Pain in the lower back or low back pain is a common concern, affecting up to 90% of Americans at some point in their lifetime. Up to 50% will have more than one episode. Low back pain is not a specific disease. Rather, it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified. Back pain can have many underlying reasons, but often no specific cause will be found and the pain will stop. This chapter tries to touch on many of the causes of back pain and proper evaluation and diagnosis.

Back Pain Symptoms

Pain in the lumbosacral area (lower part of the back) is the primary symptom of low back pain.

The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
The pain may become worse with activity.
Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.

Causes of Back Pain


Kidney problems

Kidney infections, stones, and traumatic bleeding of the kidney (hematoma) are frequently associated with low back pain. Diagnosis can involve urine analysis, sound-wave tests (ultrasound), or other imaging studies of the abdomen.

Pregnancy

Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors' advice.

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Back Pain Treatment

General recommendations are to resume normal, or near normal, activity as soon as possible. However, stretching or activities that place additional strain on the back are discouraged.

Sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.
No specific back exercises were found that improved pain or increased functional ability in people with acute back pain. Exercise, however, may be useful for people with chronic back pain to help them return to normal activities and work.
Nonprescription medications may provide relief from pain.

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