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What’s Causing This Severe Lower Back Pain?

About 80 percent of adults will experience lower back pain at least once in their lifetime. Pain can range from the dull and aching kind to the sharp and stabbing variety. There are lots of reasons why your back hurts, from muscle strains to herniated disks. Almost all points to the lumbar spine, which has a complex structure that leaves it susceptible to pain and injury.

So what causes severe lower back pain? Most acute lower back pain comes from injury to the muscles, ligaments, joints, and discs. Your body's natural response to injury is mobilizing inflammatory healing response, which can cause severe pain. In order to pinpoint the probable cause, you should understand factors such as symptoms, physical findings, imaging studies, and injection techniques, which will help create an accurate diagnosis.

Range of Lower Back Pain Symptoms

These symptoms could be mild to debilitating, with the pain building up gradually or starting suddenly and becoming worse as time passes by. There are a variety of ways in which you can experience the symptoms of lower back pain. You may feel a dull or achy pain contained to the lower back or a stinging, burning kind that moves from your lower back to the backs of your thighs. This can also extend into the lower legs or feet.

Pain can also present as muscle spasms and tightness in the lower back, hips, and pelvis. The sensation can worsen after sitting or standing too long and you may have difficulty standing up straight, shifting from standing to sitting and walking.

There are three categories of lower back pain:

  • Acute - the pain comes in suddenly and lasts for a few days and even weeks. This is usually felt after injury or tissue damage. As your body heals, the pain gradually subsides.
  • Sub-acute - this type of pain lasts around six weeks to three months and usually mechanical in nature, but prolonged. If pain lasts this long, has become severe, and limits your ability to do your usual activities such as walking, sleeping, and working, it's more than advisable to seek medical help as soon as possible.
  • Chronic - this kind of pain is usually severe, does not respond to initial treatments, and lasts more than three months. A medical checkup is needed to determine the exact pain source.

Lower back pain can also be categorized into a mechanical one or radicular. Mechanical is the most common kind and comes primarily from muscles, ligaments, and joints. It can also originate from bones in and around the spine. The sensation tends to be localized not just to the lower back, but also to the buttocks and even the tops of your legs. Mechanical pain happens when the spine is loaded based on motions, activity, sitting, standing, or resting.

Radicular pain happens when the spinal nerve root becomes inflamed or impinged. It may follow a nerve root pattern or run down into your buttocks or legs. The pain can be described as sharp and burning, or like electric jolts. It can also be associated with weakness or numbness. Radicular pain is usually felt on only one side of your body.

Other Sources of Lower Back Pain

Lower back pain causes are not only confined to lumbar reasons. Pain can also come from myelopathic and neuropathic pain, deformity, tumors, infections, inflammatory conditions, and pain that comes from another part of the body and presents in the lower back (such as ulcerative colitis or kidney stone).

A thorough diagnosis is needed for sub-acute and chronic lower back pain in order to determine the appropriate treatment and rehabilitation. Early and consistent treatment lessens the risk of the pain recurring and prevents it from becoming a chronic condition.

Causes of Lower Back Pain

The common causes of lower back pain are mechanical issues and soft-tissue injuries. These include compression of nerve roots, damage to the intervertebral discs, and improper movement of the spinal joints. The single most common cause is pulled or torn muscle and/or ligaments.

Strains on the lower back can happen gradually from repetitive movements or materialize suddenly. Muscles can get strained when they are stretched too far or get torn, which damages the muscle itself. Sprains occur when ligaments, which hold your bones together, are overstretched and torn.

Usual causes of sprains and strains include lifting heavy objects, twisting the spine while lifting, falls or other sudden movements that put too much stress on the back, consistent bad posture, and sports injuries.

Causes of Chronic Lower Back Pain

Chronic pain lasts for more than three months and it's bad enough that your body's natural healing process couldn't keep up. Problems in the disc and joints, and/or an irritated nerve root are the results of chronic back pain. Common causes include:

  • Lumbar herniated disc
  • Degenerative disc disease
  • Facet joints dysfunction
  • Sacroiliac joint dysfunction
  • Spinal stenosis
  • Spondylolisthesis
  • Osteoarthritis
  • Deformity
  • Trauma
  • Compression fracture

There are also less common causes of back pain, such as infection, tumor, and autoimmune disease. A thorough medical check-up is needed to come up with the correct diagnosis in identifying the cause of lower back pain symptoms.

