Lower Back Pain – The Most Common Causes

We all have experienced lower back pain at some time or the other. In most instances, this pain radiates from the lower back and is non-specific; this means, there isn’t any primary reason that is found to be causing it. The most common causes of any lower back pain or a lumbar backache are lumbar strain and nerve irritation, lumbar radiculopathy and bony encroachment as well as different conditions of the bone & joints. Let’s take a look at the most common causes of lower back pain in detail:

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Lumbar strain (acute/chronic)

This is essentially a stretch injury to the tendons, muscles and/or the ligaments of the lower back. This kind of a stretching incident leads to microscopic tears in the tissues. This injury may take place because of trauma or improper use. When any soft tissue is injured, it is referred to as an “acute” injury (if it’s been present for a few days to weeks). In case this strain lasts in excess of 3 months, it’s called a “chronic” injury.

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Nerve irritation

The lumbar spine’s nerves may get irritated by impingement (mechanical pressure) by bone/ tissues. It may also occur due to some form of disease along their paths – ranging from the roots right at the spinal cord upto the skin’s surface.

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Lumbar Radiculopathy

This nerve irritation is caused by disc damage. These discs are positioned between the vertebrae. This damage is caused by traumatic injury, degeneration of the disc’s outer ring or both. Resultantly, this can lead to a rupture of the softer section of the disc (which lies at its centre).

When this portion herniates through the disc’s outer ring, it abuts the spinal cord or the nerves of the bony spinal column. It is this rupture that causes “sciatica” pain.

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Bony Encroachment

Any type of condition which results in growth/movement of the lumbar spine’s vertebrae can limit the space for the nerves and the spinal cord (which are adjacent to it). Bony encroachment can be caused by:

• Foraminal narrowing (this is narrowing of the portal via which the spinal nerve moves through the spinal column, and out of the spinal canal into the body)
• Spondylolisthesis (the slippage of 1 vertebra, relative to another)
• Spinal stenosis (nerve root/spinal cord compression by soft tissues within the spinal cord or bony spurs)

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Bone & Joint Conditions

The conditions that can lead to low back pain and include:

• Ones that exist from birth (congenital)
• Those which result from injury/wear & tear (degenerative)
• Ones that are caused by arthritis (inflammation of the joints)
• Caused by age-related degenerative changes. Degeneration of the disc is called spondylosis.

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Injury to the Bones & Joints

Fractures of the lumbar spine & the sacrum bone that most commonly tend to affect elderly people who have osteoporosis. Those who have been on cortisone medication for a long time are more affected by this. For these people, even mild stresses of the spine (including actions such as bending down to pick up something), can result in a fractured bone. In younger patients, vertebral fractures take place only after a severe trauma e.g: a motor vehicle accident, or a convulsive seizure.

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Arthritis

Spondyloarthropathies can affect the sacroiliac joints and lower back and sacroiliac joints. Examples include psoriatic arthritis, reactive arthritis (Reiter’s disease), psoriatic arthritis, ankylosing spondylitis & inflammatory bowel disease related arthritis. Each of these can cause low back pain & stiffness; typically, this is worse in the morning and these conditions tend to surface in the second & third decades of life.

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For more information about lower back pain and how physiotherapy can help in alleviating it, call New Body Physiotherapy and Postural Management at (02) 9958 2277.

Best Regards,
Corey Iskenderian