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Lower Back Pain
Lower back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist. Unfortunately, almost everyone, at some point during life will experience lower back pain. The most common cause is muscle strain often related to heavy physical labor, lifting or forceful movement, bending or twisting into awkward positions, or standing in one position too long.
Other Causes of Lower Back Pain
There are many different conditions that cause or contribute to lower back pain. Many involve nerve compression (eg, pinched nerve) that may generate pain and other symptoms. Types of spinal disorders include trauma-related and degenerative; meaning age-related. Some of these spinal problems are listed below.
- Bulging or herniated disc. A disc may bulge outward. A herniated disc occurs when the soft interior matter escapes through a crack or ruptures through the disc's protective outer layer. Both disc problems can cause nerve compression, inflammation, and pain.
- Spinal stenosis develops when the spinal canal or a nerve passageway abnormally narrows.
- Spinal arthritis, also called spinal osteoarthritis or spondylosis, is a common degenerative spine problem. It affects the spine's facet joints and may contribute to the development of bone spurs.
- Spondylolisthesis occurs when a lumbar (low back) vertebral body slips forward over the vertebra below it.
- Vertebral fractures (burst or compression types) are often caused by some type of trauma (eg, fall).
- Osteomyelitis is a bacterial infection that can develop in one of the spine's bones.
- Spinal tumors are an abnormal growth of cells ( a mass) and are diagnosed as benign (non-cancerous) or malignant (cancer).
Easing Lower Back Pain at Home
If you've recently injured your lower back, there are a few things you can do.
- Ice then heat
During the first 24 to 48 hours, use ice wrapped in a towel or cloth. Ice helps to reduce swelling, muscle spasms, and pain. Thereafter, switch to heat. Heat helps warm and relaxes sore tissues.
Warning: Never apply a cold or heat source directly onto skin, always wrap it in something.
- Over-the-counter medications
Tylenol or Advil, taken according to package directions, may help reduce inflammation and pain.
- Take it easy
While days of bed rest is no longer recommended, you may need to modify your daily routine to give your lower back the opportunity to recover.
When to Seek Medical Attention
- Lower back pain is, or becomes severe and persistent
- Does not subside after a few days
- Interferes with sleep and daily activities
The symptoms listed below always require immediate medical attention:
- Bowel or bladder dysfunction
- Groin or leg weakness or numbness
Written by Richard G. Fessler, MD, PhD