Low back pain is routinely one of the top 2 or 3 reasons to visit a doctor in America and a leading cause of missed time at work. In fact, about 80% of Americans will experience low back pain at some point in their lives. There can be many causes of low back pain, ranging from minor to more serious. Below are a few of the most common causes of low back pain and some helpful tips for prevention. This is for educational purposes only and it is always important to receive a proper evaluation by a pain management physician.
- Muscle Spasms: Also known as myalgia or sometimes the related myofascial pain syndrome. This is a very common cause of a steady, aching low back pain that can be so severe that one may have difficulty with basic movements or breathing. They are due to an involuntary, sustained contraction in the muscles associated with inflammation and pain. Muscle spasms can develop suddenly or over the course of many days. Some common causes are stress, dehydration, caffeine or alcohol use, poor posture, lack of proper sleep, spending time in uncomfortable shoes, sudden or repetitive muscle movements, muscle injury/strains, or a viral illness. They can also be caused by disorders originating near the spine such as facet arthritis or herniated discs. Aside from lifestyle modifications, other basic treatments include rest, heat application, stretching, massage therapy, NSAID’s, muscle relaxers, and trigger point injections.
- Herniated Disc(s): These can occur after a car accident, an injury related to heavy lifting, increased abdominal pressure or due to natural daily stresses and gradual degeneration. Typically diagnosed via an MRI, herniated discs can cause mild to severe pain in the low back, sometimes radiating down the leg and past the knee. Rarely, it can be associated with numbness, tingling, or weakness in the leg. For prevention, it is important to maintain good posture while sitting or driving, lift objects by bending at your knees rather than your back, and avoid heavy straining while using the bathroom. Usual treatments include NSAID’s, physical therapy, core strengthening, weight loss, epidural steroid injections, and sometimes surgery for advanced cases.
- Lumbar Facet Syndrome: More simply refers to arthritis of the small joints of the low back. This syndrome typically produces aching pain in the sides of the low back, sometimes radiating to the buttocks, and worse with leaning back or twisting motions. Facet pain can occur due to gradual wear and tear of these small joints in our spine or after an acute injury such as a car accident. Other factors associated with this are obesity, smoking, osteoarthritis, and poor posture. Treatments include NSAID’s, physical therapy, weight loss, and facet joint injections. For longer term relief, patients can benefit from a radiofrequency ablation of the medial branch nerves which are tiny microscopic nerves that sense pain from these painful facet joints.
- Sacroiliac Joint Pain: Also known as SI joint pain, this condition usually produces a dull, aching pain at the intersection of the low back/buttocks where the sacrum and iliac bones meet. The pain can sometimes radiate to the back of the thighs, hip or groin. It can be worse after prolonged standing or sitting, or when crossing one’s legs. SI Joint pain is due to inflammation or arthritis of this joint that can occur due to daily stresses as we age, trauma, osteoarthritis, pregnancy, or certain autoimmune diseases. Treatments include NSAIDs, physical therapy, improved posture, weight reduction, SI joint injections and SI nerve ablations. Very rarely, surgery may be indicated.