Lower back pain is a universal nuisance, something most of us experience at some point in life. Whether it’s a dull ache after a long day or a sharp, sudden twinge, it is a reminder of how much we rely on a healthy spine to keep us moving. Consultant Spinal Neurosurgeon Mr Pratipal Kalsi sheds light on the causes of lower back pain, the best ways to prevent and manage it, and when it is time to call in the professionals for treatment.

What’s behind lower back pain?

Back in 2020, when the Covid lockdowns and curfews were the norm, many people across the globe were not only working from home, often perched on makeshift office furniture, but also spending far more of their spare hours sitting down. So, it doesn’t come as a surprise that 619 million people – nearly 10% of the world’s population – were reported to be suffering with lower back pain that year alone. Moreover, the unprecedented times aside, over 60% of adults are expected to experience low back pain at least once in their lifetime.

However, while incredibly widespread and one of the leading causes of disability, lower back pain is not one-size-fits-all. Its causes and remedies vary accordingly – the pain can sneak up on you after an awkward twist or build gradually over time causing chronic discomfort. Let’s unpack some of the common culprits:

Strains and sprains

Overdoing it at the gym, lifting something a bit too heavy, repetitive movements, or just a sudden awkward motion can leave your muscles and ligaments in revolt, causing pain and stiffness.

Disc problems

Herniated or degenerated discs can pinch nearby nerves and cause sciatica, which sends pain radiating through the buttocks and into the leg.

Arthritis

Osteoarthritis wears away cartilage, the natural cushioning of joints, which can also affect the lower back. This can make the spine stiff and movements uncomfortable or painful, especially as we age.

Spinal stenosis

A narrowed spinal canal can compress nerves, leading to symptoms such as numbness or weakness in the legs and pain.

Accidents and trauma

Falls, car accidents, or sports injuries can fracture or destabilise parts of the spine.

Underlying conditions

Though rare, infections, tumours, or inflammatory disorders like ankylosing spondylitis can also cause lower back pain.

Managing and preventing back pain

When lower back pain strikes, how do you respond?  Management will depend on the cause, severity and your overall health, but these are some of the tried-and-tested approaches:

Motion is the best lotion

Understandably, you may be tempted to lie down when sore and staying upright feels like torture. You should most certainly avoid activities that aggravate the pain, such as heavy lifting or bending, especially when the pain is severe, caused by trauma, acute injury, or accompanied by fever, weakness or incontinence.

However, be warned: in most cases, prolonged bed rest is likely to extend your episode of back pain, while gentle movements and active rest can promote healing and prevent stiffness. Active rest means reducing strain on muscles and joints while keeping the body mobile with low-impact activities such as walking, swimming or stretching.

Self-care and lifestyle changes

• Sit up straight! Maintaining good posture and ergonomics while sitting, standing and lifting will help prevent strain.
• Regular exercise – especially core-strengthening activities – improves spinal support and flexibility.
• Maintaining a healthy weight reduces chances of strain on weight-bearing joints, including those in your lower back.
• Using heat pads or cold packs can provide relief by reducing swelling and soothing sore muscles.

Medications

• Mild aches and discomfort can be alleviated with over-the-counter pain relievers such as paracetamol or ibuprofen.
• For more severe symptoms, your doctor may prescribe muscle relaxants or medications tailored to nerve pain.

Physiotherapy

• A tailored physio programme can help with ongoing pain by strengthening weak muscles, improving posture, and enhancing mobility.
• Massage, particularly when the pain is acute, can help reduce muscle tension, improve circulation, and promote relaxation.

Targeted injections

For patients with persistent pain, epidural steroid injections or nerve blocks can reduce inflammation and provide temporary relief.

Surgery

If all else fails, or when specific conditions – for example, a herniated disc, overgrowth of bone due to osteoarthritis, or treatment-resistant spinal stenosis – demand intervention, surgery might be the best option. Decompression surgeries, such as lumbar laminectomy or lumbar discectomy, and spinal fusion can address the underlying issues and alleviate symptoms.

When to raise the red flag

Not all back pain is equal. While many cases of lower back pain improve with time and conservative management, certain symptoms warrant immediate medical attention. These include:

• Pain that’s unrelenting or worsening despite treatment.
• Fever, night sweats or unexplained weight loss alongside back pain.
• Weakness, numbness or tingling in the legs, genitals or buttocks.
• Either loss of bowel or bladder control or difficulty emptying them can be a potential sign of cauda equina syndrome requiring emergency treatment.

If you experience any of these symptoms, it is crucial that you consult a specialist promptly. While not life-threatening, this condition can cause permanent damage and affect your health.

Lower back pain doesn’t have to take centre stage in your life. By understanding its causes, staying active, making smart lifestyle choices, and seeking timely medical advice, you can regain your quality of life and prevent future episodes – without looking back (pun intended). Remember to always follow proper lifting techniques to prevent back injuries, both at work and at home!
 

For a thorough assessment and expert care, book an appointment with our Consultant Neurosurgeons by calling 020 8949 9020 or complete our online form.