6 Reasons For Lower Back Pain

Are you dealing with a back problem, and wondering what the heck is going on in my back? Why is it hurting?

I’m going to cover with you today the top six reasons for lower back pain.

#1 Herniated Discs

This is commonly talked about by people. It’s found on MRI’s. Some people think that lower disc height, on an X-Ray could be a herniated disc as well. And it’s true this is a possible reason for a back problem for lower back pain.

The pain that is generated from a disc tends to be different from person to person, what I find, as a specialist Physical Therapists, is that it’s right in the middle of the back. When people point to their back, they point right to the middle, not off to the sides at all. And sometimes they will say that the pain feels like a band across their back. The pain doesn’t go up and down, but it’s a sideways band across their back at the same level.

If you have pain in that kind of distribution on your back, there is a chance you might have a disc injury. You can have one showing on an MRI, you can have a diagnosed herniated disc, or a bulging disc, or there could be all kinds of names for disc injuries. It could be painless, where it doesn’t have to hurt at all.

The disc itself is innervated. It has nerves all around it, and so it can be a pain generating tissue for people with back problems.

#2 Arthritis – Osteoarthritis

There are all kinds of different types of arthritis. People say arthritis, which just means arthritis related to the bones. Now in the spine, in the lower back, you have three joints at every single level. Arthritis typically occurs in the joints called the sets, you have a pair of these at every level of the low back. And these four sets, they have a smooth surface that rub on each other, whenever you bend forward, backwards, or move in any direction.

Inside those joints is a little bit of cartilage that should move frictionless, but if you have arthritis, then the surfaces of those set joints can become uneven and not smooth, and it can move inappropriately. Which over time, over the course of years or decades, that joint can get really arthritic and even become fused, torn, and doesn’t move very well. It can cause tons of problems. In the back, this can be painful in itself.

Which is another reason that people have a lower back problem.

#3 Stenosis – Lumbar Stenosis

There are different types of stenosis. What that word means is that there is a hole, which is naturally occurring, something passes through there like a nerve or a blood vessel. This hole is closing which is what stenosis means – that the hole is closing.

In the spine, you have a bunch of holes, where nerves come out of the sides to go down into your legs and other areas of your body. And there is a hole in the middle of the vertebrae, in the middle of the spine, where your spinal cord runs through. If there is central stenosis, it means that the spinal cord pathway is closing somehow. Then there is the lateral stenosis, which means that the holes on the sides are affected, those are closing depending on other factors, which hols are affected.

It is up in the air and how it presents in people is different. If it is one of the holes on the side of the lateral stenosis, as they call it, typically there is pain going into one leg, or weakness into one leg, or just a one-sided problem.

It usually affects the leg. For some people, they will have leg problems and no back pain. But for most people with stenosis diagnosis, that we have seen here in the clinic, they have some back pain along with it.

Central stenosis is the more serious one, because obviously your spinal cord is involved. In extreme cases, the really extreme ones, they lose their bowel and bladder function, which means that they are having accidents, or not making it to the bathroom in time. And that’s not good.

You need to go to the hospital or go see a specialist right away for help. If you are having accidents at home, and you know that you might have stenosis, or you think you might have stenosis. Now for central stenosis it can be mild which, even though it’s mild is diagnosed on an MRI or X-ray, it can still hurt quite a bit, it can hurt severely, but the amount of closing is not as bad as it is in other people. It’s considered mild or moderate.

For people with painful stenosis problems, it is uncomfortable to be up and walking. They tend to feel better when they sit down, when they get off their feet, when they curl up into a ball, lying down versus lying on their back, lying on their side tends to feel better as well. They also don’t like to be up a whole lot, because the pressure from gravity on their spine closes those holes even more and can make the synthesis problem worse for the low back.

#4 Muscle Spasms.

Of course, the lower back is covered in muscles that run up and down the back, and frequently those back muscles will seize up. A muscle spasm is just simply a muscle that is contracting, squeezing tight without you meaning to do so. It’s involuntary.

What that does is, it doesn’t allow you to move normally. Typically, people freeze or get stuck. This this the type of problem a muscle spasm can cause, and what people tell us here in the clinic is that they feel stuck in their back, or that they couldn’t move.

That muscle is just gripping on for dear life because there is something in the spine that’s causing it to do that. It could be a pinched nerve, or it could be a joint problem. Muscles are very smart. They want to protect. They sense that something is going on, and they want to protect the spine. So they grip on and hold on, but it’s extremely painful, extremely uncomfortable.

