Low Back Pain: 5 Causes, Symptoms and Effective Treatment

Back pain is something almost everyone deals with at some point, but did you know that low back pain is the leading cause of disability worldwide? It’s so common that nearly 80% of people will experience it at least once in their lifetime¹. In my practice at Daniel da Cruz Physiotherapy, it’s one of the most common issues I help patients treat.

Low back pain can happen for many reasons, from lifting something heavy the wrong way to just sitting too much.

In this article, we’ll look at what causes low back pain, who is most at risk, and what you can do to treat it. We’ll also share the latest research and expert advice to help you take care of your back.

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What is Low Back Pain?

Low back pain is defined as pain, muscle tension, or stiffness below the rib cage and above the legs and the lower part of your spine.

It can be placed into different categories like acute (lasting less than six weeks), sub-acute (lasting six to twelve weeks), or chronic (lasting more than twelve weeks).

Low back pain is very common, and it affects about 540 million people at any given time, making it the leading cause of disability worldwide.

It can strike anyone, but it is most prevalent in adults aged 30 to 50, this is due to the natural aging process and sedentary lifestyles.

As people age, the discs between the vertebrae in the spine can lose fluid and flexibility, leading to conditions like degenerative disc disease, which is a common cause of low back pain in older adults³.

What Will You Experience If You Have Low Back Pain?

1. Dull, Aching Pain: A constant, deep ache in the lower back that does not go away and even gets worse with sitting or standing for long periods.
2. Sharp, Stabbing Pain: Sudden, intense pain that can shoot down into your legs, often described as a “stabbing” sensation, which will show that there is nerve involvement like sciatica.
3. Stiffness in the Lower Back: Difficulty in moving or bending your back, especially in the morning or after sitting for long periods.
4. Pain That Worsens with Movement: Activities like lifting, twisting, or bending can increase the pain, making it sharper or more intense.
5. Radiating Pain: Pain that travels from the lower back down into the buttocks, thighs, or even the calves and feet, which happens when the nerve is irritated or compressed.
6. Numbness or Tingling: A tingling or “pins and needles” sensation in the lower back, buttocks, or legs, which will be a sign of nerve compression.
7. Weakness in the Legs: Feeling of reduced strength in the legs or difficulty in lifting the foot or toes, sometimes making walking difficult.
8. Pain That Improves with Rest: Often, lying down or changing positions can some temporary relief from the discomfort.
9. Difficulty Standing Up Straight: A noticeable curve in your posture when you try to stand up, often due to muscle spasms or stiffness.
10. Limited Range of Motion: Finding it hard to move your back fully, especially when bending over or twisting your torso.

How Does Low Back Pain Happen?

Low back pain happens because of different problems in the lower back. These problems usually affect muscles, bones, discs, or nerves.

Let’s look at some of the main reasons why low back pain occurs and what’s happening inside your body when it does:

Muscle Strain and Ligament Sprain

Low back pain often results from muscle strain or ligament sprain, occurring when muscles or ligaments are overstretched or torn, typically from lifting heavy objects, sudden movements, or awkward twisting. The pain and limited movement arise from swelling in the injured area.

Disc Problems

Spinal discs cushion the bones in your back, but they can wear down over time, losing water and flexibility, especially with age.

Stressful activities like heavy lifting or prolonged sitting can damage discs, leading to bones rubbing together or pressing on nerves. This can cause pain, especially if a disc shifts and pinches a nerve.

Joint Problems

The joints in your lower back support movement and stability but can become irritated or worn out from stress, poor posture, or aging. As cartilage breaks down, the joints can cause pain and trigger muscle spasms, intensifying discomfort.

Nerve Compression

Nerve compression in the lower back, often caused by a bulging disc, bone spur, or narrowed spinal space, can trigger pain, numbness, or weakness. The compressed nerve sends pain signals to the brain, sometimes causing pain to spread down the legs.

Inflammation

Inflammation, the body’s response to injury, causes redness, swelling, and pain in the lower back, often triggered by muscle strain, ligament sprain, or other injuries. It makes the area sensitive and painful to move, and if prolonged, can lead to ongoing pain and stiffness.

What Conditions Are Known to Cause Back Pain?

1. Muscle Strain or Ligament Sprain: Often caused by overuse, sudden movements, or improper lifting. This is the most common cause of low back pain.
2. Herniated Disc (Slipped Disc): Occurs when the soft center of a spinal disc pushes through a crack in the tougher exterior, potentially pressing on nerves.
3. Degenerative Disc Disease: The breakdown of spinal discs due to aging or wear and tear, leading to pain, especially when bending or twisting.
4. Facet Joint Syndrome: Pain that originates from the facet joints, which are small stabilizing joints located between and behind adjacent vertebrae.
5. Sciatica: A condition where pain radiates along the sciatic nerve, which runs down one or both legs from the lower back, typically caused by nerve compression.
6. Spinal Stenosis: Narrowing of the spaces within your spine, which can put pressure on the nerves traveling through the spine.
7. Spondylolisthesis: A condition where one vertebra slips forward over the one below it, which can cause pain and instability.
8. Osteoarthritis: Wear and tear of the spinal joints, which can lead to chronic low back pain, especially in older adults.
9. Sacroiliac Joint Dysfunction: Pain originating from the sacroiliac joint, which connects the lower spine to the pelvis, often due to inflammation or improper movement.
10. Spinal Fractures: Breaks or cracks in the bones of the spine, usually due to trauma or osteoporosis, causing sharp pain and potential deformity.
11. Ankylosing Spondylitis: A type of arthritis that causes chronic inflammation of the spine and sacroiliac joints, leading to stiffness and pain.
12. Cauda Equina Syndrome: A rare but serious condition where the bundle of nerves at the end of the spinal cord becomes compressed, requiring immediate medical attention.

