At some point in life, 80% of Americans experience lower back pain. Those of you have already know how painful and debilitating it can be.
Fortunately, most back pain is self-limited and resolves without specific treatment. However, back pain can sometimes indicate a serious issue that requires medical attention. It may also become chronic, having a lasting impact on your ability to exercise and function.
Preventing back pain is very important, as medical treatment of back pain can often not be effective in relieving symptoms.
In this article, I will review 5 common causes of low back pain and what you can do to give yourself the best shot at full recovery.
Technically speaking, obesity doesn’t “cause” back pain – it is a risk factor for back pain. Still, I have chosen to list it as a cause because of its role in so many cases of low back pain. Multiple studies show that if you are overweight or obese, your risk for back pain is much greater than if you maintain an optimal body composition.1 If you lose weight, you will likely (though not always) experience a decrease in pain.2 Other studies show that overweight people do not respond as well to treatment as healthy weight low back pain sufferers.3
If you carry extra body fat, eliminating it should be your primary goal whether you have back pain or not, as its detrimental effects on health extend way beyond back pain.
2. Sprains & Strains
These injuries (see my article on strains and sprains for detailed definitions and explanations of these terms), known as musculoskeletal back injuries, are very common and may result from even the most routine everyday activities. Simply picking up a box from the floor, lifting weights with incorrect form, or even just sneezing can cause a strain or sprain. A muscle or ligament injury is often accompanied by severe spasms, which can cause extreme pain. Recovery time varies considerably from person to person. Minor sprains and strains can resolve in a few days, while more serious ones may take weeks or even months to improve.
You can minimize your chances of this kind of injury by staying flexible, maintaining a strong core, and lifting objects or weight with proper form (i.e. keeping a neutral spine position instead of allowing your back to round).
If you do experience a strain or sprain, applying ice to the affected area (20 minutes every few hours for 2-3 days after the injury) will help minimize swelling. After 2-3 days, heat should help the injured structures recover. Taking Tylenol or an anti-inflammatory medicine like Motrin or Aleve often provides some relief, though some believe that inflammation is important for healing and it is counterproductive to use anti-inflammatory drugs. Prescription muscle relaxers, like Flexeril or Zanaflex, can go a long way in hastening recovery. If possible, avoid the activity that caused the injury and work back into your routine slowly, paying careful attention to your body’s cues. During recovery, stay as active as your body will allow, as bed rest will likely make the situation worse.
3. Disc Degeneration/Herniation
The bones of the spine are separated by disks, which act to cushion the vertebrae. Disk degeneration can cause low back pain. If the outer ring of a disk is damaged, the insides can slip out and press on the nerves as they exit the spine.4 This can cause pain that runs down the leg, known as radiculopathy.
Aging is the primary cause of disk degeneration, but smoking raises the risk of disk injury. To prevent pain from disk degeneration and minimize the chances of herniation, you should engage in smart exercise, maintain a healthy bodyweight, and refrain from smoking. If you do have disk disease, treatment options range from physical therapy and medications to surgery. Keep in mind that surgery is often ineffective in relieving back pain, and you must really think long and hard before electing to go forward with it, even if that’s what your doctor recommends.
4. Muscle Imbalances & Poor Posture
Sitting can lead to low back pain. When you sit for extended periods of time, especially with your head hunched and shoulders rolled forward (as is common in many people with desk jobs), the muscles around your hips can become tight and cause pain. The pain can worsen if your abs or the muscles that surround the spine are weak, as they help support the spine.
Excess weight in the belly can cause you to walk your spine tilted back (this happens with pregnancy as well), which can cause pain. Maintaining good posture and a neutral spine position, keeping your core muscles strong and your body flexible and avoiding prolonged, continuous sitting will lessen your risk of back pain.
Arthritis is a general term that describes many different diseases causing tenderness, pain, swelling, and stiffness of a joint.5 Osteoarthritis is the term used for arthritis of the bones. Arthritis of the facet joints, which connect the vertebrae, causes rubbing of the bones and may result in severe pain. As the joints rub, bone spurs (abnormal bone development) can form and press on the nerves as they exit the spine. Aging, obesity, diabetes and genetics are all risk factors for spinal arthritis.
Once again, prevention is key, and although there’s not much you can do about genetics or aging, staying lean and flexible will most certainly help. Treatment is aimed at decreasing inflammation and maintaining joint movement and flexibility.
In line with most of my recommendations, the best way to minimize your chances of back pain is to live a healthy lifestyle. While this will not guarantee a back pain-free life, it will help significantly and provide you with countless other health benefits.
- Heuch I, Heuch I, Hagen K, Zwart JA. Body mass index as a risk factor for developing chronic low back pain: a target=”_blank” rel=”nofollow” follow-up in the Nord-Trondelag Health Study. Spine (Phila Pa 1976). Jan 2013 15;38 (2): 133-9. ↩
- Lidar Z, Behrbalk E, Regev GJ, Salame K, Keynan O, Schweiger C, Appelbaum L, Levy Y, Keidar A. Intervertebral disc height changes after weight reduction in morbidly obese patients and its effect on quality of life in radicular and low back pain. Spine (Phila Pa 1976). Nov 2012 1;37(23): 1947-52. ↩
- Rihn JA, Radcliff K, Hilibrand AS, Anderson DT, Zhao W, Lurie J, Vaccaro AR, Freedman MK, Albert TJ, Weinstein JN. Does obesity affect outcomes of treatment for lumbar stenosis and degenerate ive spondylolisthesis? Analysis of the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). Nov 2012 1;37(23):1933-46. ↩
- Interestingly, often times someone with low back pain will show no signs of degenerated disks on an MRI or x-ray, while someone without any pain may have significant x-ray evidence of degenerated disks. ↩
- Ray, C. Osteoarthritis of the Spine. Spine-Health. Jun 2005. ↩