Did you know that around 60-80% of adults in ‘Western’ countries will suffer from lower back pain at some point in their life?
If you experience lower back pain once, you are 50% more likely to suffer from it again in the future.
Lower back pain can vary from a dull ache to a sharper, more severe pain.
Luckily, 90% of all lower back pain can be treated without surgery. Usually, it is the result of muscle strain due to standing in one position for too long, hard physical labour, lifting, a forceful movement, or bending or moving awkwardly.
However, there are causes of lower back pain which don’t relate to muscle strain or injury. These include:
- Slipped disc
- Rheumatoid arthritis
- Ankylosing spondylitis
1. Lower back pain caused by coccydynia
If your lower back pain is caused by coccydynia then you will feel pain in the base of your spine where your tailbone (coccyx) is. It can cause anything from mild discomfort to severe pain, and it usually occurs because of damage to the coccyx or the surrounding tissue.
The symptoms of coccydynia may be exacerbated by standing or sitting in a certain position, and the pain can make it difficult to carry out everyday activities.
A doctor may advise taking painkillers such as paracetamol, for coccydynia. Speak to a pharmacist or doctor for further guidance on whether to use these medications and how to get and use them.
You should also see a doctor immediately if you experience:
- Leg weakness
- Leg numbness
- New incontinence
And you should see a doctor within 48 hours if:
- The pain is not improving after a few weeks
- The pain does not get better with simple measures (such as painkillers and physiotherapy)
- The pain is severe and prevents you from doing daily activities
2. Lower back pain caused by sciatica
Lower back pain resulting from sciatica will usually cause pain in your buttocks and down your legs as well. This is because the sciatic nerves run from the back of your pelvis, down both legs, to your feet.
Sciatica is usually caused by a slipped disc, which then presses on the sciatica nerve, and results in pain. This pain can feel like a tingling sensation that begins in your lower back and travels through your buttocks, down your leg, and to your foot and toes. It can also cause numbness, and a feeling of weakness in your leg muscles.
Sciatica pain can usually be treated at home with painkillers, exercise, and hot and cold packs. You should always speak to a pharmacist or doctor for further guidance before taking any painkillers.
We will reveal some helpful exercises for sciatica later in this article.
In some cases, further treatment might be necessary. But you should see a doctor immediately if you develop any of the following symptoms:
- Tingling or numbness between your legs or around your buttocks
- Recent loss of bladder or bowel control
- Pain and tingling affecting both legs
- Weakness in your legs
- Severe back pain
3. Lower back pain caused by a slipped disc (intervertebral disc prolapse)
A slipped disc can cause lower back pain, which can spread to other parts of the body. It occurs when the outer case of the disc bursts, causing the gel inside it to bulge out.
The damaged disc can put pressure on the spinal cord or a single nerve root. This can cause pain in the area of the protruding disc and in the area that is controlled by the nerve the disc is pressing on.
The cause of a slipped disc is often unknown, but it can be the result of:
- Bending awkwardly
- Heavy or awkward lifting
- Sitting for long periods, such as while driving
- Being overweight
- Weight-bearing sports, such as weightlifting
- A traumatic injury to your back, such as a fall or car accident
There are ways to prevent a slipped disc from occurring, which you can read more about here.
Treatment of a slipped disc usually involves keeping active, physiotherapy, and medication. After about 4-6 weeks the slipped disc should recover, but in some cases further treatment might be needed.
See a doctor immediately if you experience any of the following symptoms:
- Numbness around the anal and genital region
- Weakness or paralysis of the leg
- An inability to control bowel movements
- Unintentional passing of urine
- An inability to walk
- Pain which is getting worse rather than improving
4. Lower back pain caused by spondylolisthesis
Spondylolisthesis refers to a condition where a bone in the lumbar spine (lower back) has slipped out of position and onto the bone below it.
This causes lower back pain that will usually feel worse with activity, and result in tight hamstrings, pain in the buttocks, stiffness, and tenderness where the affected bone is.
The treatment of spondylolisthesis tends to involve anti-inflammatory painkillers, physiotherapy, and bed rest. However, it is dependent on the severity of the pain you are experiencing. Some cases of spondylolisthesis may even require surgery.