What Are Some Mistakes People Make When They Have Back Pain?

Ignoring the Pain

One of the biggest mistakes is ignoring the pain, hoping it will just go away. Low back pain often starts as mild and comes and goes, but if you ignore it, it can become more severe and constant.

By not addressing the early signs, a small issue can turn into a big problem.

Self-Diagnosing and Self-Treating

Another common mistake is trying to figure out and treat the problem on your own without seeing a healthcare professional. While rest and pain relievers might help for a while, they don’t fix the real cause of the pain.

Misdiagnosing your problem can lead to the wrong treatments, letting the issue get worse.

Pushing Through the Pain

Many people, especially those who are active, try to push through the pain and keep going with their activities. This can cause more injury, more inflammation, and make recovery take longer.

It’s important to listen to your body and give your back the rest it needs to heal.

Delaying Treatment

Some people wait too long to see a physiotherapist, thinking the pain is not serious enough. But getting help early is important to stop further damage. If you wait too long, the problem can get more complicated and harder to treat, meaning you will need more intense treatments later.

Inadequate Rehabilitation

After seeing a doctor, some people don’t follow through with their rehab program. Skipping physical therapy or not doing the exercises they’re given can slow down recovery and make it easier to get hurt again.

Rehab is key to getting back strength, flexibility, and normal function in your back.

What Happens If You Ignore Back Pain?

Chronic Pain

What starts as occasional discomfort can turn into constant, chronic pain if you don’t treat it. Chronic low back pain can make daily tasks difficult and seriously affect your quality of life.

Loss of Mobility

As the pain gets worse, you will find it harder to move your back. This can lead to stiffness and losing the ability to do basic activities like bending or lifting. Conditions like chronic low back pain can make everyday movements a struggle.

Muscle Weakness and Atrophy

Without treatment, the muscles in your back can weaken over time. This is especially true if the pain makes you avoid using your back. Weaker muscles can lead to more instability in your spine and a higher risk of getting hurt again.

Joint Degeneration

If left untreated, conditions like arthritis can get worse, leading to the breakdown of cartilage in the spine. This can cause more pain and stiffness and may eventually lead to the need for surgery, such as a spinal fusion.

Permanent Damage

In severe cases, ignoring low back pain can lead to permanent damage. Problems like slipped discs, nerve damage, or joint issues can become irreversible if not treated quickly. This can result in long-term disability or loss of normal back movement.

How Long Does It Take to Recover from Back Pain?

The outlook for low back pain depends on the cause and how quickly you get back pain treatment. With early diagnosis and proper care, many back issues can be managed, and you can fully recover.

Problems like muscle strain or minor disc issues often respond well to rest, physical therapy, and other simple treatments. However, more serious problems like severe disc herniation or advanced arthritis might need surgery for a good outcome.

In summary, low back pain might seem like a small problem at first, but it’s important not to ignore it. Taking action early can prevent serious consequences and lead to a much better outcome. If you’re dealing with low back pain, don’t wait—early treatment is key to getting back to your normal activities and avoiding long-term issues.

What Treatment Options Are Available for Back Pain?

Orthopedic Manual Therapy

Orthopedic manual therapy involves hands-on techniques to manipulate and mobilize the joints and soft tissues in the lower back. This approach is often used to improve joint mobility, reduce pain, and enhance function.

• Joint Mobilization
  Joint mobilization techniques involve the gentle movement of joints in specific directions to restore normal motion. This can help reduce stiffness, improve range of motion, and alleviate pain caused by joint restrictions⁷.
• Soft Tissue Manipulation
  Soft tissue manipulation targets the muscles, tendons, and ligaments around the spine. Techniques such as deep tissue massage and trigger point therapy can help release muscle knots, improve circulation, and reduce muscle tension.

Myofascial Release

Myofascial release is a manual therapy technique that focuses on relieving tension in the fascia, the connective tissue that surrounds muscles. This treatment can help reduce pain, improve mobility, and release tightness in the lower back muscles.

During myofascial release, a physical therapist applies gentle, sustained pressure to the fascia, targeting areas of tension. This pressure helps release restrictions in the fascia, improving blood flow and reducing pain⁶. Myofascial release can be particularly effective for patients with chronic low back pain who experience tightness and stiffness that limit their movement.

