How to Identify the Leading Causes of Chronic Lower Back Pain
Back pain is incredibly common — the majority of people will experience back pain at some point in their lives. However, it’s worth pointing out that acute back pain is much more common than chronic back pain, and each sort of problem will demand a different approach to diagnosis and treatment.
You might be tempted to write off lower back pain as a natural consequence of aging, but chronic pain is typically a sign that something deeper is to blame. Instead of struggling through the pain, learn the common causes of back pain and work toward a solution with the help of your doctor.
Muscle or Ligament Strain
Repetitive muscle strain can take a big toll on your body, and your back often bears the brunt of the damage. Repeated lifting, a sudden fall, or an awkward movement can strain back muscles immediately, but the effects last for days, weeks, or months.
Over-stretched or torn muscles can cause painful muscle spasms, and when a ligament is stretched or torn, a lumbar sprain results. Symptoms can range from a mild ache in the lower back to stabbing pain, and the inflamed area may be sore to the touch.
Your spine contains a series of bones (vertebrae), and a disc sits in each space between these bones. The disc is sturdy yet flexible, which helps it cushion and absorb shock, but sometimes it bulges out of its resting place between the vertebrae and presses on a spinal nerve.
Although not every bulging disc causes pain or discomfort, this condition can send severe pain down your buttock and leg via the sciatic nerve. In fact, your pain may be worse in your foot than it is in your back, and it’s typically constant and burning rather than dull and intermittent.
Degenerative Disc Disease
If your pain tends to move with you, there’s a good chance that a disc is beginning to degenerate, losing its ability to cushion bone and protect nerves. Not surprisingly, discs tend to degenerate with age, but people as young as 20 can begin to feel the uncomfortable effects, too.
There’s a good chance your pain is near constant, but you’ll notice it intensifies to extreme levels now and then. Sitting for a long stretch of time, bending or twisting might bring a sharp twinge, yet many people with degenerative disc disease find that walking or running can actually bring some relief.
While degenerating discs can make sitting difficult, a slipped vertebrae can make movement excruciating.
The condition known as isthmic spondylolisthesis usually begins in childhood, but you likely won’t notice the common symptoms until young adulthood: pain when bending backward, tired feeling in the legs (or numbness, due to sciatica), very tight hamstrings, and relief when sitting back or reclining. The pain comes from the vertebrae compressing the nerves in and around the disc below.
Osteoarthritis is an exceedingly common condition that typically hits after middle age and can cause problems in many joints, including the spine. The pain and inflammation comes on gradually, and as the cartilage in the spine breaks down more and more, you’ll probably find that your back stiffens, especially at the start and end of the day.
Too much activity will inflame the problem, and sometimes even touching the affected area can be painful. Although osteoarthritis is a progressive disease, there are measures you can take to stay mobile and flexible.
The curvature of your spine can dictate your level of back discomfort. Scoliosis is an abnormal curve in the spine: instead of a straight line of vertebrae, an X-ray would show your spinal column bends to the side in either a "c" shape or an "s" shape.
Naturally, this formation can put extra pressure on certain areas, which may lead to back pain. Generally, scoliosis manifests during childhood or adolescence, but even if it is diagnosed in adulthood, bracing or surgery can often manage the problem very well.
If you have osteoporosis (or your bone density is declining), you’re at risk for spinal fracture — a potentially debilitating event that brings a pattern of symptoms. These compression fractures are much more common in adults over 50, and if you suffer from osteoporosis, something as simple as a sneeze or tight hug can cause the damage.
Since a fracture is a definite event, you may notice a sudden pain in your back, followed by less spinal flexibility, and perhaps even a loss of height. Standing or walking typically makes the pain worse, but lying on your back might relieve the discomfort.
Sacroiliac Joint Disease
When the pain travels through your lower back and down into your groin and buttocks, there could be a deeper joint problem at play.
While all signs might appear to point to sciatica, if your pain is symmetrical and concentrated around your pelvis — and you can ease the discomfort by changing positions — the issue could very well be in the sacroiliac joint, where the bottom of the spine connects to the hip bones on either side. Too much or too little movement in the sacroiliac joint can bring on sacroiliac joint disease.
Spinal tumors are rare, and although this probably isn’t the cause of your chronic back pain, it’s important to be aware of the symptoms that point to this serious disease.
A spinal tumor can cause pain in the neck or back, depending on where it presses on or in the spine, and neurological symptoms can follow.
Weakness or numbness in the extremities, loss of bladder or bowel control, unexplained weight loss, ongoing fever, and pain that gets worse at night are some of the major warning signs.
Your spine is charged with holding your body weight when you stand, sit upright, or move around, so it’s no surprise things go wrong from time to time. Luckily, many cases of back pain (even degenerative problems) can be managed well, as long as you commit to treatment and self-care.
Keep in mind that lower back pain doesn’t necessarily mean a life of immobility and dependence, but if it comes along with other worrying symptoms, it’s important to see your doctor right away for a thorough exam.