Some Causes Of Lower Back Pain
Now, remember, getting your back pain diagnosed by the doctor is what you need to do before you start looking for any type of treatment options. The following are some, but certainly not all of the, causes of back pain.
1. Musculo-skeletal Dysfunction – This is a mixed bag of conditions like muscle strains, bony mis-alignment, joint imbalances, muscle weakness, soft tissue shortening.
Pain coming from muscle problems or mis-alignment is usually localized in one area. But, depending on what muscles are involved, the pain could be felt in one of several places. Most of the time, you’ll have pain when your back muscles tighten up. Like when bending forward, walking, lifting or carrying something, and so on.
Most of the time the pain isn’t sharp. It feels like more of a stiffness or a dull ache when you’re bending or moving.
Usually these types of causes are relatively easy (and inexpensive) to treat and manage. Most of the time, some pain pills and a gentle exercise program will give you a lot of relief fast. The main drawback is that you actually have to do the work to get results.
2. Pinched nerve(s) – The term “pinched” comes from the fact that a nerve, when it leaves the spinal cord gets compressed between a rock and a hard place – sorry. But, the nerve is “pinched” between two structures. One of them is more likely your intervertebral disc.
Pinched nerves can be, how they say, exquisitely painful. It’s usually described as a sharp or shooting pain that goes down the leg from the back. In the majority of cases, the pain goes down one leg and not both.
Usually, being in standing or sitting causes more pain because the nerve gets more pressure put on it. But, most people with pinched nerves feel more pain when they bend or lean to one side more than the other because it pinches the nerve more.
Treatment can range from the extremely conservative (treat it with gentle stretching and conditioning exercises) to extremely radical (“Let’s open this person up and cut out all the “bad stuff”). It depends on how bad the “pinch” is.
While pinched nerves may or may not respond well to exercise, you can get some relief by finding a relatively pain free position to lay in with plenty of pillows to support holding you there. Then just rest in that position. This relieves some of the irritation to the nerve and let’s it calm down.
You can also try heat and/or ice (which ever helps best) and your doc may prescribe some pain meds for you. However, sometimes a pinched nerve may require surgery depending on what’s actually pinching it and how severe it is.
3. Spinal Stenosis – This is a condition where the spinal canal or the spaces where the nerves come out of the spine is getting more narrow. There are a few reasons why this happens. One of them is that there is an over growth of bone tissue in these areas and crowds out the nerve putting pressure on it.
Symptoms of spinal stenosis can be similar to a pinched nerve with pain and weakness. But, in some cases of stenosis the symptoms can be on both sides of the body.
Stenosis can be treated by exercise, positioning, and rest. You can also try ice and heat to relieve some of the pain in the muscles. But, unfortunately, severe stenosis is generally corrected by surgery.
4. Ruptured Disc – So, you’ve heard of a bulging, slipped, herniated disc, right? A ruptured disc is the most severe. So, what is it? I usually ask people to think of what happens when you squeeze a jelly filled doughnut. Once the jelly is out of the doughnut, it’s basically impossible to get it back in.
Now, there’s a progression from a compressed, bulging, herniated, then ruptured disc. Having a “ruptured disc” is the worst because it usually means that the border of your vertebral disc has broken. When it breaks off it usually presses around the nerve and causes a lot of problems.
And, like the pinched nerve, pain that you get from a ruptured disc is usually on one side or the other and it travels down the leg. Usually the back of the leg.The pain is usually pretty sharp and shooting. Some people describe it being like “an electric shock”.
In many cases of a true disc rupture, you may also get some other problems besides pain. You may have trouble feeling parts of your leg or foot. You may also have problems moving your foot or leg and it may feel pretty weak when you compare it to the other leg.
Also, depending on which spinal level has the disc disruption, you may have problems in the “bathroom and bedroom department”. You may notice problems urinating or “going #2” or problems in the sex department too.
Again, symptoms may be relieved by finding a position that feels like it takes the pressure off the nerve and relieves a lot of the other symptoms that you have.
As far as treatment goes, there really is no exercise that is going to “fix” a ruptured disc. Depending on the severity, usually surgery is the best option to remove or cut back the disc herniation.
5. Vetebral Fracture – This is basically a broken back bone. And there are a lot of ways that you can have a fractured back bone. You could have something like a compression fracture that comes from falling generally. Or, you could have something called a “pars interarticularis defect” (pretty exotic) which is a stress fracture in a particular area on one of your vertebrae.
As with most fractures, you’re going to have pain. Most of the time it’s going to be localized to the area of the fracture and it’s probably going to feel sharp with some motions. But, most of the time there will be a dull ache.
Just like with broken bones in other parts of your body, you have basically 2 options for treatment. You can either just rest and let it heal on its own. Or, you may need surgery to fix it. It really depends on how bad the fracture is and if it has the potential to cause other problems.
6. Disease Process – What this means is something like a kidney infection or prostatitis in men. But, it also can be something as severe as cancer. Most of the time these types of pain are pretty severe. And even though the pain is generally constant, it can get pretty severe at night. So severe that it can wake you up at night.
As far as treatment for this back pain, this is something that needs to be addressed by your doctor. The sooner the better.
7. Failed Surgery – Unfortunately for a lot of people who’ve had back surgery in the past, they continue to have back pain. And, just as with each of the other back pain causes mentioned above, there could be a number of reasons why a person continues to have back pain after surgery.
For one, one person themselves may not tolerate having screws or metal plates attached to their vertebrae as well as someone else. These can cause irritation and aching. Also, some people may continue to have inflammation in the area where others may not.
On the part of the doctor, the screws or other hardware may not have been aligned properly and so continue to irritate the surrounding tissues. Or, there may have been additional injury to the surrounding tissue during the surgery that continues to cause a lot of pain.
But, in many cases continued pain after back surgery can be caused by weak and tight muscles. And, most people don’t fully understand that after surgery they’re going to run into problems with tight and weak muscles.
Having weak and tight muscles after surgery is natural and should be expected. But, many people don’t appreciate that. They think that because they’ve had surgery to fix their pain, they shouldn’t continue to have pain once the surgery is complete.
So, when they keep having pain after surgery, they think that the doctor didn’t do their job right, or, that “something is really wrong” with them. They fail to realize that inflammation, muscle weakness, inactivity (and the decreased blood circulation that comes with it) and other factors combine to cause continued pain.
In cases like this, one of the best things to do is to go through a gentle exercise and stretching program for several weeks. This should produce positive results if the pain is being caused by sore/tight muscles rather than other things that could go wrong with a surgery. If the pain continues, you’ll want to follow up with your doctor for more options.
Now that we know what can cause pain in the lower back, what next? How do you get relief from back pain?