Back pain - low Health Article

Common Causes

You'll usually first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an injury or accident. But prior to that moment in time, the structures in your back may be losing strength or integrity.

The specific structure in your back responsible for your pain is hardly ever identified. Whether identified or not, there are several possible sources of low back pain:

• Aortic aneurysm
• Degeneration of the disks
• Kidney problems, such as infections or stones
• Muscle spasm (very tense muscles that remain contracted)
• Other medical conditions like fibromyalgia
• Poor alignment of the vertebrae
• Ruptured or herniated disk
• Small fractures to the spine from osteoporosis
• Spinal stenosis (narrowing of the spinal canal)
• Spine curvatures (like scoliosis or kyphosis) which may be inherited and seen in children or teens
• Strain or tears to the muscles or ligaments supporting the back

Low back pain from any cause usually involves spasms of the large, supportive muscles alongside the spine. The muscle spasm and stiffness accompanying back pain can feel particularly uncomfortable.

You are at particular risk for low back pain if you:

• Are over age 30
• Are pregnant
• Feel stressed or depressed
• Have a low pain threshold
• Have arthritis or osteoporosis
• Have bad posture
• Smoke, don't exercise, or are overweight
• Work in construction or another job requiring heavy lifting, lots of bending and twisting, or whole body vibration (like truck driving or using a sandblaster)

• Bladder infection
• Endometriosis
• Kidney stone
• Ovarian cancer
• Ovarian cysts
• Testicular torsion (twisted testicle)

Home Care

Many people will feel better within one week after the start of back pain. After another 4-6 weeks, the back pain will likely be completely gone. To get better quickly, take the right steps when you first get pain.

A common misconception about back pain is that you need to rest and avoid activity for a long time. In fact, bed rest is NOT recommended.

If you have no indication of a serious underlying cause for your back pain (like loss of bowel or bladder control, weakness, weight loss, or fever), then you should reduce physical activity only for the first couple of days. Gradually resume your usual activities after that. Here are some tips for how to handle pain early on:

• Stop normal physical activity for the first few days. This helps calm your symptoms and reduce inflammation.
• Apply heat or ice to the painful area. Try ice for the first 48-72 hours, then use heat after that.
• Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).

While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.

Do not perform activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. After 2-3 weeks, you should gradually resume exercise.

Begin with light cardiovascular training. Walking, riding a stationary bicycle, and swimming are great examples. Such aerobic activities can help blood flow to your back and promote healing. They also strengthen muscles in your stomach and back.

Stretching and strengthening exercises are important in the long run. However, starting these exercises too soon after an injury can make your pain worse. A physical therapist can help you determine when to begin stretching and strengthening exercises and how to do so.

AVOID the following exercises during initial recovery unless your doctor or physical therapist says it is okay:

• Jogging
• Football
• Golf
• Ballet
• Weight lifting
• Leg lifts when lying on your stomach
• Sit-ups with straight legs (rather than bent knees)