Sometimes, the reason for your lower back pain is obvious. You might have overexerted yourself lifting something heavy or felt a twinge immediately. Perhaps you’ve been warned about your posture contributing to back issues. But often, the origin of lower back pain feels mysterious.
Your lumbar spine, situated in your lower back, is vital for supporting your upper body’s weight and enabling everyday movements like bending, twisting, and coordinating your hips, pelvis, legs, and feet. “This frequent use makes the bones, muscles, ligaments, discs, and nerves in your lumbar spine prone to injuries and wear and tear over time, leading to lower back pain,” explains Dr. Kenneth Palmer, an orthopedic surgeon specializing in spine surgery at Houston Methodist.
Lower back pain can manifest in various ways, including:
- A persistent dull ache in your hips and/or pelvis
- Muscle spasms or a feeling of tightness
- Sharp, shooting pain that begins in your lower back and travels down your leg (sciatica)
- Pain that worsens when sitting but eases quickly with walking
- Pain that is more intense in the morning
Dr. Palmer notes, “People usually experience a combination of these symptoms, which can appear suddenly or gradually. Lower back pain can be intermittent, flaring up occasionally but generally worsening over time.”
The symptoms of lower back pain can also differ from person to person, depending on the underlying cause.
Let’s explore the common culprits behind lower back pain.
Common Causes of Lower Back Pain: Strains and Sprains
Your lumbar spine is constantly working, often without you realizing it. Throughout the day, it endures a lot of stress and motion.
A lower back sprain or strain can occur due to a sudden injury, such as a fall, lifting a heavy object incorrectly, or during sports activities. These can also develop gradually due to repetitive motions or poor posture.
“Muscle strains and ligament sprains are the most frequent causes of lower back pain,” says Dr. Palmer. “While they can be painful, these common issues are usually not long-lasting, typically resolving within a few days to a few months at most.”
Your doctor can guide you on the best self-care strategies to help heal your lower back pain.
“Treatment for a pulled back muscle or strained ligament is usually straightforward and may include pain relievers, anti-inflammatory medications, muscle relaxants, ice to reduce inflammation, heat to promote healing, and avoiding strenuous activities until the pain subsides,” explains Dr. Palmer. “The best approach will depend on the severity of your injury and your overall core and lower body strength.”
If your lower back pain persists despite these treatments, it’s important to consider other potential causes.
Chronic Lower Back Pain: Deeper Issues
“Chronic lower back pain is less likely to stem from muscle or ligament injuries and more likely to be related to problems with the lumbar discs, nerves, joints, or vertebrae,” Dr. Palmer clarifies. “Several conditions can lead to chronic pain in the lower back.”
Osteoarthritis, the most prevalent form of arthritis, and degenerative disc disease, the natural wear and tear of spinal discs, are often underlying factors in chronic lower back pain. However, trauma from accidents and acute stress can also contribute.
Herniated Disc
“The adult thoracic and lumbar spine consists of about 17 vertebrae stacked upon each other. Between each vertebra, there’s a cushioning disc that helps absorb pressure,” explains Dr. Palmer.
Each disc is composed of a tough outer layer and a gel-like inner core.
A lumbar herniated disc occurs when the inner gel of one of the five discs in your lower back protrudes or bulges beyond the outer layer. This can happen due to injury or gradual, age-related degeneration. When this inner gel presses on nearby nerves, it causes pain.
Facet Joint Damage
The facet joints, which connect the vertebrae in your lower back, bear significant compressive force and stress. Over time, the cartilage in these joints can break down, leading to lower back pain.
“Facet joint damage, often resulting from osteoarthritis, can be caused by poor posture or repetitive overuse. It can lead to inflammation, stiffness, muscle spasms, and pain,” Dr. Palmer elaborates. “Furthermore, if facet joint damage impinges on a nearby nerve, it can cause sciatica.”
Compression Fracture
“A spinal compression fracture happens when a vertebra in your lumbar spine essentially collapses. This is frequently due to osteoporosis, but can also result from trauma,” says Dr. Palmer.
This collapse can cause intense pain, and individuals with a lumbar compression fracture often experience sudden pain and limited spinal mobility.
Spinal Stenosis
Lumbar spinal stenosis occurs when the spinal canal in your lower back narrows, putting pressure on the nerve roots. It can be triggered by bone spurs, thickening of ligaments, or degeneration of a lumbar disc or joint.
“Compressed nerve roots can be extremely painful,” Dr. Palmer states. “Spinal stenosis not only causes lower back pain but can also lead to sciatica, with pain radiating down the legs.”
Spondylolisthesis
If a lumbar vertebra slips forward over the vertebra below it, it puts considerable pressure on the lumbar disc between them. As this disc deteriorates, it can cause lower back pain. Additionally, the flattening of the disc from this force can compress nerves, resulting in sciatica.
“Isthmic spondylolisthesis, a common type, is caused by a fracture in the pars interarticularis, a small bone near the facet joint. This fracture often occurs in youth, but pain may not appear until later in life,” explains Dr. Palmer. “Spondylolisthesis can also be caused by degenerative or congenital factors.”
Scoliosis
Your spine naturally curves in an ‘S’ shape when viewed from the side. However, scoliosis is a condition where the spine curves sideways when viewed from the back. This spinal deformity can lead to back pain.
“An improper spinal curvature increases the likelihood of degeneration in the lumbar joints and discs,” warns Dr. Palmer. “While most scoliosis cases don’t require treatment, severe curvature can place significant stress on the lower back and cause pain.”
When to Consult a Specialist for Lower Back Pain
If your lower back pain doesn’t improve with rest and self-care, it’s advisable to see a spine specialist.
“A spine specialist will conduct a physical examination and may order imaging scans to diagnose the underlying cause of your lower back pain. Based on the diagnosis, they will create a treatment plan to alleviate your pain and prevent it from disrupting your daily life,” concludes Dr. Palmer.
