp or aching, come on suddenly or increase gradually, appear with exertion or certain movements (for example, bending over), or persist regardless of what the person is doing.

Pain may be pinpoint or radiating (i.e. spreading to other areas). At the same time, a person has pain not only in the back in the lumbar region, but also in other parts of the body, such as the lower abdomen, perineum, leg or buttock.

Low back pain may present with stiffness or muscle spasms. It may be difficult for a person to bend over or rise from a lying position, stand with a straight back, or maintain good posture while walking.

If the pain is caused by a muscle spasm or a pinched nerve, it can be unbearable and even disabling. Such pain forces you to stay in bed until medical attention is received.

Why does the lower back hurt

The most common cause of back pain is one or another pathology of the musculoskeletal system: sprains, pinching, inflammation. They are often found in men who work with their hands, athletes, young mothers.

Also, discomfort in the lower back can be a sign of acute or chronic diseases of the internal organs. This is due to the fact that pain impulses are able to be transmitted along nerve fibers to neighboring regions. In this case, they say that the pain “gives” to the lower back.

Diseases of the musculoskeletal system causing back pain

Most often, back pain is caused by injuries and pathologies of the musculoskeletal system – sprains of muscles and ligaments, spinal injuries, hernia and protrusion of the intervertebral discs, inflammation of the joints, diseases of the bone tissue.

Deformities and sprains of muscles and ligaments

Such injuries can occur due to awkward movement if a person lifts something very heavy or does not follow safety precautions when working with bulky objects. You can also get injured while playing sports or if you just sneeze unsuccessfully.

Lower back pain may occur if lifting heavy objects without safety precautions

With sprains and deformities, pain increases during movement, muscle spasms may appear. It may be painful for a person to walk, lean forward, or keep their back straight.

Diagnosis in case of deformation and stretching of muscles and ligaments is based on data from a physical examination and instrumental studies – ultrasound, X-ray, MRI of the lumbar region. If you suspect a sprain or deformity of muscles or ligaments, you should contact an orthopedic traumatologist.

Treatment is to relieve acute pain and muscle spasm – for this, ice compresses, painkillers, drugs to relieve muscle spasm (muscle relaxants) are used. It is important to let the damaged area rest so that the tissues can recover – it usually takes about 2 weeks. After that, it is important to start rehabilitation: physiotherapy exercises aimed at restoring muscle function are shown.

Without treatment, deformities and sprains lead to limited mobility: trying not to injure the damaged area, a person reduces activity, which can lead to weight gain, reduced bone strength and loss of muscle mass.

Spinal injuries

An injury (usually a fracture) to one or more vertebrae resulting from falls, accidents, sports activities or domestic injuries. In people with bone density disorders (for example, osteoporosis), such damage can be caused by even a minor impact.

Treatment of spinal injuries is to prevent displacement and further deformation of the vertebral discs. If the damage is not severe, it is recommended to sleep on a hard surface and limit physical activity. If the damage is significant, surgical methods are used for fixation.

Without treatment, damage to the vertebral discs can cause stenosis (narrowing) of the spinal canal, neurological disorders, including sciatica – pinching of nerve fibers extending from the spine.

Pathologies of the intervertebral discs

Intervertebral discs are fibrocartilaginous plates with jelly-like contents located between the vertebrae. They act as shock-absorbing pillows for the vertebrae, ensuring their mobility. Discs can become dislodged (protrusions) or rupture (herniated), causing severe pain and limiting spinal mobility.

Herniated discs and protrusions can occur in people with a weak muscular frame and overweight, in those who lead a sedentary lifestyle or lift weights. Smokers are more prone to pathologies of the intervertebral discs.

Herniated disc – protrusion of the intervertebral disc into the spinal canal

Treatment consists in relieving pain and inflammation – for this, rest, painkillers, ointments and compresses on the inflamed area are recommended. Your doctor may prescribe physical therapy or a course of exercise therapy. With moderate damage, the disc can recover if the cause of the hernia or protrusion is excluded, for example, by strengthening the muscle corset, reducing weight and not putting excessive stress on the spine.

If the back pain is so severe that it interferes with daily activities, does not subside within 1-1.5 months, or if the symptoms worsen, you need to see your doctor again. In some cases, steroid therapy or even surgery may be required.
With age, the development of a degenerative disease of the intervertebral discs is possible – they become flatter and perform a worse shock-absorbing function, which can also cause pain. In this case, the treatment includes pain relief and general recovery of the body.

