Lower Back Pain Center

What is lower back pain?  Low back pain (LBP) is often described as sudden, sharp, persistent, or dull pain felt below the waist. LBP is very common and affects the majority of people at some point during their life.

Low back pain is most commonly caused by muscle strain associated with heavy physical work, lifting or forceful movement, bending or twisting, awkward positions, or standing in one position too long. Any of these movements can exacerbate a prior or existing low back disorder.

Other conditions that can cause low back pain include:

• lumbar herniated disc
• spinal stenosis
• arthritis (osteoarthritis)
• spinal infection (osteomyelitis)
• spinal tumors (benign and malignant)
• spondylolisthesis
• vertebral fractures (eg, burst fracture).

Low Back Anatomy Lesson

Understanding the anatomy of your spine will help you better understand what's causing your low back pain.

Your low back, which is called your lumbar spine in medical-speak, is made up of many parts.

There are 5 lumbar vertebrae—the bones of your spine. They are labelled L1 through L5.  Your lubmar spine vertebrae are the largest vertebrae in the spine; this is what enables them to play a large role in carrying and distributing your weight.

On the posterior (back) side of your vertebrae, you have facet joints.  As with all joints, the facets help facilitate safe movement.  In your lumbar spine, they are particularly important to your flexibility (how far forward and back you can bend).

The intervertebral discs are in between your vertebrae (as the name would suggest).  Their function is to absorb your movements; in a way, they are like the shocks on your car.  Intervertebral discs have a tire-like outer section, which is the annulus fibrosus.  They also have an inner section filled with a gel-like substance, and that is called the nucleus pulposus.

Another important part of your spine are the spinal nerves.  The spinal cord travels down from the brain in the spinal canal, a protective tunnel made by the vertebrae and discs.  Branching off from the spinal cord are the spinal nerves.  In the lumbar spine, the spinal cord has become a bundle of nerves called the cauda equina; nerves there branch out to the legs.  These nerves help you feel and move.

The other "soft tissues" of the lumbar spine are the muscles, ligaments, tendons, and blood vessels.  The muscles, ligaments, and tendons support your spine and make it so you can move, lift, twist, etc. safely.

As you can see, your lumbar spine is complex, and injury or change to any of these parts can lead to lower back pain.

Lower Back Pain Symptoms

Low back pain is either acute or chronic. Acute lower back pain may begin suddenly with intense pain usually lasting less than 3 months.

Chronic low back pain is persistent long-term pain, sometimes lasting throughout life. Even chronic pain may present episodes of acute pain.

Other symptoms include localized pain in a specific area of the low back, general aching, and/or pain that radiates into the low back, buttocks, and leg(s). Sometimes pain is accompanied by neurologic symptoms such as numbness, tingling, or weakness.

Neurologic symptoms requiring immediate medical attention include:

• bowel or bladder dysfunction
• groin or leg weakness or numbness
• severe symptoms that do not subside after a few days
• pain prohibiting everyday activities

Common Lower Back Pain Questions

I'm experiencing acute low back pain; how do I know when I need to go see a doctor?
If you recently injured your low back (from lifting something improperly or even from sleeping poorly one night), you may be wondering:  How long will this pain last?  Is there anything I can do at home?  When is it serious enough to warrant a visit to the doctor?

We have answers for you.  In order to ease your symptoms, you can try:

• ice and heat: For the first 24 to 48 hours after you hurt your back, use ice to reduce swelling, muscle spasms, and pain. After that, switch to heat, which will help warm and relax sore tissues.  (Never put a source of heat or ice direclty on your skin; always wrap it in something.)
• over-the-counter medications: Tylenol or Advil are some of your options.
• taking it easy:  Lengthy bedrest is no longer recommended as a treatment option for lower back pain, but you shouldn't exercise with the same intensity, for example.  You may need to modify your daily routine in order to give your low back a chance to recover. 

If your lower back pain persists and starts to interfere severely with your sleep or daily activities (such as your ability to work), you should visit a doctor.  Other reasons to call a doctor include:

• bowel or bladder problems (emergency situation)
• leg weakness or numbness (emergency situation)

What is causing my lower back pain?
There are many spine conditions that could be causing your lower back pain, from muscle strain to a herniated disc.  Your doctor should be able to make an accurate diagnosis, and that will enable him/her to develop a treatment plan for you.

Will I need surgery?
You may need surgery to address your lower back pain, but most likely, you will try non-surgical treatments first.

Read our article on non-surgical lower back pain treatments.

Read our article on lower back pain surgery.