Lower Back Pain – Causes and Treatment
Lower back pain refers to pain in the lumbar region of the spine. It is one of the most common health complaints worldwide and can be acute or chronic in nature.
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Lower back pain refers to pain in the lumbar region of the spine. It is one of the most common health complaints worldwide and can be acute or chronic in nature.
What is Lower Back Pain?
Lower back pain (medically referred to as lumbalgia or lumbago) describes pain located in the lumbar region of the spine – the area between the ribcage and the buttocks. It is one of the most prevalent health conditions globally and a leading cause of disability and work absenteeism.
Lower back pain is classified by duration: acute (less than 6 weeks), subacute (6 to 12 weeks), and chronic (more than 12 weeks).
Causes
In the majority of cases, lower back pain is classified as non-specific, meaning no clear structural or organic cause can be identified. Common contributing factors include:
- Muscle tension and overuse from poor posture or heavy lifting
- Intervertebral disc problems, such as a herniated disc (prolapse) or disc degeneration
- Facet joint arthritis (spondylarthrosis)
- Spinal stenosis – narrowing of the spinal canal
- Osteoporosis with vertebral compression fractures
- Spondylolisthesis – slipping of a vertebra
- Psychosocial factors such as stress, anxiety, or depression
- Less commonly: inflammatory conditions (e.g., ankylosing spondylitis), kidney disease, or tumors
Symptoms
Lower back pain can manifest in various ways:
- Dull, aching, or sharp pain in the lower back
- Pain radiating into the buttocks, legs, or feet (sciatica)
- Morning stiffness and reduced range of motion
- Pain worsening when sitting, standing, or bending
- Tingling, numbness, or weakness in the legs (indicating nerve involvement)
Red flag symptoms requiring immediate medical attention include: paralysis, bladder or bowel dysfunction, unexplained weight loss, or fever combined with back pain.
Diagnosis
Diagnosis begins with a thorough medical history and physical examination. Depending on findings, further investigations may include:
- X-rays of the lumbar spine
- MRI (magnetic resonance imaging) or CT scan to assess disc and nerve structures
- Blood tests to rule out inflammatory or systemic conditions
- Nerve conduction studies (electrophysiology) if nerve damage is suspected
Treatment
Conservative Treatment
Most cases of lower back pain respond well to conservative management:
- Exercise therapy and physiotherapy – targeted core strengthening and stretching
- Pain medications – e.g., ibuprofen, diclofenac (NSAIDs) or paracetamol
- Heat or cold therapy
- Manual therapy or osteopathy
- Acupuncture
- Psychological pain therapy for chronic conditions
- Relaxation techniques such as progressive muscle relaxation or yoga
Interventional and Surgical Treatment
If conservative treatment is insufficient or a specific cause is identified, further interventions may be required:
- Injection therapy (e.g., corticosteroid injections into facet joints or epidural space)
- Surgical procedures, such as discectomy for herniated discs with neurological deficits or decompression surgery for severe spinal stenosis
Prevention
Many episodes of lower back pain can be prevented or reduced through proactive measures:
- Regular physical activity (swimming, cycling, back-strengthening classes)
- Ergonomic workplace setup
- Avoiding prolonged sitting without breaks
- Maintaining a healthy body weight
- Back school programs and posture training
References
- World Health Organization (WHO) – Musculoskeletal conditions: Low back pain. Available at: www.who.int
- Airaksinen O. et al. – European guidelines for the management of chronic nonspecific low back pain. European Spine Journal, 2006; 15 (Suppl 2): S192–S300.
- Deyo R.A., Weinstein J.N. – Low Back Pain. New England Journal of Medicine, 2001; 344(5): 363–370.
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Related search terms: lower back pain + low back pain + lumbar pain + lumbago