Exercises for Low Back Pain

Exercise therapy is a cornerstone of physical therapy for low back pain. It involves specific exercises designed to strengthen the muscles supporting the spine, improve flexibility, and enhance overall function.

• Core Strengthening
  Exercises that target the core muscles, including the abdominals, back, and hips, are crucial for providing stability to the lower back. Strengthening these muscles can reduce the strain on the spine and prevent future pain episodes.
• Flexibility and Mobility
  Mobility exercises help improve flexibility in the muscles and ligaments surrounding the spine. Improved flexibility can reduce tension and stiffness in the lower back, which is important for pain relief and prevention.

Laser Therapy for Low Back Pain

Laser therapy is a non-invasive treatment that uses light energy to promote tissue healing and reduce pain. It is often used as part of a comprehensive treatment plan for low back pain.

Laser therapy works by delivering light energy to the affected area, which stimulates cellular repair and reduces inflammation. This can help accelerate healing and can give pain relief without the need for medications⁸.

Laser therapy can be particularly beneficial for patients with acute low back pain, as it can reduce pain and inflammation quickly, allowing them to engage in other therapies more effectively.

Dry Needling

Dry needling is a technique where thin needles are inserted into specific points in the muscles, known as trigger points, to relieve pain and improve function.

The needles stimulate the muscles and trigger a response that helps release tightness, reduce inflammation, and improve blood flow to the area. This can be especially effective for treating muscle spasms and chronic pain in the lower back⁹. Dry needling can help reduce pain and improve muscle function, making it a useful addition to a physical therapy program for low back pain.

Strapping and Taping

Strapping, also known as taping, involves applying special tapes to the skin to support the muscles and joints in the lower back. This technique is often used to reduce pain, support injured areas, and improve posture.

The tape provides external support to the muscles and joints, helping to reduce strain and prevent further injury. It also promotes better posture by encouraging the body to move in a way that reduces stress on the lower back¹⁰. Strapping is particularly useful for patients who need extra support during physical activities or for those recovering from an injury. It can also help remind patients to keep proper posture throughout the day.

Practical Tips for Managing Low Back Pain

Managing low back pain does not have to be complicated. With the right approach and a few practical tips, you can reduce pain, improve your mobility, and prevent future issues. Here are some simple and effective tips based on research and expert advice.

Stay Active, But Don’t Overdo It

One of the best things you can do for low back pain is to keep moving. Gentle activities like walking, swimming, or cycling can help keep your muscles flexible and strong without putting too much strain on your back. However, avoid overdoing it—listen to your body, and don’t push through sharp pain.

Practice Good Posture

Good posture is key to preventing and managing low back pain. Whether you’re sitting, standing, or lifting, keep your spine in a neutral position. This means keeping your shoulders back, your core engaged, and avoiding slouching. When lifting, bend at your knees, not your waist, and keep the object close to your body.

Use Ice and Heat

If you’re dealing with acute low back pain, try using ice packs during the first 48 hours to reduce inflammation. After that, switch to heat packs or warm baths to relax tense muscles and improve blood flow. Use ice or heat for 15-20 minutes at a time, several times a day.

Strengthen Your Core

A strong core supports your spine and reduces the risk of injury. Include exercises like planks, bridges, and pelvic tilts in your routine to strengthen your abdominal and back muscles. Start with a few repetitions and gradually increase as you get stronger.

Avoid Prolonged Sitting

Sitting for long periods can put extra pressure on your lower back. If you have a desk job, make it a habit to stand up, stretch, and move around every 30 minutes. If possible, use a standing desk or sit on an exercise ball to engage your core while working.

Stay Hydrated

Keeping your body well-hydrated is important for the health of your spinal discs. These discs need water to stay flexible and absorb shock. Aim to drink plenty of water throughout the day to keep your discs and the rest of your body healthy.

Follow Your Physiotherapy Program

Consistency is key to recovery. Even after your pain subsides, continuing with your exercises can help prevent future episodes of low back pain.

Conclusion

As your physiotherapist, I want you to know that dealing with low back pain doesn’t have to be a struggle. With the right steps and a little patience, you can get back to feeling strong, mobile, and comfortable again. Every day, I see people just like you who are frustrated by pain, but I also see how effective the right treatment can be.

Take it one step at a time, and trust the process. With the right care and commitment, you’ll see improvement. I’m confident that you can overcome this and get back to feeling like yourself again.

If you ever need anything, just reach out—I’m here to help.

About the Author

Daniel da Cruz, a qualified physiotherapist since 2018, specializes in treating back pain in Sandton at Daniel da Cruz Physiotherapy.

Working from Medical on Maude as a Physiotherapist in Sandton, Daniel helps patients recover from conditions such as herniated discs, sciatica, spinal stenosis, and mechanical low back pain using evidence-based physiotherapy, manual therapy, and structured exercise programs. His personalized, holistic approach has helped hundreds in Sandton overcome pain, restore mobility, and return to active, pain-free living.

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