Almost everyone experiences low back pain every now and then. Whether mild or severe, lasting a short time or for years, low back pain can greatly affect your daily life. When low back pain strikes, how do you go to work? Take care of your kids? Clean the house?
It's not easy, but you can be proactive when it comes to managing your low back pain. Before you take steps to ease low back pain, it's helpful to understand the causes and symptoms of low back pain.
Causes of Low Back Pain
Many factors can contribute to low back pain -- from strained muscles to strained "nerves" An acute injury -- lifting and twisting a heavy load, for example -- can lead to low back pain. And, over time, aging causes degenerative spinal changes starting as early as the 30s or sooner. Here's a quick overview of low back pain culprits:
- Overuse of muscles and ligaments, caused by a competitive tennis match or an ambitious day in the garden.
- Disk injury, tears or other damage to the "shock absorbers" between the spinal bones (vertebrae).
- Disk degeneration, the wear and tear, shrinking, and collapse of disks that can be more common with age.
- Degenerative spondylolisthesis, changes to spinal structures, which allows a vertebra to slip forward from the next vertebra.
- Spinal stenosis, narrowing of the space around the spinal cord, which puts pressure on nerve roots.
- Scoliosis, an abnormal curvature of the spine that may cause pain for some people.
Low Back Pain Symptoms
Low back pain symptoms vary greatly from person to person. They are different depending upon the cause of the pain. Your pain may be dull or sharp. It may come and go. And depending upon its source, pain may get worse with standing, sitting, bending, or walking. Pain can even extend into your buttock or leg. Along with this shooting pain may come feelings of numbness, tingling, or weakness down your leg. Called sciatica, these symptoms may be a common result of a herniated disk in the lower back, where the disk bulges out toward the spinal canal.
Low Back Pain: What You Can Do
Listen to your body. If a certain movement or exercise causes pain, stop and pay attention. Discuss with your doctor or other health care professional what movements are safe for you to do. Here are a few reminders about what you can do to protect your back:
Rest, but not too much. In most cases, it's best to not stay in bed for more than a day or two after an acute injury. If you stay in bed longer than this, your muscles start to lose strength and their ability to support your back. Stay as active as you can, while continuing to listen to your body's signals.
Sit and stand safely. What are the positions you're in most of day? Whether at work or home, are you doing everything you can to protect your low back with good posture? You've heard it before, but it bears repeating: Good posture is critical. Sit or stand with your back aligned; imagine a line from your ears through your hips. Try to catch yourself when you're slouching.
Here are some other things to remember:
- Sit and drive as little as possible if back pain is acute. Avoid sitting on soft, low couches.
- Make sure your work surface is at a comfortable height for you.
- Use a chair with good lumbar support or use a pillow or rolled-up towel for support. Position your chair at the right height for your task. Rest your feet on a low stool.
- When getting up from a sitting position, scoot to the edge of your seat, get your feet directly underneath you, and stand. Avoid bending at the waist.
- When driving, make sure you've got good lumbar support. Position the seat so you maintain a curve in your low back and your hips are lower than your knees.
- When getting out of the car, support your back: Swing both legs out, don't twist. On long road trips, take regular breaks to walk around for a few minutes.
Lift and move safely. Change positions often. If you have a desk job, for example, be sure to get up, move around, and stretch every hour. Gently arch your back. Need a reminder to move? Set an alarm on your phone or computer. When doing activities like cleaning, weeding, or vacuuming, remember to keep the curve in your lower back as much as you can.
Whether you're lifting your child or a bag of groceries, use these lifting tips as a guide.
- Plan the lift and take your time.
- Get close to the load and test its weight before you lift. If you think it's too awkward or heavy, don't lift it. When the grocery checker asks if you want help to your car, swallow your pride and say yes. Or, at the very least, have the checker pack less in each bag.
- Put your feet shoulder width apart, tighten your stomach muscles, get a firm grasp, and lift with your legs, not your back. How do you do that? Bend at the knees, instead of your waist. That makes your legs do the work, not your low back. The muscles in your legs are larger and stronger than the muscles of the lower back.
- As you lift, keep your head in line with your back and don't twist or jerk. Don't sling your toddler up onto your hip! Point your toes in the direction you are moving. Then pivot. As you move, hold the object as close as you can to your body. This takes some stress off your back.
- When placing a child in a car seat, don't reach from outside the car. Squat and get as close to the seat as you can. If your child is old enough, have him or her climb into the car seat.
Avoid smoking. Does it seem like smoking has little to do with your back? You might be surprised. Smoking can contribute to reduced blood flow to your spine and cause it to age faster, putting you at greater risk for low back pain.
Eat well and maintain a healthy weight. Maintaining a healthy weight takes some of the strain off your lower back. Also, eating enough calcium and vitamin D helps promote bone strength.
What you need for treatment depends on the cause of your low back pain.
Your doctor may recommend temporary use of medications to relieve pain. These might include over-the counter medicines such as acetaminophen or nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, or naproxen. Sometimes stronger medications may be prescribed for pain treatment. If pain is severe or lasts, you may need oral or injected steroids.
Physical therapy or chiropractic can bring relief for many. These targeted treatments may include:
- Ice or heat
- Ultrasound or electrical stimulation
- A specific program of stretching and strengthening exercises
- Spinal manipulation
A doctor, massage therapist, physical therapist, or other health care professional can guide you in a safe back exercise program. Depending on your medical condition or cause of your back pain, certain exercises or activities may not be safe for you. For many people, gentle low-impact aerobic exercises like walking or swimming about 30 minutes a day can help to keep muscles strong and flexible. These are often combined with specific exercises to strengthen the muscles that support your back.
In certain cases where back pain does not get better with nonsurgical treatments, surgery may be an option.