What is causing your lower back pain?

Suffering from frequent or chronic low back pain is a special kind of misery.

There aren’t many things you can do that don’t somehow involve moving your low back and thus risk making your low back pain worse. Even the mere thought certain things – like sneezing or putting your socks on – are enough to make your heart race in anticipation of the torment to come. And sometimes the worst part of the low back pain is not knowing what’s causing it which means you don’t know how to fix it and stop if from coming back over and over again.

Ultimately the best way to figure out what’s causing your low back pain is to use advanced imaging (x-rays, MRI’s, ultrasound, CT scans), diagnostic tests (orthopedic and neurological), and the expert opinions of health professionals that deal with this stuff every day (chiropractors, orthopedists, neurologists). Trying to judge the source of the low back pain by just the location, quality, and quantity of the pain alone is like trying to judge the size and shape of an iceberg by just seeing what’s above the surface of the water – it’s an educated guess. That being said, what follows is a rough guide about different sources of low back pain and how you might, repeat might, be able to identify the source.

Chronic, unrelenting pain low back pain that doesn’t matter what position you’re in or what activity you’re doing:

This is potentially the worst case scenario because it’s points in the direction of pathology, disease, and cancer. If the pain is from an injured muscle or joint then typically the pain levels will vary with position and activity, but when it’s constant… that’s a different story. Seek medical attention immediately.

Chronic or frequent low back pain with numbness or tingling (that might get worse when you cough or sneeze):

Numbness and tingling happen when the nerves are involved. The most likely thing to irritate or compress a nerve in your lower back is a bulging or herniated disc. There are different kinds of disc problems and each require a different kind of treatment, but the common symptom is pain with numbness and tingling in a certain part of your thigh, leg, or foot. Each nerve root that comes out of your spine travels down into your legs connects to certain muscles and certain parts of your skin (called myotomes and dermatomes). If the numbness and tingling always happen in the same specific areas of your leg or foot then you can have a good idea of exactly which nerve root and disc are involved.

The best treatment for a disc issue depends on the nature of the problem – acute vs chronic, bulging vs herniated, traumatically induced or degenerative. Get multiple opinions before you make a decision on treatment and consider both your long term and short term goals. Of course you want to get out of pain as fast as possible, but what if that route only offers you short term results and you find yourself dealing with this problem again in less than a year? Consider your long term results and quality of life before you decide on any treatment.

Frequent or occasional low back pain the seems to depend on your position or activity:

Injured muscles, injured ligaments, and misaligned joints tend to hurt only when in use, so this type of pain in your lower back can often be traced back to a facet joint, strained muscle, or sprained ligament. How fast an injury heals depends a lot on how much blood supply that tissue has and how fast the body can make new tissue. Muscles can heal pretty quickly, but tendons and ligaments take longer. Two of the keys when treating this type of problem are allowing the injured area time to rest (don’t rush the recovery process and risk re-injury before the problem is fully resolved) and having good nutrition (the body needs good food to make healthy and strong tissue).

As with most frequent and chronic health problems you’ll want to consult with a doctor (or two, or three) to find the source of the problem and to learn about your treatment options.