Back pain is one of the most common reasons people visit a physician or are absent from work. The lower back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the lower back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the lower back supply sensation and power the muscles in the pelvis, legs, and feet. Back pain, which may range in intensity from a dull, constant ache to a sudden, sharp or shooting pain, can begin suddenly as a result of an accident or by lifting something heavy, or develop over time due to age.

The lower back includes five vertebrae, referred to as L1 through L5, in the lumbar region. The spaces between the vertebrae are maintained by round pads called intervertebral discs that absorb shock throughout the spinal column and cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and control body movements and transmit signals from the body to the brain.

Due to significant overlap of the nerves that connect to many of the discs, muscles, ligaments, and other spinal structures, a person often has difficulty accurately sensing the true cause of lower back pain. For example, a degenerated or torn lumbar disc may create the same pain sensation as a pulled muscle while both can create inflammation and painful muscle spasms in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain assists in determining the cause.

Most lower back pain can be described as acute – lasting a few days to a few weeks. Generally, acute back pain is mechanical in nature, meaning that there is a disruption in the way that the components of the back – the spine, muscles, intervertebral discs, and nerves – fit together and move. Mechanical causes of lower back pain may include skeletal irregularities, such as scoliosis – a curvature of the spine, lordosis – an abnormally exaggerated arch in the lower back, kyphosis – excessive outward arch of the spine, and other congenital anomalies of the spine. Injuries, such as sprains – overstretched or torn ligaments, strains – tears in tendons or muscle, and spasms – sudden contraction of a muscle or group of muscles, may also lead to lower back pain. Pain is considered chronic if it lasts for more than three months and exceeds the body’s natural healing process. There are numerous causes of chronic pain in the lower back that often involve a disc problem, a joint problem, and/or an irritated nerve root.

Basic remedies applied at home can be effective for treating mild or acute pain from muscle strain, as well as reducing the effects of chronic, severe pain. Self-care is administered by the individual and can easily be adjusted. Many episodes of lower back pain can be improved by briefly avoiding strenuous activity. It is not advised to rest for more than a few days, as too much inactivity can make healing more difficult. Heat from a warm bath, hot water bottle, electric heating pad, or chemical or adhesive heat wraps can relax tense muscles and improve blood flow. Increased blood flow brings nutrients and oxygen that muscles need to heal and stay healthy. If the lower back is painful due to inflammation, ice or cold packs can be used to reduce swelling. Protect the skin while applying heat or ice to prevent tissue damage.

Physical therapy is often part of a lower back pain management regimen. Stretching muscles in the lower back, hips, and legs assists in loosening and relaxing the muscles that support the weight of the upper body. The more mobile the muscles are, the more the back is able to move without injury. When starting a stretching routine, it is suggested to start slowly, stretching for 20 to 30 seconds and stop a stretch if it causes pain. Strengthening the core muscles found in the abdomen, hip, and gluteal region that support the spine can also assist in relieving lower back pain.

Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress – repeated or constant contact between soft body tissue and a hard or sharp object, vibration, repetitive motion, and awkward posture. Exercise regularly to keep muscles strong and flexible. Consult a physician for a list of lowimpact, age-appropriate exercises that are specifically targeted to strengthening lower back and abdominal muscles. Maintain a healthy weight and consume a nutritious diet with sufficient daily intake of calcium, phosphorus, and vitamin D to promote new bone growth.

Most back pain gradually improves with home treatment and self-care, usually within a few weeks. Contact a physician or orthopedic surgeon if the pain is severe, persists past a few weeks, spreads down one or both legs, causes weakness, numbness, or tingling in one or both legs, or is accompanied by unexplained weight loss. In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain causes new bowel or bladder problems, is accompanied by a fever, or follows a fall, blow to the back, or other injury.