Pain in the Lower Back: Causes, Symptoms, Diagnosis, Treatment and Prevention

The lower part of the back is the area behind the abdomen from the rib cage to the pelvis and is also called the lumbar region.

Almost everyone will experience some kind of back pain in their life.

Back pain is the main cause of job losses. Low back pain usually resolves on its own and is commonly the result of a strain injury. There are many treatments for low back pain.

At risk of low back pain?

Studies have shown that up to 80% of the general population are affected by low back pain (lumbago) at some point in their lives.

Learn to prevent back pain by knowing what activities could put you at risk:

  • Manual manipulation of materials (especially lifting).
  • Twist the trunk.
  • Bending the trunk forward.
  • Bending the trunk to the side.
  • Falls
  • Extended session.
  • Sedentary jobs
  • Highly physical works.
  • Exposure to the vibration of the whole body.
  • Smoking cigarettes.
  • Obesity .
  • Extreme height.


The symptoms of low back pain range from sharp and throbbing to severe pain. The pains can be constant or intermittent and positional. Acute low back pain may appear suddenly after the injury.

Chronic back pain is defined as pain that lasts more than three months. Consult a doctor if you have prolonged back pain for more than 72 hours.

Low back pain and serious back injuries

Severe back pain after an injury should be evaluated by a health professional. Warning signs of a more serious injury include pain when coughing or urinating, loss of bowel or bladder control, weakness in the legs, and fever. These additional symptoms require a medical evaluation.

Is it muscular or sciatica?

Back pain that occurs after excessive exercise or lifting heavy objects is often an effort injury. However, occasionally these activities cause disc injuries and rupture or hernia. When a herniated disc irritates the sciatic nerve, it can cause back pain.

What is sciatica?

Sciatica is a form of nerve pain caused by pressure on the sciatic nerve. The sciatic nerve is a large nerve that goes down the buttocks and extends down the back of the leg.

Pressing or pinching the sciatic nerve causes back pain similar to a shock or burning. Sometimes people feel as if the pain radiates down through the buttocks and down a leg, sometimes even to the foot.

Causes of pain in the lower back

Does your work cause back pain?

A job that involves pulling, lifting or twisting with the lower back can cause lower back pain and injuries. Even the prolonged position in an awkward position can cause lower back pain. Stand up for hours and hours?

That can also cause lower back pain. The best way to prevent back pain is to know if you are at risk.

Jobs that can cause lower back pain

  • Airline crew (pilots, baggage handlers).
  • Nurses and health workers.
  • Bus drivers and taxis.
  • Warehouse workers.
  • Construction workers.
  • Installers and carpet cleaners.
  • Farmers (agricultural, dairy).
  • Firemen and police.
  • Mechanics.
  • Office staff (eg, Telemarketers, file clerks, computer operators).

Workouts that can cause lower back pain

Most athletic injuries to the back are sprains of the ligaments or strains of the muscles that surround the spine. Serious conditions or complications can have symptoms similar to those of a routine sprain or strain.

The most common sports injuries occur after excessive repetitive use of the spine either by torsion, compression or bending. High impact sports such as running, soccer or volleyball can often cause lower back pain.

Sports such as golf, in which repetitive twisting is often involved, can also cause lower back pain.

Chronic conditions that cause back pain

Conditions that can lead to chronic low back pain include spinal stenosis , spondylitisand fibromyalgia . Spinal stenosis is the narrowing of the normal spinal canal through which the spinal cord passes .

Spondylitis is a chronic inflammation of the spine. Fibromyalgia is a muscular disorder that presents chronic muscle pain and sensitivity.

Herniated discs and lower back pain

The vertebrae, or bone building blocks of the spine, are cushioned by gel-shaped discs between the vertebrae. These discs can degenerate with aging and, as a result, are prone to injury. When a disc breaks, it is known as a herniated disc, which can cause significant pain.


The description of your back pain is very important for your doctor to diagnose your condition properly. It may be helpful to note when and where the back pain began, what activities it does, the related symptoms, and any chronic medical conditions.

Tests used to diagnose back pain:

  • Bone scan.
  • Computed tomography (CT).
  • Discography.
  • Magnetic resonance (MR).
  • Electrodiagnostics
  • Bone scans.
  • Ultrasound images.
  • Blood test.

Treatment for low back pain

Cold or hot therapy for low back pain?

Hot or cold packs can help relieve pain and reduce symptoms. The soothing relief of heat, or the dull relief of a cold compress, is only temporary and will not treat the most serious causes of back pain.

However, they can provide greater mobility for people with acute, subacute or chronic pain, which allows people to get up and get moving.

Does bed rest help relieve back pain?

Doctors often recommend continuing their usual activities of daily life as soon as possible. Studies suggest that strict bed rest can often prolong or worsen low back pain.

Bed rest can also cause secondary complications, such as depression , decreased muscle tone and blood clots in the legs.

You should try to keep moving while avoiding activities that noticeably worsen back pain. By staying active, those who suffer from lower back pain can obtain greater flexibility and a faster recovery.

Yoga for back pain

If the back pain does not go away in three months, there is evidence that yoga can help.

In a recent study, people who took 12 weeks of yoga classes had fewer low back pain symptoms than people who received a book on back pain care. The benefits lasted several months after finishing the classes.

The study suggests that conventional stretching also works just as well. Make sure your instructor has experience in teaching people with back pain and modify the postures for you as needed.

