Understanding the causes of lower back pain is the first step in finding a solution to relieve the pain. First, know that you’re not alone. Statistics show that up to 80 percent of Americans will have back or spine pain at some time in their lives. Much of the back pain we see at Neurosurgery One is in the lower back, in the area called the lumbar spine. The good news is that while there are many causes of lower back pain, it usually gets better on its own or with a few home remedies. Most patients will never have to visit a Denver spine surgeon.
The most common causes of lower back pain are:
- Genetics (inherited characteristics)
- Improper use of your back
These are the causes of low back pain that generally can be treated with proper nutrition, physical therapy, and over-the-counter pain relievers. If your pain grows sharply worse or you have nagging lower back pain that doesn’t abate after four to six weeks, you should see a spine doctor.
Degenerative Causes of Lower Back Pain
There are two main conditions that cause low back pain, as well as leg pain in some cases. If you are experiencing lower back pain due to one of these conditions, you will require the care of an expert spine surgeon. These are:
- Herniated disc: Discs are rubbery, fluid-filled cushions between the bones in your spine that absorb shock as you lift, bend, and twist. As you age, they slowly lose some of the fluid and become thinner and weaker. This can lead to a herniated disc, where some of the softer inner part of the disc pushes through a crack in the outer part.
- Arthritis and spinal stenosis: Arthritis can lead to a narrowing of the open spaces within your spine, allowing improper contact between bones with subsequent pain, or putting pressure on nerves that then causes leg pain and sometimes back pain as well.
Not everyone with these conditions will experience lower back pain. The severity of the condition, your genetics, pain tolerance, activity level, and other factors contribute to whether you will feel pain and to what degree.
One of those other contributing factors is weight. Obesity can lead to disc damage and increase the pain caused by arthritis. Carrying extra weight, especially around the waist, can put pressure on discs and other spinal structures. If you have a BMI (body mass index) of 25 or higher — which qualifies as overweight — you have a higher chance of developing osteoarthritis due to the strain the extra weight puts on your joints, including your spine.
When Lower Back Pain is an Emergency
Lower back pain is rarely caused by a condition that requires emergency treatment, even if it comes on suddenly such as in a back spasm. There are some occasions, however, when you should seek care as quickly as possible:
- Severe weakness or numbness in legs or feet, particularly in the saddle area (inner thighs)
- Difficulty walking
- Pain in the back and/or legs accompanied by a change in bowel or bladder habits
- Back pain that does not diminish with rest, and pain that is worse at night
Treating the Causes of Lower Back Pain
In general, if you have been diagnosed with degenerative disc disease, herniated disc, or spinal stenosis that is causing your back pain, we will begin with the most conservative treatments. For most of my patients, I recommend exercises that strengthen your core — the muscles that support your back — such as pilates, yoga, or even just walking. Other conservative treatments include physical therapy, steroid injections, use of over-the-counter pain relievers, and sometimes limited use of prescription pain medicines.
Surgery for Lower Back Pain
If your lower back pain and/or leg pain does not resolve with conservative treatments and if you have a condition that is confirmed through an imaging scan, such as an MRI, spine surgery may be an effective treatment. With the exceptions noted above, spine surgery is rarely a surgery that must be performed immediately. And while surgery may successfully treat your condition, our Denver spine surgeons consider more than just your diagnosis when making a recommendation. We work with you to consider personal factors such as:
- Lifestyle: Is your pain intolerable and preventing you from staying active (which is essential to your overall health) or enjoying your life?
- Health Status: Does your health support surgery? Factors such as smoking or uncontrolled diabetes increase the risk of infection; and obesity can make recovery more difficult. All of these health factors can be dealt with but we work with you to ensure you understand the implications.
- Age and Recovery: Will you enjoy the benefits of spine surgery after recovery? Do you have support during recovery? These and other questions influence whether spine surgery is right for you.
Possible surgeries to treat lower back pain fall into two classifications:
- Decompression surgeries remove the part of the structure that is compressing the nerve and causing your pain. Spine decompression surgeries have differing names depending on the structures in the spine that are being removed or altered. Often more than one of these procedures will be used. You can learn more about decompression surgeries for lower back pain on our website.
- Stabilization spine surgery is performed to reduce or eliminate motion between the vertebrae causing pain. The most common type of stabilization spine surgery for lower back pain is spinal fusion where two or more vertebrae are fused.
When to See a Spine Surgeon for Lower Back Pain
In general, most lower back pain can be assessed and treated by your family practice physician. If your pain continues or your doctor believes a consult with a specialist is warranted, you may be referred to a spine specialist such as the Denver spine surgeons at Neurosurgery One. If you are unsure about where to turn for help, please call our office and we are happy to answer your questions and tell you whether a visit to a spine surgeon makes sense.