Guide to Lower Back Pain: Types of Pain and How to Treat it.

Lower back pain is one of the top reasons why people visit their doctor every year. It’s even been estimated that 40% of missed work days in the US are due to back pain. Globally, back pain is considered the leading cause of disability. Suffice to say, low back pain is a very common problem that most adults will experience throughout their lifetime.

In fact, 9 out of 10 adults will experience back pain in their lifetime.

There are different types of back pain, and varying degrees of back pain severity. However, back pain is not considered a disease. Lower back pain is considered a “health problem” or can be a symptom of a disease. Most back pain goes away by making lifestyle changes or having non-invasive treatments. Very rarely is surgery required to fix lower back pain.

In saying this, lower back pain is recurring. In other words, back pain is something that most people will experience in episodes. 30% of people have a lower back pain recurrence within 6 months of the initial flare-up. 40% of people will experience lower back pain again within 1 year. This means that lower back pain is not just an isolated “one time thing”—it’s a chronic vulnerability.

What is lower back pain? (the technical answer): The lumbar spine (low back) is a complex structure of bones, joints, nerves, ligaments, and muscles that work together to support your upper body. The lower back not only provides support, but strength, flexibility and mobility to the upper body as well. This complex system is susceptible to injury, thus causing back pain.

2 Types of Lower Back Pain

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1) Mechanical (Axial): This is the common, catch-all form of back pain. This pain is when muscle, ligaments, or joints become injured or irritated. This type of pain is felt in the lower back itself, buttocks and thighs. The pain is dependant on your movement. If you are sitting, laying, twisting, you may feel varying degrees of pain

2) Radicular: This type of pain occurs when the nerve exiting the spine becomes irritated or compressed. This type of pain is often described as “sharp”, “shooting”, and “electrical”. Sciatica is a common form of radicular pain. Travelling down the nerve, radicular pain is not felt in the back as much as in the legs or buttocks. The pattern of pain is specific to each nerve.

Back Pain is broken down into severity:
  • Acute pain. This type of pain is caused from injury or tissue damage (like pain after a heavy duty workout or getting into an accident). This pain comes on fairly suddenly and lasts for a few days or weeks. Pain gets better as your body heals.
  • Subacute low back pain. This pain is mechanical (from an injury or strain) and lasts several weeks to months. This type of pain may require that you seek medical attention for a remedy. This pain gets in the way of normal activities, is prolonged, but can eventually away on its own.
  • Chronic back pain. This lower back pain lasts more than 3 months. This pain is severe and does not respond well to treatments. The exact source of the pain may also be hard to determine.

3 Typical Back Pain Patterns

While this may sound counterintuitive, back pain doesn’t always manifest just in your back. For example, sciatica can felt as back pain or pain in the buttocks that travels down the leg and foot. However, the root cause of sciatica is a compressed or irritated sciatic nerve. Here are typical patterns of back pain:

  • Back Dominant Pain: Back dominant pain tends to radiate down the back to butt and hips. Some people feel back dominant pain all the way down their leg. Particular movements can spike pain (like when arching the back), the pain comes in spasms, however, it is not typically caused from nerve damage or irritation (sciatica).
  • Leg Dominant Pain: Leg dominant pain is typically from a disc problem that puts pressure on the nerves and travels down the leg. Most often, this pain is caused by sciatica. This leg pain feels better when lying down, usually gets better by itself, but may require medication, imaging, and rarely, surgery.
  • Leg Dominant Pain (Moving): Leg dominant pain that is worsened when you stand, walk, or run but feels better when you’re bending forward or sitting is usually caused by narrowing of the spinal canal. This is called “neurogenic claudication”. This pain is also more complicated than back dominant pain and may require medication, imaging, and rarely, surgery.

How to Treat Back Pain

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So, what can be done with lower back pain? If you’ve just gotten over a back pain flare-up, you’ll likely be extra motivated to start doing more to prevent another painful episode. The fact of the matter is that no matter what type of pain you’ve experienced or are experiencing (acute, subacute or chronic), there are things you can do each day to help your situation.

Chances are, the approach to remedying your back pain will be multidisciplinary. In other words, it’s usually recommended that back pain is treated by engaging in various practices, activities, and working with a wide-range of care professionals. Here are some of the things you can do to help combat pack pain and prevent future flare-ups.

  • Manage Stress. It’s becoming more commonly accepted that stress levels play into how you physically feel. If you’re under a lot of stress or anxiety, this stress can manifest physically. Back pain and chronic pain are closely linked to stress, anxiety, and mental illness.
  • Exercise. Have you ever heard of that saying “motion is lotion”? This couldn’t be more true. Although it may be painful to exercise, it’s more painful and damaging in the long run to avoid exercise altogether. People who do not move and perform lower back pain stretches get worse.
  • Sleep. Just like stress and mental health playing a big role in back pain, so does sleep. A lack of sleep can have adverse health effects, including depression, weight gain, weakened immune system and more--all of which can make healing from a back injury a challenge.
  • Chiropractor. In some cases, spinal manipulation and other chiropractic work can help your lower back pain. Talk to your primary care physician and see if he/ she recommends a chiropractor to treat your specific back pain.
  • Massage/ Acupuncture. Massage relieves muscle spasms to improve mobility and quality of movement. Acupuncture works with your body’s pressure points to relieve stress. Ask your physician if he/she thinks you could benefit from massage or acupuncture.
  • Pilates/ Yoga. Low impact exercises like yoga and pilates strengthen your abdominal core and stretch your body. Regular yoga and pilates can support your back and can offer stress relief as well.
  • Therapy. Studies show that people who suffer from various mental health issues, including anxiety, depression, stress sensitivity, sleep problems, and psychosis report more back pain symptoms.

Your mindset and daily habits are critical. Your attitude contributes greatly to how your perceive your back pain and the permanence of your pain.

If you're interested in being one of the first to use PeerWell's PreHab program for spinal/back surgery preparation, email us. We will get back to you with a few questions to see if you qualify for our free preoperative back surgery prep program!

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Hi, I'm Grace. I write all things surgery for the PeerWell blog. You may remember me from such titles as: "Diabetes & Joint Replacement 101" & "Sex After a Joint Replacement".

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