Should I see a chiropractor for my back pain?

Spinal manipulation is used by chiropractors and osteopathic doctors to treat low back pain in selected patients. Spinal manipulation applies hand pressure in areas of the lower back to relax the irritated muscle and decrease the intensity of pain.

Traction, the use of pulleys and weights to lengthen and stretch the spine can result in temporary relief. Both techniques will not treat any underlying cause of back pain, but will offer temporary relief of lower back pain.

Massage therapy for low back pain

Studies have shown that massage treatments can help relieve chronic low back pain. Massage treatment can restore people to their usual activities of daily living and decrease pain.

Massage therapy is limited and would not be the most effective solution for patients with spinal complications, injuries or disc problems, since massage focuses on the release of muscle tension and not on the structure of the spine.

Acupuncture to relieve low back pain

Acupuncture may be moderately effective for chronic low back pain. With acupuncture, fine needles are inserted at various points on the body.

Acupuncture practitioners hypothesize that when these fine needles are inserted into the skin and then stimulated by twisting or beating them, natural chemicals such as endorphins, serotonin and acetylcholine are released to relieve pain.

Anecdotal evidence suggests that acupuncture can be an effective analgesic. More scientific and clinical studies are underway to demonstrate the efficacy of acupuncture therapy.

Pain medication to treat back pain

A wide range of medications is used to treat acute and chronic low back pain. Analgesic medications are specially formulated to relieve pain. They include acetaminophen and over-the-counter aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be used to relieve pain and inflammation. Non-prescription NSAIDs include ibuprofen, ketoprofen and naproxensodium. Several others, including a type of NSAID called COX-2 inhibitors, are available only by prescription.

There are also many topical creams or sprays that can dull and calm back pain. These are applied to the skin and, therefore, stimulate the localized nerves to provide a sensation of heat or cold in order to attenuate the sensation of pain. Topical analgesics can reduce inflammation and increase blood flow.

Injections to relieve low back pain

Epidural steroid injections are a common short-term option for treating low back pain and sciatica.

These injections work by reducing inflammation to relieve pain. The injections are intended for short-term use and should not be used for a prolonged period of time, as they can worsen the pain in the long term.

For those with chronic pain or severe spinal cord injury, a nerve block may be used to prevent nerve conduction in a certain area. This essentially blocks all sensation of nerves. Nerve blocks are usually only used in extreme cases of severe pain.

Is it time for a back surgery?

Back surgery is usually the last resort when all other treatment options have been tried. Surgery can be considered an option to relieve pain caused by severe musculoskeletal injuries or nerve compression that results from vertebrae that move or collapse.

Back surgeries often have a long recovery period, and some patients may lose mobility and flexibility after surgery. It is also important to keep in mind that not all surgical procedures are successful.

As such, it is important that patients talk to their doctors and know all the risks associated with a procedure before undergoing back surgery.

Physiotherapy for the treatment of back pain

Rehabilitation programs can not only help in healing but also reduce the risk of re-injuring the lower back. Physical therapy guided by stretching, strengthening and low impact exercises is used to optimize short and long term results.

Tips to strengthen your back

Find relief from back pain: lighten your bags

Carrying a bag, briefcase or bag with excess filling can tighten the lower back. If you must carry a heavy load, consider using a wheeled case. By reducing the amount of weight you carry, you reduce the pressure on the spine.

Help keep your children’s backs healthy by making sure their backpacks are not overloaded. A heavy backpack could mean a future back pain for the little ones.

Better posture for the relief of back pain

The back provides optimal support when we stop properly and do not fall behind. Sitting with a suitable support for the lumbar area with the shoulders back and even a footrest can prevent back pain.

The proper balance on the feet when standing can also minimize the risk of developing lower back pain while it is up.

Flexion exercises

Flexion and extension exercises are commonly used to prevent low back pain. Be sure to check with your doctor about any program you are considering.

Simple exercises for the lower back:

Ankle pumps:  Lie on your back and move your ankles up and down.

Heel slides: Lie on your back and bend and then straighten your knees one at a time.

Squats on the wall : with your back against the wall, sit as you would in a chair with your knees lined up on your ankles. Press gently against the wall, keeping your abdominal muscles tightened. Hold for five seconds.

Stretching the individual knee to the chest : lying flat on the back, pull the knee towards the chest.

Is your back pain getting worse?

Do not be guilty of exacerbating your already aching back. Try these tips to prevent low back pain:

  • Wear comfortable shoes with low heels if you are standing all day.
  • Do not bend when standing or sitting.
  • At home or work, make sure the work surfaces are at a comfortable height.
  • Warm up and stretching before exercise or other strenuous physical activity.
  • Do not attempt to lift objects that are too heavy and do not twist when lifting objects.
  • Carry a healthy lifestyle, stop smoking and avoid excess weight.

Preventing low back pain

The steps to decrease your risk of back pain as you get older include exercising regularly (and not irregularly), maintaining a healthy weight, lifting with your legs and not your lower back, and optimizing your workstation.

After any period of prolonged inactivity, a low-impact exercise regimen is recommended. Strolling at speed, swimming or riding a bike 30 minutes a day can increase muscle strength and flexibility and protect your lower back from injuries or strains.

Frequent stretching can help relax muscle tension, strengthen core muscles and improve overall posture for a healthier back.