Scoliosis of the lumbar spine

Scoliosis (curvature) of the spine is a displacement of the spinal column to the right or left relative to the vertical axis. Pathology leads to increased pressure on certain areas of the intervertebral discs and vertebrae, as well as to pinching of tissues and nerve fibers. Scoliosis can cause severe pain in the lower back on the right or left – where there is a lot of load – and severely limit the mobility of the spine.

Scoliosis (curvature) of the spine can cause severe pain in the part of the lower back where there is a large load

Scoliosis can occur due to the weakening of the muscular corset in the absence of sufficient physical activity, a sedentary lifestyle (in schoolchildren, office workers). In this case, it is difficult for the muscles to maintain the physiological position of the back and curvatures are formed.

Treatment includes the introduction of balanced physical activity (physiotherapy, swimming), massage and manual therapy, physiotherapy to strengthen muscles, such as electrical stimulation. With severe injuries, wearing a corset is indicated, which helps maintain the correct position of the spine.

Arthritis and arthrosis

Inflammation and degenerative processes in the joints of the spine can also cause severe back pain. There are many forms of arthritis, among them are osteoarthritis (damage to cartilage and adjacent tissues), ankylosing spondylitis (Bekhterev’s disease – damage to the joints of the spine, which leads to fusion of the vertebrae).

Arthritis can be caused by natural aging, genetic predisposition, autoimmune diseases.

Treatment of arthritis, depending on the form, may include the use of non-steroidal and steroidal anti-inflammatory and analgesic drugs, physiotherapy (magnetotherapy, electrophoresis), therapeutic massage, physiotherapy exercises.

Physiotherapy treatments help relieve pain in joint pathologies

Spondylolisthesis

Displacement of a vertebra relative to the spinal column (spondylolisthesis) occurs as a result of trauma or degenerative processes in the spine. Pathology occurs in athletes, older people or people with a hereditary predisposition to bone diseases (for example, osteoporosis – a violation of bone density). Spondylolisthesis can lead to severe pain in the lower back, buttocks and legs, cramps or weakness in the legs.

Treatment involves the removal of pain and inflammation that occurs against the background of squeezing adjacent tissues by the vertebrae. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal painkillers in tablets or injections with corticosteroid drugs. At the same time, physiotherapeutic procedures and physiotherapy exercises are prescribed to strengthen the muscles and restore the position of the vertebrae. If spondylolisthesis is accompanied by very severe pain, surgical treatment is used.

In traumatic and non-infectious pathologies of the musculoskeletal system, back pain usually subsides or decreases when the person assumes a comfortable position.

If spondylolisthesis is accompanied by severe pain, the doctor may prescribe corticosteroid injections

Infectious diseases of the spine

Inflammation of bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe back pain. These pathologies, as a rule, are of a secondary nature, that is, they arise as a complication of inflammation of other organs (the infection enters the tissues with the blood flow).

Treatment involves hospitalization, lasts up to 1 month, and then requires rehabilitation, which takes 6 to 12 months.

Tumor diseases of the spine

Neoplasms can develop under the influence of hereditary or external factors (for example, radiation), but most often occur as repeated foci (metastases) in oncological diseases of other organs – the lungs, mammary glands, prostate, thyroid gland, kidneys.

One of the most characteristic symptoms in neoplastic pathologies is pain that does not subside when changing position or after rest. Symptoms such as numbness, partial paralysis, uncontrolled urination, and a sharp increase in body temperature with chills are also possible. Without treatment, the symptoms worsen.

Treatment is based on the type of tumor, location, and symptoms, and may include chemotherapy, radiotherapy, and surgical removal of the tumor. Anesthesia is carried out with non-hormonal or steroid drugs. To stabilize the spine, the doctor may prescribe the wearing of a corset.

Orthopedic corset helps to stabilize the spine

Diseases of the internal organs causing back pain

Low back pain may occur in diseases not associated with pathologies of the spine and adjacent tissues. Acute or aching, it can accompany inflammation of the internal organs: pyelonephritis, urolithiasis, abdominal aortic aneurysm. In women, pain in the lower back can develop with gynecological pathologies.

Urolithiasis

A disease in which stones form in the kidneys and bladder – solid formations from the sediment of the chemical components of urine. Back pain is one of the main signs of pathology. Depending on the size and location, kidney stones can cause dull and aching pain that comes and goes periodically, or very sharp pain that does not go away on its own and requires emergency medical attention.