Lower Back Pain Symptoms

Your pain can start off as an acute one due to an injury but can become chronic eventually. It's important to manage pain at an early stage in order to prevent pain from becoming a chronic condition. The common symptoms of lower back problems are:

  • Dull, aching pain - this is the opposite of sharp and burning pain and typically remains within the lower back. You can also experience aches in the hips and pelvis, severe muscle spasms, and limited mobility with this kind of pain.
  • Pain that travels to the buttocks, legs, and feet - this includes a sharp, stinging sensation moving down from the back to the thighs and even your legs and feet. This pain is also called sciatica. It's typically felt on just one side of the body and caused by irritation of the sciatic nerve.
  • Pain that gets worse after prolonged sitting - sitting too much puts pressure on your spinal cord and discs, which leads to lower back pain. This is why those who sit all day for work are advised to stand, stretch, and walk around after an hour of prolonged sitting.
  • Pain that gets better when changing positions - you may have a condition that makes one position more painful to maintain than others. If you have spinal stenosis, leaning forward into something can lessen the pain. It's important to note how pain changes when you shift positions in order to identify the pain source.
  • Pain that gets worse after waking up and better after moving around - there are many people who wake up with lower back pain, which starts to disappear as soon as they get up and start to move around. Stiffness due to hours of rest can cause pain. Other factors, such as the quality of pillows and mattresses, can contribute to the discomfort.

Symptoms That Require Immediate Attention

There are cases in which your lower back pain is a sign of a more serious condition and should be attended to by a doctor immediately. Get yourself a check-up if you experience the following:

  • Fever and chills
  • Severe, unrelenting pain in the abdomen
  • Loss of bladder and bowel control
  • Recent weight loss not due to lifestyle changes, such as diet and exercise

Also, if you experience pain after a major trauma (such as a car crash), it's a must to see your doctor right away.

Diagnosing Lower Back Pain

You need to provide a detailed description of your symptoms and medical history for your doctor to come up with an accurate diagnosis. Here are the ways in which your doctor can identify the source of your lower back pain:

  • Medical history - your doctor will get information about your current symptoms - how your pain feels like, how far it spreads, how often it strikes, and if there are other symptoms that come with the pain. He will also want to know your activity levels, sleep habits, posture, and possible injuries.
  • Physical exam - this is needed in order to narrow down the possible causes of your pain. You may be subjected to neurologic, reflex, leg raise, and range of motion tests. Diagnostic imaging tests may be needed too to gain more information about the cause of your pain. Your doctor may order to get one or more of these: x-rays, CT scan/myelograms, MRI, and injection studies.

Early Treatments for Lower Back Pain

Your treatment options are tailored to suit your needs. These treatments can be home care, medicinal remedies, alternative care, or in extreme cases, surgery. Your doctor can recommend a combination of these treatments in order to hit the spot.

In most cases, all you will need is self-care for your lower back pain. These pain relief methods include short rest periods, avoiding aggravating activities, heat/cold therapy, over-the-counter medications, and doing low-impact. exercises.

Non-Surgical Treatments for Lower Back Pain

If home-care treatments do not work as expected, your doctor will recommend medical non-surgical measures to reduce your pain. These are prescribed usually with a physical therapy program. These usual medical treatments include muscle relaxants, narcotic pain medications, back braces, and epidural steroid injections.

Alternative treatments can be considered as well. You can try manual manipulation, in which a chiropractor makes physical adjustments to your spine to reduce pain and improve mobility. There's also acupuncture, which involves placing thin needles on the skin to stimulate certain points in the body, resulting in ease of stiffness and discomfort.

For milder cases, you can also try massage therapy to relieve muscle spasms and increase blood flow, which can make healing faster.

Surgery For Lower Back Pain

For severe back pain that doesn't get better after six to twelve weeks of non-surgical methods, your doctor may suggest getting back surgery. Factors to consider before getting back surgery are your ability to function and your healing process and your lifestyle.

Your surgical options include decompression surgery (which is performed to alleviate back pain caused by pinched nerves) and lumbar spinal fusion (in which the soft tissues between two or more adjacent vertebral bones are removed and then replaced with bone or metal). Your doctor can also suggest lumbar artificial disc replacement and putting in a posterior motion device.

Post-operative Care for the Lower Back

Getting back surgery will require considerable recovery time, so you really have to think hard before agreeing to it. The recovery period will depend on several factors, such as your condition before surgery, how extensive the surgery is, and the skills and experience of your surgeon.

For example, a microdiscectomy for a lumbar herniated disc usually does not require an overnight hospital spay since it's considered minimally invasive. Recovery will take at least one week. For a lumbar fusion, you will have to stay in the hospital overnight. You will be advised to return to your daily activities slowly, with some activity restrictions over the next three to twelve months.

You may be asked to undergo physical therapy as part of post-operative healing. This is needed to rebuild your strength and range of motion. This is accompanied by painkillers or muscle relaxant to help you deal with post-operative pain. In some cases, doctors will also recommend using back braces, special beds, supportive pillows, and shower stools during the recovery period.

Don't Take Chances With Your Severe Lower Back Pain

Seek advice from the top-rated and board-certified spine and pain specialists here at New York Pain Care. We will take a comprehensive look at your problem and explore all options - non-surgical, interventional, and alternative treatments - to help you finally find relief and get back to living pain-free.

We treat everything from lower back pain to serious knee injuries, as our team consists of spine specialists, sports medicine doctors, physical therapists, physiatrists, and certified acupuncturists. Call us today and get to know New York Pain Care's Integrative and Non-Surgical approach to treating pain.

Learn more: 9 Simple Stretches for Lower Back Pain Relief

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