Lower Back Pain: 17 Causes & How to Relieve

Lower back pain can be caused by poor posture, repetitive strain injuries, sciatic nerve inflammation, a herniated disc, kidney stones, pregnancy or trauma to the lower back. It can range from mild to severe in intensity and may even limit mobility. 

Depending on the cause, lower back pain may be accompanied by symptoms such as a leg tingling or numbness, muscle weakness, fever, or pain or burning when urinating.

It is important to see your family doctor or an orthopedic surgeon if your back pain is severe, appears suddenly or presents with additional symptoms, so that the doctor can identify the underlying cause and initiate the most appropriate treatment. 

What causes lower back pain?

The main causes of lower back pain are:

1. Bad posture

Bad posture is one of the most common causes of lower back pain, as sitting with incorrect posture can cause increased pressure on the coccyx, resulting in lower back pain.

How to relieve: If your pain is related to bad posture, you should get up throughout the day to stretch and lightly massage the affected area. In addition, you should actively be aware and correct your posture to prevent further pain or the appearance of other problems.

2. Repetitive strain injuries

Performing repetitive activities that involve the lower back, like riding a bike or bending several times throughout the day, can cause muscular and ligament inflammation, leading to pain. In addition, performing exercises which overload the back and also lead result in muscular inflammation in the lower back, causing pain.

How to relieve : If your pain is related to repetitive activity, you should rest and, if necessary, take anti-inflammatories (like diclofenac) to relieve your symptoms. Nonetheless, pain that does not resolve with anti-inflammatories should be assessed by your doctor to evaluate the cause.

3. Sciatic nerve inflammation

The sciatic nerve starts at the end of the spine, and when it becomes inflamed or compressed, it can cause intense pain in the lower back as well as pain in the glutes and legs. Sciatic nerve inflammation can also lead to difficulty with straightening your back, bending down, and walking. Learn more about what causes sciatic nerve pain.

How to relieve: Once your identify the first signs of sciatic nerve inflammation, you should see your doctor for assessment, so that he or she can formally diagnose your problem and start treatment. Treatment can be done with anti-inflammatories as well as physiotherapy, which can reduce pain, and inflammation, and strengthen the back. You can also consider trying our recommended home remedies and stretching exercises.

4. Herniated disc

A herniated disc occurs when and intervertebral disc sticks out from its space, leading to compression of nerves and pain in the lower back. In addition to feeling lower back pain, you may also experience difficulty walking or bending down, leg weakness and even changes to bladder function, due to compression of local nerves. Learn more about herniated discs and how they can happen.

How to relieve: If you suspect you have a herniated disc, you should see your doctor for diagnosis. He or she will evaluate your symptoms and order imaging like X-ray or MRI. In addition, you should also participate in physiotherapy to improve your quality of life. 

5. Kidney stones

Kidney stones are characterized by a sharp pain in the lower back, more specifically to the sides. It occurs when kidney stones cause inflammation and obstruct urine flow in the urinary tract. Learn about the most common symptoms of kidney stones and assess your risk for stones with our online quiz.

How to relieve: If you experience symptoms of kidney stones, you should see your doctor for assessment to confirm whether kidney stones are present. Appropriate treatment will be decided based on characteristics like the size or shape of the stones. To avoid the formation of kidney stones, it is important to maintain healthy lifestyle habits, like eating a balanced diet, exercising regularly and drinking at least 2 L (12 cups) of water throughout the day.

6. Pregnancy

Pregnancy can cause lower back pain that can radiate to the legs. It is especially reported in the 2nd or 3rd trimester, due to the growing belly and increased curvature of the spine, which can compress the sciatic nerve.

How to relieve: You can perform exercises that relieve pressure from your sciatic nerve, as approved by your obstetrician. Exercises like yoga or Pilates, for example, can help to stretch and strengthen your back muscles.

Furthermore, pregnant women should avoid standing for prolonged periods of time and when sitting. They should also avoid crossing their legs. In some cases, your doctor may recommend wearing a pregnancy belt or kin tape to support your belly and back to help reduce lower back pain.

7. Trauma to the lower back

Trauma to the lower back, caused by a car accidents or falls, for example, can lead to lower back pain.

These traumas can injure muscles, tendons or ligaments in the lumbar region or even cause fractures in the vertebrae in the lumbar spine.

How to relieve: Minor injuries can be treated with rest and cold therapy applied for 15 minutes, 2 to 3 times a day. Suspected fractures should be assessed immediately, so that treatment can be initiated to reduce complications.  

Physiotherapy may also be prescribed to promote recovery and relieve pain, even in mild cases.

8. Spinal osteoarthritis

Osteoarthritis is characterized by wear and tear of the cartilage in the vertebrae of the spine. It can affect the lumbar spine and lead to intense pain in the lower back that worsens with movement.

Osteoarthritis in the lower back can impair mobility and trigger a tingling or numb sensation in the legs. 

Although it is more common in older adults, osteoarthritis in the lumbar spine can affect younger adults. In these cases, wear and tear is usually related to previous injuries, excessive physical activity or heavy lifting.