Urolithiasis – formation of stones in the kidneys and bladder

If you suspect kidney stones, you should contact a urologist or nephrologist. The doctor will prescribe tests and instrumental studies (ultrasound, X-ray examination, computed tomography, including the use of a contrast agent) to make a diagnosis and choose a treatment strategy.

Treatment is prescribed taking into account the size, nature, location of stones and other factors. If the stone is small (5–10 mm), and there are no other indications for surgical removal, drug treatment is used. If there is no positive dynamics within a month, removal by non-invasive or surgical methods is recommended.

Abdominal aortic aneurysm

Weakening of the walls of the abdominal aorta (aneurysm) can lead to a life-threatening condition – rupture of the aorta and intra-abdominal bleeding. As a rule, pathology occurs in older people: at risk are men over 65 years old and women over 70 years old, including smokers, those suffering from vascular diseases (high blood pressure), having cases of aneurysms before or a hereditary predisposition to them.

Low back pain due to abdominal aortic aneurysm does not subside with time and may be accompanied by pain in the abdomen and legs.

If an aneurysm is suspected, abdominal ultrasound and computed tomography are prescribed.

Treatment depends on the size of the aneurysm. Minor changes require follow-up with instrumental examination twice a year and lifestyle changes. Significant (over 5 cm, with a high risk of rupture) – are an indication for abdominal or minimally invasive surgery.

How to prevent back pain

Since low back pain is most commonly caused by traumatic injury to the muscles, fascia, joints, or bones, the main prevention recommendation is to follow safety precautions, maintain a strong muscle core, and maintain healthy bones and joints.

Prevention of back sprains and microtraumas:

• a varied diet that includes vitamins and minerals needed to maintain healthy bones, muscles and joints;
• maintaining a healthy weight;
• regular physical activity: exercises to prevent back pain should include strength training to develop the muscular frame, stretching to relieve muscle cramps and spasms, and cardio to maintain blood circulation and tissue nutrition;
• compliance with safety regulations during sports activities – for example, the first classes in the gym must be supervised by a qualified trainer;
• keeping safe at home – many injuries can be avoided by wearing comfortable shoes, holding on to the railing on the stairs, taking your time when the street is slippery;
• compliance with safety precautions when lifting weights – the load on the spine will be less if you approach the object as close as possible (do not reach for it), and when lifting objects from the floor, bend your legs, and not tilt the body.

Yoga and Pilates classes help relieve cramps and tightness in the lower back

Smoking impairs blood circulation and impairs tissue nutrition – this increases the risk of damage and injury.

What to do if your lower back hurts

If the lower back hurts, the causes may be different, which means that the treatment tactics will be different.

In case of severe physical overwork, the back needs to be given a rest – perhaps this will be enough for the muscles to recover and the mobility of the spine to return.

If the pain does not go away within 1-2 days or if it is very severe, you need to see a doctor. While waiting for the doctor, you can try to relieve acute pain with painkillers.

At the appointment, the doctor will conduct an examination, determine the cause of the pain and give recommendations for treatment. This will help eliminate dangerous conditions and prevent the development of complications.

Warming (lumbar pepper patch, hot water heater, sauna) is contraindicated for inflammation, but can relieve acute pain in the lower back if it is caused by muscle overwork or a pinched nerve. These methods can only be used after consulting a doctor.

Which doctor should I contact with a complaint of back pain

If you suspect a pathology of the musculoskeletal system, you should contact a neurologist and an orthopedic traumatologist.

Diagnosis is carried out during a physical examination and using instrumental methods: magnetic resonance therapy, computed tomography, X-ray and ultrasound. It is also possible to prescribe a myelogram (X-ray or CT scan with a contrast agent that is injected into the spinal canal) and electromyography – a study that allows you to assess the condition of nerve and muscle fibers.

If you suspect kidney disease, you should contact a urologist, nephrologist or general practitioner. The doctor will analyze complaints and conduct a physical examination, and then prescribe laboratory and instrumental studies to clarify the diagnosis.

Based on blood and urine tests, the doctor will be able to determine if there is inflammation in the organs of the urinary system, and ultrasound and X-ray studies will help visualize the organs, determine the cause of pain and choose the most effective treatment tactics.

If the origin of back pain is not clear, you should contact your general practitioner or general practitioner.

The doctor will take an anamnesis (disease history), analyze hereditary risks, conduct a physical examination and prescribe tests that will identify inflammatory processes or abnormalities in the functioning of internal organs.

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A biochemical blood test allows you to evaluate the work of internal organs and identify chronic diseases.