This is a common reason that people will visit the emergency room and get muscle relaxers. Because it will allow that muscle spasm to come down. But if that’s you, or you have had that in the past, or you know of somebody that has been going to the emergency room, or even a normal doctor to get must relaxers, and if it works, there is usually some underlying problem that keeps causing that muscle to spasm and that that needs to be fixed.

The muscle relaxers won’t last too long. They are not a good long-term solution. But that’s muscle spasms, and those are probably the most painful in the short term.

#5 Degenerative Changes

We hear of two different types. There is degenerative disc disease, and degenerative joint disease. The reason why there are two different types is because, obviously the disc disease version affects the disc. What people will find on an X-ray or an MRI, is that the disc isn’t necessarily herniated, but it looks degenerated. It looks like it lost it’s height. It doesn’t have the same quality as other discs around it.

Versus degenerative joint disease, that tends to relate to other joints that aren’t related to the disc directly. Those joints can become affected as well, the cartilage can get worn down, and you can get arthritic changes inside those joints.

So. whenever you have degeneration inside of the spine, it tends to mean that the motion inside the lower back is not normal, and it tends to spread. Now it doesn’t spread like an infection would spread, or like a rash would spread. Think of it more so like a car problem, if you get a flat tire, and you keep driving on it, it’s going to eventually affect another tire or the axle, or the wheel, the hard part of the on the inside of the tire.

It’s going to affect some other parts of the car if you keep going on it. That is kind of how it works in the low back. If you have degeneration in a joint, or a disc in your lower back, unless you do something about it, it’s usually just a matter of time before a joint nearby, either above or below, or off to the side, becomes affected. Then you have multiple spots that have degeneration, or you might have other things going on, such as muscle spasms and disc injury, like a herniation.

Stenosis can also develop as a result of this and you can have a combination of issues that result in degenerative disc disease and degenerative joint disease.

#6 Hip Problems

This is not what people always think about, but I see it commonly happen here in the clinic, with people that come in for back problems. They tend to have a hip problem that hasn’t been diagnosed, or looked at properly, or isn’t even really bothering them that much. But once we get somebody here in the clinic, the hip is one of the first things we look at when they are dealing with the back problems.

We will look at how their hip is moving and 8, sometimes 9 times out of 10. I think there are some hip issues that are affecting their back problem. They are not able to bend their hip all the way up, or they don’t have proper rotation in their hip. Or the muscles around their hip are not as strong as they should be, or not controlling the hip joint as well as it could. Which then begins to affect the back over time.

This is why there are cases where there are people that go get MRIs or X-rays for their back pain, and they look perfectly normal. The doctors are shocked, and they will tell the patient, that there is nothing wrong with their back, the discs look healthy. There is no stenosis. There are no pinched nerves that we they see. They know you have pain, but there is nothing they can do for you.

That is typically what happens because there is no injury to the back yet. It’s just letting you know that it is irritated. It doesn’t like it. And there’s usually a hip problem that’s occurring.

Now hip problems are sticky because, you know, in American culture in our technologically advanced world, where everybody’s got smartphones and computers, we tend to sit a lot and may not getting as much as normal activity as we used to in the past where we’re standing up moving around. In our hips, joint or hip joints can get stiff, our muscles around the hip joints can get weak. And that can set up a back problem to occur gradually and slowly over time, while never really noticing that the hip is bothering you.

The common symptom that people report when we start to ask them about their hips, if they are having any problems with it, is they usually say that they feel tightness. Sometimes they feel tightness in their hips, especially on the front, outside of the hip, like where the back-pocket areas. They also say that they get tight there, sometimes higher on the hip as well. Sometimes the front of the thighs, and hip also get tight and sore at times.

But people don’t always associate it with a hip problem. Like they’re having pain in their hip. They just say that they have tightness, but that tightness is usually a telltale sign that it’s feeding into a back problem.

There you go, guys, there are the six most common reasons for lower back pain.

Now if you want to learn more about this, I encourage you to visit our website, www.EPManualPhysicalTherapy.com check out our blog, there are tons of resources there. We also have a eBook that you can download that covers the top 10 tips for lower back problems.

If you think that we might be able to help you out, if you are considering hiring us to help you with your back problem, give us a call at 915-503-1314 and we’ll be happy to help you.

You can also click that button below and request a FREE Discovery Visit. If you can get to El Paso, Texas, you are welcome to set up an in person 20 minute free discovery visit where we can take a look at you by hand, and figure out what is going on in your low back, so that we can begin to develop a plan for your back problem.