You should see a doctor immediately if you experience any of the following symptoms:
- An inability to move your leg(s)
- New bladder or bowel incontinence
- Numbness around the genitals or buttocks region
- Severe leg pain
- Sudden weakness in the legs
5. Lower back pain caused by osteoarthritis
Osteoarthritis is the most common form of arthritis and it affects your joints, causing pain and stiffness.
This pain usually only occurs in the affected joint, but it can spread to other parts of your body. The pain also tends to get worse when you use the joint, and for some people the pain is constant.
Osteoarthritis occurs when your body is unable to repair the damage caused to the bone’s protective cartilage.
The exact reason for this is unknown; everyone’s joints are exposed to damage, but usually the body can repair the damage. With osteoarthritis, the protective cartilage breaks down, causing pain, swelling and problems with moving the joint. Bony growths - extra bone that forms at joints - can develop, and the area can become inflamed (red and swollen).
While there is no cure, there are things you can do to reduce your symptoms, such as regular exercise, maintaining a healthy weight, wearing appropriate footwear, and using devices that help to reduce the strain on your joints.
There are also structured exercise programmes you can follow if your symptoms are more severe. In rare cases, surgery may be necessary to repair, strengthen, or replace the joint.
If you have any of the following symptoms, you should see a doctor immediately:
- A red, hot or swollen joint
- A fever
- Feeling unwell
- Uncontrolled pain
- An inability to move the joint
6. Lower back pain caused by rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease, which means that your immune system - which protects your body from infection - mistakenly attacks the cells in your joints.
This causes inflammation of your joints, which can lead to swelling, stiffness, and pain.
At first, the pain results from inflammation of the joints, but as the disease progresses, it can be due to damage to the joints.
Although there currently is no cure for rheumatoid arthritis, early diagnosis and treatment can help to limit the progression of the disease.
This includes taking medication to prevent rheumatoid arthritis from getting worse and reducing the risk of complications. As well as maintaining a healthy lifestyle, which includes a varied and balanced diet and low impact exercise.
If you develop any of the following symptoms you should see a doctor within 24 hours:
- A sudden painful, swollen joint that you are not able to move
- A fever
7. Lower back pain caused by ankylosing spondylitis
Ankylosing spondylitis is a type of arthritis that primarily affects the spine. It causes inflammation of the spinal joints, which causes severe, chronic pain and discomfort.
The reasons for this inflammation is unknown, but could be linked to the HLA-B27 gene. The inflammation of the spine can also cause new bone to grow, which makes the spine fuse together and can result in loss of flexibility (ankylosis).
The symptoms of ankylosing spondylitis tend to develop gradually, and often come and go. There are treatments available which can relieve some of these symptoms, although there is no cure.
Treatment involves delaying the process of the spine fusing, which is achieved through exercise, physiotherapy and medication.
In particular, ankylosing spondylitis can affect the base of the spine as it progresses, which can cause severe lower back pain.
If you develop any of the following symptoms, please seek medical help immediately:
- Painful red eye
- Severe, sudden onset chest pain
- Pain or numbness in your lower back or feet
- Urinary or bowel incontinence
- Weakness of your legs
- Joint pain and a fever
Exercises for lower back pain
When you experience non-specific lower back pain, or low back pain, you might feel like avoiding exercise. But moving more can be good for your back.
Exercises for lower back pain can help strengthen your back, abdominal and leg muscles, all of which support your spine and may reduce back pain.
Always speak to a doctor before doing any exercise for back pain. Depending on the cause and severity of the pain, some exercises might be harmful.
Performing exercises for your lower back can help to improve the stability and flexibility of the spine. To reduce your lower back pain you may want to try these simple exercises:
- Bottom to heels stretch
- Knee rolls
- Back extensions
- Deep abdominal strengthening
- Pelvic tilts
If your back pain is caused by sciatica, there are specific sciatica stretches you can do to help ease the pain by mobilising the sciatica nerve. These include:
- A knee to chest stretch
- Sciatic mobilising stretch
- Back extensions
- Standing hamstring stretch
- Lying deep gluteal stretch
There are preventative measures you can take to avoid lower back pain at work, such as sitting correctly, lifting with proper form, and taking regular breaks.
Lower back pain can be debilitating. To treat it, you need to know what’s wrong. If the pain is the result of an underlying condition you need to treat that condition to relieve the pain.
However, if it’s non-specific back pain - back pain which is not related to a specific condition - then you may be able to do lower back exercises to relieve the pain.
If you're worried about lower back pain, you should see a doctor.