Low Back Pain: Causes and Treatments

Updated: Nov 19

Eighty percent of the population will experience low back pain in their lifetime, and this is fairly consistent around the globe. The female gender is at higher risk for suffering low back pain. Low back pain is the most common cause of disability worldwide. It is also responsible for the highest health care costs than any other medical condition, surpassing cancer and heart disease. Low back pain is associated with a high risk of depression and opioid use.  The severity of back pain and risk of disability increases with age.


What causes low back pain?


There are many causes of low back pain. The most common type of back pain is mechanical low back pain which refers to injury and/or dysfunction of muscles, ligaments and/or joints. Disc bulges and herniations can cause low back pain and compression to the sciatic nerve giving rise to back and leg pain (sciatica). Arthritis of the lower spine can lead to degenerative disc thinning and thickening of spinal joints and ligaments. This wearing out of the lower spine can lead to back pain but also narrowing or stenosis of the spinal canals. Spinal stenosis can lead to compression to the spinal nerves travelling to the back and legs causing lower back and leg pain as well as numbness, tingling, weakness and heaviness of the legs. Symptoms of spinal stenosis are generally worse with standing and walking impacting overall functional abilities. 



Does cancer cause low back pain?


Cancer can cause low back pain, but it is rare. About 6 people out of 1000 will have cancer as the cause of the low back pain. This risk of cancer increases to 9% among people with low back pain who also have had a previous history of cancer of the prostate, lung or breast. Constant back pain, even at rest with a loss of appetite and unexplained weight loss require an assessment from a health care professional to rule out cancer.  


How does pregnancy cause low back pain?


Low back pain is common in pregnancy especially in the last trimester.  This is because of the additional load to the lower back due to weight gain and an increase in the lumbar lordosis (curvature). This additional load leads to straining of the low back muscles, joints and discs.  There is also a hormone produced in the last trimester which makes the low back and pelvic ligaments loose in preparation for delivery, and this can make the lower back more vulnerable to injury.   



Can low back pain cause hip or knee pain?


Low back pain can often refer to pain in the hip and knee. This type of pain can come from irritation of the muscles, ligament or joints of the spine. Herniated discs and spinal stenosis can place pressure on the nerves travelling to the hip and knee and give rise to hip and/or knee pain and weakness.


What treatments are effective for low back pain?


First line treatment for low back pain should be non-pharmacological. A back pain program like the Boot Camp Program for Persistent Low Back Pain that combines manual therapy (mobilization, manipulation and massage) with exercise and education is recommended for most people with low back pain. The type of exercise will depend on the cause of the low back pain. Patients with lumbar spinal stenosis tend to do better with flexion exercises whereas people with disc herniations generally do better with extension exercises. Keeping active and maintaining normal activities as best a possible is also recommended. Surgery is rarely recommended for low back pain but can often help people who have back related leg pain that does not get better with conservative treatment. 



Looking for help with Low Back Pain?

We recommend our Persistent Low Back Pain Boot Camp Program available on our website.



Spinemobility is a Not-for-Profit Research and Resource Centre aimed at developing and testing innovative programs and devices with the goal of maximizing function, improving quality of life and reducing the risk of disability caused by spine and spine related conditions. 

 

A key component of what we do is to provide clinicians with the tools, knowledge, skills and self-confidence to implement in their clinics our evidence-based programs.

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Disclaimer: The material on this website is for educational use only. It should not be used as a substitute for advice from your physician or other

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