Lumbar pain | Why is my lower back always hurting?

Keep reading to learn more about lumbar pain and how different treatment options can help you manage and relieve pain in your lower back.

What is the lumbar area?

The lumbar area of the spine typically refers to the region of the lower back that’s located between the lowest rib and the top of the pelvis. It’s made up of five large vertebrae labelled L1 through L5 with intervertebral discs located between them.

In practical terms, you can visualise the region by picturing the area running from just below where a bra strap would sit to the area around where your belt line is located.

What causes pain in the lower back?

Lower back pain is usually ‘non-specific’ which means there is no cause of the pain that could be identified by a physical assessment, x-ray, or scan. For a smaller percentage of people, there is a specific cause for their back pain, which is typically attributed to problems with a specific joint, disc, muscle or ligament. In an even smaller percentage of cases, your lower back pain may be caused by an infection, malignancy (cancer), or fracture.

Why is lower back pain so common?

Studies have shown that 80% of adults will experience an episode of lower back pain at some point in their lives, with up to 10% of those suffering from pain for longer than 3 months. When pain continues for more than 3 months, it’s usually labelled persistent or ‘chronic’.

Lower back pain could almost be thought of as inevitable (like catching a cold) as it’s so common. To expect to avoid all back pain is impossible, as age-related pain is a normal experience that we will all experience at some point.

Lifestyle factors also play a role in how often we experience back pain and how severe it gets when we do. This includes:

• Being sedentary
• Eating a diet that’s lacking in valuable nutrients and minerals
• Poor sleep quality
• Excess stress
• Repetitive manual handling without sufficient breaks
• Smoking

Lastly, how we think and respond to back pain can influence how long we suffer from it. For example, if we address the root causes early enough, we can often limit the impact that back pain has on us. If we don’t, the pain can get worse until it starts to impact our ability to function and our quality of life.

How to relieve lower back pain

Even if the cause of your back pain isn’t known, there are still lots of things you can do to improve your condition and treat your symptoms.

The most important factor in the management of lower back pain is to keep moving in a way you can manage. It’s usually advised to ease off and take it easy in the initial, very painful stage of your back pain episode, however, try to avoid total bed rest and make it a goal to return to normal activities as soon as you are able.

While it may feel safer to rest and you may be worried about moving, your back is a strong and robust structure that was built to move. It’s important to remember that even if it’s painful to do so, this does not necessarily indicate that you are doing any additional damage to your back. Our pain system can become overprotective to the point where normal movements become painful. You may have just done a little bit too much for what your back is currently able to manage.

Hot and cold therapy

Many people find using cold or hot packs (or alternating between the two) beneficial for relieving acute episodes of lower back pain. There is no evidence to suggest that either hot or cold therapy is superior to the other, therefore we advise you to use whichever option feels better and more beneficial to you.

Seeking tailored professional advice

If symptoms persist, we recommend you seek a further assessment from a GP or physiotherapist. A physio will be able to provide tailored advice and guidance based on your unique condition. They will also assess your range of functional movement and have a feel through the affected areas to let you know what they think is happening. From here, you can discuss what you would like to achieve with physiotherapy and develop a plan of treatment that’s unique to you.

If you’re after pain relief advice, speak to a pharmacist about suitable options if you are struggling to manage your back pain.

Desk and office workers

If you are a desk-based worker, it’s important to change positions regularly when seated (slouching is fine!) and to get up and move regularly. Contrary to popular belief, no one position is superior to another. The most important factor is regular movement and changing how you are sitting regularly. A good saying to remember is “your best posture is your next posture!”

Can sciatica cause lower back pain?

Sciatica is often used as an umbrella term to describe pain that goes down the back of the leg. Despite the name, it confusingly may or may not involve compression or irritation of the sciatic nerve.  

Symptoms typically include a combination of pain, numbness, and pins and needles going down the leg. Irritation of the nerves or muscles in the lower back can cause sciatica-like symptoms in addition to pain in your back, however, sciatica is a symptom of a lower back problem rather than a cause of back pain. 

Pain on one side of the lower back

It is common to experience pain on one side of the lower back. Think of your job, hobbies, and daily activities including any recent manual labour or DIY that you’ve done around the house. Typically, you’ll lean on one side of your body more than the other, which can create an imbalance and put pressure on the nerves and muscles down that side.

Because so much pressure goes through it, this can put more stress or pressure on one side of our lower back, resulting in one side becoming overworked, sore, and stiff.

Stiffness in the lower back

Many of us may feel that our lower back is stiff. However, we mustn't compare our range of motion or movement capability with someone else’s, as we are all different and capable of different levels of activity. What’s more important is that you compare any stiffness in your back to how it normally feels.

Stiffness in the lower back can be caused by a few different things, but what’s most common as a cause is a lack of general activity or variation in movement. To help avoid this, we recommend you get to know what your back is capable of and what’s comfortable for you. Try asking yourself:

• What’s normal for you?
• How often do you explore the full range of movements your back is capable of?
• What pain is ‘normal’ for you?
• What activities cause a flare-up in this stiffness?

If you’re worried or cautious about moving your back, it might be beneficial to seek advice from a physiotherapist who can help you regain confidence around movement. When we’re in pain, we often don’t ‘test’ what we’re capable of, leading to more stiffness and more pain.

If you feel that the stiffness is not related to a recent change in activity levels, or if you are finding that you are stiff in multiple joints for a prolonged period in the morning (greater than 30 to 60 minutes), then it’s advisable to contact your GP for more advice.

Numbness in the lower back

Numbness in the lower back is very rare. What’s more common is numbness being felt in the legs because of irritation or compression of the nerves that originate in the spine.

If you do experience numbness around your internal or external genitalia, inner thighs, or back passage, we recommend seeking urgent medical attention.

Pinching pain in the lower back

Different people will experience different sensations in their body, especially when pain manifests in an area as large as the back. Most pain in the lumbar area is ‘non-specific', which means there is no specific identifiable tissue or structure that’s causing it.

While it’s hard to provide a concrete cause of pinching pain in the lower back without examining the individual, what we do know is that our nervous system can go into “protection mode” from time to time. This can cause muscle spasms and mobility issues that prevent us from moving as smoothly as we normally would.  This could give rise to different pain sensations such as pinching.

It is beneficial to try and relax your breathing and body as much as possible during movements that you feel may bring on the pinching pain. This will help to reduce any protective muscle spasm, thus helping restore your movements back to normal.

How physiotherapy can help

Lower back pain is the single number one cause of disability worldwide. Thankfully, it’s also the condition for which the greatest number of people can benefit from rehabilitation.

Seeing a physiotherapist is by far the most effective way for you to understand more about your back and treat the source of your pain and discomfort.

When you see a physio for the first time, they’ll start by assessing your current physical condition and asking you a few questions about your routine and your activity levels to get a better understanding of what might be causing you pain.

They’ll also walk you through some exercises and movements that are geared towards mobilising and strengthening the area in question.

Interested in seeing one of our physios? Click here to get started

Last updated Thursday 11 July 2024

First published on Thursday 11 July 2024