Orthopedist Questions Orthopedist

What causes lower back pain?

I am a 37 year old female. I have lower back pain which I think is my spine. What causes lower back pain?

1 Answer

There are a number of conditions that may be behind your pain. There is not enough time to discuss them all, but we will briefly review some of the more prominent ones.

Pelvic Inflammatory Disease

Pelvic inflammatory disease is a disease that affects the reproductive organs in women. This condition affects approximately one million women in the United States every single year. There are a number of bacteria that can cause this disease. With time, the bacteria can create infections in the pelvic organs. One of the common symptoms of this disease is persistent pain in the lower back.

A Herniated Disc

A herniated disc is another common reason for lower back pain. To understand how this condition occurs, you first need to visualize the construction of your spinal column. Your spinal column is constructed with a series of bones, or vertebrae. These bones are stacked one on top of the other. They form sections in your spine. The top seven are your cervical spine. Then, there are 12 in the middle that are your thoracic spine, or the spine that covers the area where your rib cage and chest are located. Finally, you have five on the bottom. These comprise your lumbar spine, or your lower back.

In between your vertebrae are cushioning discs. These discs have been designed to serve as shock absorbers. So when you run, walk, lift, or twist, they take some of the shock. Your discs are made up of two parts. You can almost imagine them being like a jelly filled doughnut. On the outside of your disc, there is a hard surface. On the inside, there is a soft, jelly-like inner portion.

When the outer portion of the disc is damaged, some of the inner portion is able to protrude out into the outer ring. This is a slipped disc or a herniated disc. This condition can cause some serious pain or discomfort. This is especially true if the herniated material puts pressure on the nerves in your spine. Not only will you experience pain in the location of the slipped disc, but it is also possible for you to experience pain all the way down the path of the nerve. This could include severe pain in the buttocks, down the leg, and in the foot.

You know that you might be battling with a slipped disc if you feel muscle weakness, a burning sensation, or pain that gets worse as you sit or stand. The type of pain you experience with a slipped disc is going to vary, but for many, this is the cause of their chronic lower back pain.

Sciatica

Sciatica is a condition that may be linked to a herniated disc. Your sciatic nerve is the largest nerve in your body. It starts at your spinal cord and goes down to your buttocks and then legs. Your sciatic nerve is one of the most important nerves that you have as it is responsible for your ability to control as well as feel your legs. When this nerve is irritated, it produces sciatica.

Sciatica may be a moderate pain, or it could be a severe and excruciating pain in your lower back, buttocks, and legs. Sciatica is a condition that is often caused by a herniated disc, but it can also be caused by issues with the muscles in your buttocks. Other conditions that might cause sciatica include:

Spinal Stenosis
Piriformis Syndrome
Spondylolisthesis
Kidney Stones

As the name implies, kidney stones are a solid, stone-like material that typically originates in your kidneys. That being said, kidney stones may originate from another part of your urinary tract, including:

Kidneys
Bladder
Urethra
Ureters
Kidney stones can be unbelievably painful. The material that they are made up of varies, depending on the condition that led to their creation.

Spinal Stenosis

Your spine is made up of a number of bones called vertebrae that not only give you stability but also make it possible for you to twist and turn. In the center of your vertebra, there is an opening where nerves are able to run from your brain down your spine. These are the nerves that send signals to your entire body. They determine how your limbs function, they determine the sensations you feel, and they determine how well you are able to maintain balance.

Spinal stenosis is a condition where your spinal column gets narrow and starts to put pressure on your spinal cord. This is a gradual process, but it can leave you with debilitating pain.

We have discussed just a handful of the more common reasons why you may be experiencing chronic lower back pain. Now let’s switch our focus and discuss some of the treatment options that are available.

Treating Chronic Pain in the Lower Back

At times, it can be difficult to pinpoint the exact reason why a person has chronic lower back pain. This is why most medical professionals are not in a rush to diagnose the source of back pain if the cause is not readily identifiable. If the source of the pain cannot be identified or if the source of the pain cannot be treated, the goal becomes minimizing flare-ups as well as making the pain manageable using conservative treatments.

Physical Therapy

Exercise is key when treating most back pain. One of the first treatment options that is usually offered is physical therapy. That being said, physical therapy should not be seen as a one-size-fits-all thing. A physical therapist is going to need to tailor the exercises they offer you to your specific symptoms. In-office physical therapy is just part of what’s needed. In order for there to be long-term improvement, you would also need to do your exercise routine at home.

Some of the goals of physical therapy for an individual with lower back pain may include:

Exercises to improve flexibility
Aerobic exercises
Core strengthening
Improving posture
Improving limits of pain tolerance
Modifying Your Lifestyle

There are a number of foods that lead to inflammation. These include foods that have a lot of refined sugar or trans fats. During your medical consultation, your diet may be examined to see if there are certain foods that are making your condition worse.

One of the hardest things for an individual with chronic pain is to make changes to their lifestyle. It may be necessary for a person to accept the fact that their body has changed and that they now have new limitations. If they want to heal and if they want to get the most out of life, they are going to have to listen to what their body is telling them. This includes being conscious of activities that make the pain worse as well as activities that make the pain better. If there is an underlying condition causing the pain, being mindful of what your body is telling you may help you prevent the condition from getting worse.

Finding an Emotional Balance

Chronic pain can take a toll on you physically, but it is also be emotionally straining. Frustration, depression, and irritability may make your chronic lower back pain worse. There are a number of relaxation strategies and techniques that can be used as part of pain management to help prevent your mind from focusing on the pain.