Severe lower back pain: Causes and treatments

Lower back pain is the single leading cause of disability worldwide. Most people will experience it at least once in their life, and there are many possible causes. Fortunately, there’s a lot of hope for relief. Rehabilitation therapies have more potential to improve lower back pain than any other condition. 

This article will cover 12 of the most common causes of lower back pain along with rehabilitation treatments that can help you feel better.

What’s the outlook for severe lower back pain?

It’s hard to make any general statements about severe lower back pain because each case is unique. Many of the body’s systems converge in the lower back, and conditions in any of the bones, muscles, joints and organs situated in the lower back can cause pain, such as the kidneys, pancreas and large intestine. The potential treatments and outlook for recovering from lower back pain depend on the root cause. 

Treatment for your back pain will depend on whether the issue is caused by a problem with the structure, musculature and fascia of your back or an internal organ below the surface. The nature of your pain, whether it’s caused by a congenital condition, an infection or an injury, for instance, will also affect your prognosis.

What can cause severe lower back pain?

You might expect back injuries to happen at work or during physical activities. But they often happen when you least expect it, such as while doing mundane tasks like picking up a piece of trash. Strains and sprains can happen when you twist, bend or lift something with improper form — especially if you don’t get much exercise or you don’t have much core strength. And not all back pain is caused by injuries. 

Any structural problems or issues with the discs between vertebrae can cause a lot of pain. Discs often break down with age, and they can move out of alignment over time, compressing spinal nerves. Having poor posture, sitting for long periods and carrying excess weight can put stress on the structure of your spine. Over a long period of time, this can make you more likely to experience lower back pain. 

Finally, disease can cause pain in the lumbar and sacral areas of the spine or the muscles and organs near them. Several types of arthritis, fibromyalgia and other inflammatory conditions can begin with pain in the lower back. Some less common sources of lower back pain are spinal tumors, osteoporosis, congenital issues like scoliosis, and pregnancy.

The following are 12 of the most common causes of severe lower back pain:

• Acute injury — A fracture, strain or sprain can cause severe lower back pain to show up suddenly. A strain is an injury to a muscle or tendon, and a sprain affects ligaments that hold the spine together. 
• Myofascial pain — Any disruption of the nerve signals coming from the spine can result in sensations of tightness and pain in the low back muscles.

• Herniated or ruptured discs — Discs in the lumbar area are some of the most likely to slip through weak parts of the spine, compressing and irritating nearby nerves. 
• Sciatica — The sciatic nerve runs through the lower back and down the legs. Pressure on this nerve can cause pain, weakness, numbing or tingling in the same areas.
• Inflammatory conditions — Inflammatory back pain is also known as ankylosing spondylitis or axial spondyloarthritis. Reactive arthritis, which is joint pain and swelling triggered by an infection somewhere else in the body, as well as rheumatoid arthritis can cause low back pain. Enteropathic arthropathy is another inflammatory condition related to inflammatory bowel disease that can cause low back pain.
• Degenerative disc disease — The vertebrae of the spine can break down with age. This may come along with other degenerative spinal conditions like arthritis or spinal stenosis.
• Spondylolisthesis — In contrast to a herniated disc, spondylolisthesis is when a vertebra moves out of alignment.
• Spinal stenosis — This can occur anywhere in the spine: Stenosis is a narrowing of the spinal canal that puts pressure on the spinal cord and nerves.
• Fibromyalgia — This condition can cause muscle pain and fatigue all over the body, and many people feel it in their lower back.
• Kidney stones or infections — The kidneys sit near the lower middle of the back, so kidney stones and infections are sometimes the cause of low back pain.
• Endometriosis — In women, uterine tissue can build up in places outside the uterus, causing a lot of pain. It can travel to different locations near the abdomen, including the lower back.
• Infections — Infections can start in the spine or other areas of the body and move to the spinal discs and vertebrae, causing back pain.

What treatments can help with severe lower back pain?

Fortunately, physical therapy offers many spine and back therapy treatments. In addition to manual therapy techniques, applying a small amount of electrical stimulation can relieve low back pain. A large part of physical therapy for back pain involves stretching and strengthening the muscles that support the back, which can improve mobility, posture and positioning. 

Along with physical therapy, you can take over-the-counter topical or oral pain relievers to help with low back pain in the short term. Alternating heat and cold therapy to increase blood flow and numb pain can be helpful, and you should avoid too much bed rest and activities that make the pain worse.

Talk with your doctor or physical therapist about treatments that may help and the associated risks. As mentioned earlier, the most appropriate treatments will depend on the cause of your pain. Other alternatives to explore include chiropractic manipulation and prescription medications such as pain relievers, anti-inflammatory drugs, numbing injections, muscle relaxers and nerve medication. In the most extreme cases, surgery may be necessary. This is usually the last resort after trying multiple other treatments.

Here’s a bit more detail on the physical therapy techniques we use at Armor Physical Therapy to treat lower back pain:

• Manual therapy — This refers to massage-like movements that break up stiffness, increase range of motion and mobilize joints. Increasing blood flow to the affected area promotes healing and pain relief.
• Electrical stimulation — Different types of low-voltage electrical stimulation, using TENS units or iontophoresis, can help with low back pain. TENS stands for transcutaneous electrical nerve stimulation. Iontophoresis delivers medication through the skin while the area is submerged in water and electrical stimulation is applied.
• Stretching exercises — Stretching the tendons and muscles of your back can take pressure off them by increasing elasticity and flexibility. 
• Therapeutic back exercises — Core muscle strengthening and dynamic lumbar stabilization exercises are helpful for the treatment of back pain. When the muscles supporting your back are strong, there’s less strain on the tendons and ligaments holding your back together.
• Low-impact aerobic conditioning — Low-impact aerobics like water therapy, biking and walking help keep your body healthy and conditioned so injuries and disease cause less pain.

Armor PT can help with severe lower back pain

Severe lower back pain can get in the way of work, exercise and things you do for fun. Don’t forget physical therapy and rehabilitation have a lot of potential to help you find relief in the short and long term. 

At Armor PT, our physical therapists can help you determine potential causes based on your symptoms and a few simple tests. They can provide education on your specific issues from there and treatments that can help you start feeling better right away.

Don’t wait to get help with severe lower back pain. Call us or request an appointment today.