Lower back pain – all you need to know

From a mild sprain to sciatica, lower back pain can be painful and frustrating. Here’s how to find relief.

What are the symptoms?

When to get emergency help

What causes it?

Who can be affected?

Self-care tips

When to see a doctor

How is it diagnosed?

What’s the treatment?

How to prevent lower back pain

Lower back pain can range from mild to severe, come on suddenly or gradually, be persistent, or come and go. It can get in the way of everyday life, stopping you from walking, working, and sleeping. Here’s what to do about it.


Do you have a dull and achy pain, or a sharp pain, in your lower back? Does it make standing up straight or getting up from a chair difficult? 

Lower back pain is a common problem. It affects the lumbar (lower) region of your spine and back. Because this area supports your upper body weight, it manages a lot of movement and stress.

There are many reasons why you might have lower back pain. Most causes aren’t serious and the pain often goes away on its own over time, but some cases need medical care. Let’s dig a little deeper.


## What are the symptoms?

You might experience different types of symptoms, depending on the [cause of your back pain](https://www.livehealthily.com/health-library/symptoms/lower-back-pain-all-you-need-to-know#causes), although sometimes it may not be obvious what the trigger is. Symptoms can include pain that:

- comes on suddenly or appears gradually, and it may come and go or be constant
- feels sharp or dull and achy
- has a tingling or burning sensation
- comes after a “popping” sound, for example if you’ve injured your back by bending to pick something up
- radiates down to your bottom, or the back of your leg
- feels worse in certain positions, like bending over or crouching down, and often gets better when lying down.

You might also notice:

- __stiffness (especially in the morning)__ – making it hard to straighten your back due to less range of motion
- __posture problems__ – your lower back pain might make it hard to stand up straight, so you may look “crooked” or bent, with your lower back flat, instead of curved
- __muscle spasms__ – when the muscles contract uncontrollably. This can feel really painful and make it difficult or impossible to stand, walk or move.


Get help with this

## When to get emergency help

Most causes of lower back pain aren’t anything to worry about, but you should get emergency medical help if you have back pain and:

- tingling, weakness or numbness in both legs
- numbness or tingling around your genitals or buttocks
- difficulty peeing, or there’s blood in your urine
- you lose control of your bladder or bowel (you’re peeing or pooping yourself)
chest pain
it started after a serious accident, such as a car accident or a fall.

Get an urgent doctor’s appointment if you have back pain and:

- a fever
- weight loss that is unexplained
- you’ve developed a lump or swelling in your back, or your back has changed shape
- the pain hasn’t got better with rest, or is worse at night
- it gets worse when you sneeze, cough or poop
- the pain is coming from the top of your back and between your shoulders, rather than your lower back.

## What causes it?

Lower back pain has many causes, including:

- __a [strain or sprain](https://www.livehealthily.com/health-library/conditions/sprains)__ – from lifting something too heavy or not lifting safely, to sneezing, coughing, twisting or bending over
- __disc problems__ – spinal discs offer a cushion between the bones in your spine, but when they bulge outwards and press on nerves, it’s called a [slipped disc](https://www.livehealthily.com/health-library/conditions/slipped-disc) (prolapsed disc), which can be painful. Discs can also tear (herniated disc) causing lower back pain 
- __menstrual cramps__ – some women or assigned females at birth (AFAB) get cramps in their lower back during a [period](https://www.livehealthily.com/health-library/conditions/periods)
- __[sciatica](https://www.livehealthily.com/health-library/conditions/sciatica)__ – where the sciatic nerve, which runs from your lower back to your feet, becomes pinched and compressed because of injury or disc problems, causing lower back pain
- __[arthritis](https://www.livehealthily.com/health-library/conditions/arthritis)__ – when cartilage breaks down between your spinal joints and becomes inflamed, causing friction and pain
- __[kidney stones](https://www.livehealthily.com/health-library/conditions/kidney-stones)__ – a hard deposit that forms inside your kidneys. If large enough, or if it begins to block the tubes between your kidney and your bladder, it can cause back pain, as well as tummy pain
- __[fibromyalgia](https://www.livehealthily.com/health-library/conditions/fibromyalgia)__ – a chronic condition that causes pain all over the body, including your lower back
- __[ankylosing spondylitis](https://www.livehealthily.com/health-library/conditions/ankylosing-spondylitis)__ – a type of stress fracture or crack in spinal bones. It’s common in young athletes who exercise a lot.

Sometimes, back pain can be a sign of a serious problem such as a broken bone, infection or cancer, but this is rare. If you notice any [warning signs](https://www.livehealthily.com/health-library/symptoms/lower-back-pain-all-you-need-to-know#getting-urgent-help), get emergency medical help.

