Want to know more about lower back pain, the causes and treatments

We asked the National Institute of Neurological Disorders and Stroke for answers to basic questions.

We know: All About Lower Back Pain

What is back pain?

Back pain is a symptom that can arise from many causes. It can range from a dull, annoying ache to absolute agony. Many cases of back pain are caused by stresses on the muscles and ligaments that support the spine.

Most back pain occurs in the lumbar, or lower back area.

What are the causes of lower back pain?

Low back pain may reflect nerve or muscle irritation or bone lesions. Most low back pain follows injury or trauma to the back, but pain may also be caused by degenerative conditions such as arthritis or disc disease, osteoporosis or other bone diseases, viral infections, irritation to joints and discs, or congenital abnormalities in the spine.

Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, posture inappropriate for the activity being performed, and poor sleeping position also may contribute to low back pain.

Low back pain may indicate a more serious medical problem. Pain accompanied by fever or loss of bowel or bladder control, pain when coughing, and progressive weakness in the legs may indicate a pinched nerve or other serious condition. People with these symptoms should contact a doctor immediately to help prevent permanent damage.

Who is most likely to develop low back pain?

It occurs most often between ages 30 and 50, due in part to the aging process but also as a result of sedentary life styles with too little (sometimes punctuated by too much) exercise. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age.

How is lower back pain treated?

Treatment involves using analgesics, reducing inflammation, restoring proper function and strength to the back, and preventing recurrence of the injury. Patients should contact a doctor if there is not a noticeable reduction in pain and inflammation after 72 hours of self-care.

Treatments may include:

  • Ice and heat compresses may help reduce pain and inflammation and allow greater mobility for some individuals. As soon as possible following trauma, patients should apply a cold pack to the tender spot several times a day for up to 20 minutes. After 2 to 3 days of cold treatment, they should then apply heat (such as a heating lamp or hot pad) for brief periods to relax muscles and increase blood flow.
  • Bed rest - 1-2 days at most. Patients should resume activities as soon as possible. At night or during rest, patients should lie on one side, with a pillow between the knees (some doctors suggest resting on the back and putting a pillow beneath the knees).
  • Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Doctors and physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process.
  • Medications are often used to treat acute and chronic low back pain. Patients should always check with a doctor before taking drugs for pain relief. Medications include over-the-counter analgesics, including nonsteroidal anti-inflammatory drugs (aspirin, naproxen, and ibuprofen) and counter-irritants applied topically. A doctor may also prescribe a variety of other drugs.

Other treatments for lower back pain include spinal manipulation, acupuncture, biofeedback, interventional therapy, traction, electrical nerve stimulation, ultrasound, and various forms of surgery.

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