Some common causes of lower back pain that are caused by problems with your spine or back include muscle strain, lumbar spinal stenosis, arthritis and vertebral fractures. A herniated disc may cause low back pain and sciatica pain.
The most common cause is muscle strain from heavy lifting, or lifting incorrectly. This will generally resolve over the course of several days, with rest, and over the counter pain medication.
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Also among the causes of lower back pain, very common is arthritis of the lumbar spine, and Lumbar Spinal Stenosis, these can occur after a lifetime of bending and lifting. While either of these can cause severe back pain and limitation, they usually develop very slowly, over the course of several years, and the back pain treatment options are less urgent.
"fractures can occur from trauma or from osteoporosis"
Vertebral fractures can occur from trauma or from osteoporosis. If you are having lower back pain that began after an accident, such as a fall or a motor vehicle accident, you should be evaluated with x-rays or an MRI.
If you have a vertebral fracture from a major accident, the treatment options would vary, depending on the fracture pattern. Most lumbar fractures can be treated with a brace, or a body jacket of some type, again, depending on the situation. Surgery may be required if the fracture fragments are pressing on a nerve, or are widely separated.
"most at risk for this disease"
One of the most common causes of lower back pain in women with osteoporosis is a vertebral compression fracture. These fractures can occur with the slightest trauma, if the bone structure becomes thin and weak. Something as simple as a sneeze, or stepping off of a curb, can result in a fracture. Slender, white, females, over the age of 50, are most at risk for this disease.
Treatment options for a compression fracture would include bed rest and time, or surgical stabilization. More information about this disease can be found at my page on Back and Abdominal Pain.
"it can also cause sciatica"
A herniated disc may cause lower back pain and sciatica. Sciatica is pain that radiates into the buttock and thigh. Intervertebral discs are made up of two parts, the annulus, and the nucleus pulposis. The annulus is a tough ligament that encircles the disc, and connects the two vertebrae together. The nucleus pulposis is a soft jelly like material, which makes up the inner portion of the disc.
This construction provides a shock absorber effect, between each vertebra. Disc herniations can occur, when the nucleus pulposis pushes out through the annulus, causing lower back pain. If the herniation happens to press on a nerve, it can also cause sciatica with lower extremity pain and weakness.
"you should go to the emergency room"
A possible serious complication from a herniated disc is cauda equina syndrome. The symptoms of cauda equina syndrome are progressive weakness in your lower extremities, and/or problems with your bowels and/or bladder. If you begin having either of these symptoms, in conjunction with back pain and sciatica, you should go to the emergency room. If these symptoms are not evaluated and treated immediately, they can cause permanent injury and disability.
There are many possible causes of lower back pain, some are not so serious, and some are very serious. If you are having tolerable lower back pain, and you know why, such as if you worked in the garden all weekend, or you lifted too much, and your back hurts. You are probably safe giving it time. You can rest it a few days, treat it with over the counter pain medication, and it will probably resolve over the next few weeks.
"pain that is more severe, and for no apparent reason"
If you are having pain that is more severe, and for no apparent reason, you must take it more seriously. You may have more than a pulled muscle and you need to be seen by your doctor.
It is always better to get your pain checked out and find out that there is nothing to be worried about, than to ignore something serious. And if you do have a more threatening condition, the sooner you get it treated, the better the outcome will be.