## Who can be affected?

Anyone can get lower back pain, but you might be more likely to have it if you:

- __are an athlete, play a lot of sports, or are a manual worker__ – it increases your chances of sprains, strains and stress fractures
- __are older than 30__ – the discs in your spine begin to wear as you age, causing more pain and stiffness over time
- __are obese or overweight__ – carrying extra weight puts extra stress on your joints and spinal discs, leading to pain. It’s why pregnant women often get lower back pain
- __smoke__ – studies show that someone who has never smoked is less likely to experience back pain than a smoker or an ex-smoker
- __have a medical condition__ – like [spinal stenosis](https://www.livehealthily.com/health-library/conditions/lumbar-spinal-stenosis), [osteoporosis](https://www.livehealthily.com/health-library/conditions/osteoporosis), [osteoarthritis](https://www.livehealthily.com/health-library/conditions/osteoarthritis) or fibromyalgia. 

## Self-care tips

Most cases of lower back pain resolve on their own. But to help speed up the recovery process, you could try:

- __taking painkillers__ – acetaminophen (paracetamol) on its own isn’t recommended for back pain because studies have shown that it does not make much difference to symptoms, but it can be used with ibuprofen (check this is safe for you to take)
- __using an ice pack__ – or bag of frozen peas wrapped in a towel, to reduce pain and swelling. Do this for 20 minutes at a time every 2 to 3 hours
- __trying a heat pack (or a hot water bottle)__ – wrap this in a tea towel and place it on your back to relieve joint stiffness or muscle spasms
- __doing exercises and stretches for back pain__ – a physical therapist can help 
- __rest for a few days, but continue with your usual activities after__ – don’t stay in bed as this can make your back feel worse.


## When to see a doctor

Find out when you should get emergency or [urgent help](https://www.livehealthily.com/health-library/symptoms/lower-back-pain-all-you-need-to-know#getting-urgent-help) for lower back pain. 

See a doctor for lower back pain if:

- it doesn’t get better after treating it at home for a few weeks, or it’s getting worse
- it’s getting in the way of day-to-day activities
- it’s severe
- you're worried about it.


## How is it diagnosed?

There are many causes of lower back pain, so it may take time to get the right diagnosis.

At your appointment, you’ll be asked about your symptoms and medical history. Your doctor will also take a look at your back, posture, and ask you to move in certain ways, such as forward and backward. 

This exam is to pinpoint exactly where the pain is, and to check the range of motion at your spine, your reflexes and your muscular strength.

Most cases are caused by a strain, sprain, or osteoarthritis, and don’t need to be confirmed by medical tests. But if your doctor suspects another cause, you might have the following:

- __X-ray__ – to look at images of your bones
- __MRI__ – to examine images of your bones, muscles, tendons, and other soft tissues
- __CT scan__ – to create 3D images of your bones and soft tissues
- __electromyography (EMG)__ – tests your nerve and muscle function and checks for nerve damage 
- __blood tests or urine tests__ – detects genetic markers for some conditions that cause back pain, like [ankylosing spondylitis](https://www.livehealthily.com/health-library/conditions/ankylosing-spondylitis). Urine tests can check for [kidney stones](https://www.livehealthily.com/health-library/conditions/kidney-stones).

## What’s the treatment?

If your lower back pain is severe, or hasn’t got better with [self-care](https://www.livehealthily.com/health-library/symptoms/lower-back-pain-all-you-need-to-know#self-care-tips), your doctor might prescribe you painkillers, or medication, to help your back muscles relax. 

Other medical treatments may include:

- __group exercise sessions and physical therapy__ – to help strengthen the muscles around your spine for better support
- __manual therapy__ – where a trained therapist massages and manipulates (moves) the muscles, bones, and joints in your back
- __cognitive behavioural therapy (CBT)__ – used to help you cope with the pain
- __steroid injections__ – to reduce pain and inflammation for long-term lower back pain

If your lower back pain is caused by certain conditions, such as a slipped disc, and other treatments haven’t worked, surgery may be an option. But it isn’t usually required or recommended for low back pain.

## How to prevent lower back pain

Not all causes can be prevented, but do your best to avoid injuries that cause lower back pain by:

- __staying a weight that’s healthy for you__ – excess weight puts pressure on your vertebrae and discs
- __practicing good posture__ – avoid slouching
- __eating a healthy diet__ – include plenty of vitamin D and calcium sources to keep your bones strong
- __strengthening your tummy, hip, and back muscles__ – give pilates, yoga or tai chi a go. These exercises can strengthen and support the muscles around your spine
- __[lifting safely](https://www.livehealthily.com/self-care/what-to-do-if-you-hurt-your-back-lifting-weights#how-to-lift-weights-safely-to-avoid-hurting-your-back)__ – lift using your legs (not your back) and bend your knees. Hold heavy items close to your body and don’t twist your torso while lifting
- __warming up before any exercise__ – ease yourself in with gentle stretches.


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References

Amelia Glean

Fiona Bugler

Dr Ewan O'Farrell

Article information

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