How to relieve: Treatment is typically guided by an orthopedic surgeon, who may prescribe analgesics, anti-inflammatories, corticosteroids and/or opioid medications to help relieve pain.

The doctor may also prescribe physiotherapy and, in some cases, surgery.

9. Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune, inflammatory and chronic disease that leads to stiffness, pain and swelling in the joints. It can affect the spine and cause lower back pain, which is characteristically more intense during the first few minutes of the morning and improves with movement.

How to relieve: Your doctor may prescribe analgesics and anti-inflammatories in addition to physiotherapy to help preserve and improve spinal mobility.

10. Bone spurs

Bone spurs, scientifically known as osteophytes, can occur when a part of the vertebrae in the lumbar spine grows larger than normal, causing a protrusion of the bone.

Although this overgrowth of bone itself is not painful, it can compress the nerves in the spine, leading to symptoms such as lower back pain, tingling and even loss of strength.

How to relieve: Treatment is guided by an orthopedic surgeon, and generally involves physiotherapy and anti-inflammatory medication.

11. Ankylosing spondylitis

Ankylosing spondylitis is an inflammatory disease that can affect the vertebrae of the lumbar spine. It can lead to reduced mobility, which can worsen when the person is at rest and improve with movement. 

How to relieve: Treatment should be guided by an orthopedic surgeon who may prescribe analgesics, anti-inflammatories or muscle relaxants to relieve pain. Physiotherapy can help to increase flexibility and improve overall quality of life.

12. Degenerative disc disease

Degenerative disc disease is the progressive wear and tear of the intervertebral discs in the lumbar spine. It is usually caused by natural aging, and is common in people over 40 years of age.

Generally, this wear does not cause pain, however, in some cases, pain may be felt in the lower back, which can radiate to the buttocks, thighs or legs. It may also cause leg weakness or tingling. 

How to relieve: Treatment for degenerative disc disease should be guided by an orthopedic surgeon, who may prescribe anti-inflammatories or analgesics to relieve symptoms. Physiotherapy may also be beneficial, and surgery may be indicated for more severe cases.

13. Spondylolisthesis

Spondylolisthesis is characterized by a displacement of a vertebra in the lumbar spine in which they can slide forward. It is ussually associated with natural aging of the discs, as they usually become thinner and less hydrated. 

The main symptoms of spondylolisthesis are persistent pain in the lower back, back stiffness or tingling in the legs. Check out other symptoms of spondylolisthesis.

How to relieve: spondylolisthesis can be treated with anti-inflammatory drugs or corticosteroids, as prescribed by an orthopedic surgeon. Some patients may also benefit from physiotherapy or surgery. 

14. Fibromyalgia

Fibromyalgia is a rheumatological disease that causes widespread pain in various parts of the body, including the lower back.

In addition to lower back, other common symptoms of fibromyalgia are fatigue, muscle stiffness, tingling in the hands, depression and sleep disorders. This condition leads to an overall worsening of quality of life.

How to relieve: Treatment should be guided by a rheumatologist who may prescribe analgesics or antidepressant medication to help manage discomfort, as well as physiotherapy. Learn more about the fibromyalgia medications that your doctor may consider prescribing to help manage more specific symptoms. 

15. Osteoporosis

Osteoporosis is associated with reduced bone mass, which can affect the lumbar spine. It is more common after the age of 50 and is more commonly diagnosed in women, especially after menopause.

This condition is characterized by weaker, more fragile bones, leading to an increased risk for fractures throughout the body, including the lower back. 

How to relieve: Osteoporosis treatment should be guided by an orthopedic surgeon, who may prescribe supplements that promote bone pass preservation, like calcium and vitamin D. 

A consult with a registered dietitian may also be beneficial, as patients with osteoporosis should increase their intake of calcium-rich foods and foods with vitamin D. 

16. Lumbar stenosis

Lumbar stenosis is characterized by compression of the nerves located in the lumbar spine. It leads to symptoms like lower back pain, which can radiate to the buttocks and legs, and weakness in the legs.

How to relieve: Treatment for this condition is guided by an orthopedist and may include the use of oral anti-inflammatories, steroid injections, physiotherapy and, in some cases, surgery.

17. Spinal cancer

Spinal cancer is usually caused by metastases of cancer from other parts of the body that has spread to the spine, Tumors that grow in the lower back can lead to muscle weakness or difficulty moving.

How to relieve: Treatment is carried out by an oncologist and usually involves radiotherapy, chemotherapy or targeted therapy to relieve symptoms and slow down the cancer growth. 

When to see a doctor

It is recommended to consult an orthopedist or go to the emergency room in the following situations:

• Severe lower back pain or pain that worsens over time;
• Back pain that radiates to the buttock, thigh or leg;
• Tingling sensation or weakness in the legs;
• Fever or chills;
• Accidents that may have injured the spine;
• Muscle weakness.

Therefore, the doctor must perform a physical examination and request an X-ray of the spine, magnetic resonance imaging or computed tomography, to identify the cause of lower back pain and indicate the most appropriate treatment.