Low back pain- Causes, Prevention & Red Flags

Low back pain causes, prevention & warning signs

Low back pain is very common. Twenty percent of individuals may experience back pain at some point of time. Therefore, it is important to understand the causes of low back pain, and ways to prevent or improve it.

Low back pain is defined as pain in the back below the level of ribs and above the lower gluteal folds. As per estimates, published in a study in 2017, 9.4% of the global population may be affected by back pain at a single point of time[1]. The prevalence and disability caused by this nagging condition is also increasing over time. So, let’s look at the important causes of back pain and it’s prevention.

Low back pain causes

  • Age– Ageing can not be prevented. Just like our skin wrinkles, our spine also undergoes some changes with time. The joints in our spine, disc between the vertebrae, the muscles around the spine all become less flexible with time. The changes occurring in our spine because of age is known as Lumbar spondylosis.
  • Lack of exercise – Exercise is an important component of staying healthy besides a balanced diet. Lack of exercise makes the muscles around the spine weak and they provide less than adequate support to the bones.
  • Being overweight or obese – Weight is another important cause of low back pain. Imagine a chair or a table, you can only put a certain amount of load on it. If you put anything in excess above it’s load bearing capacity, the legs of chair would buckle. Similarly, the spinal column serves as a pillar to support our body. The intrinsic strength in our spinal bones does not increase with our weight. In fact, the bone strength decreases with age and is also known as Osteoporosis. Therefore, one can not put more than desirable weight upon it.
Obesity causes low back pain
  • Bad posture – With increasing sitting job profiles, bad posture has become another leading contributor to back pain. Our spine is meant to be straight. If we do not maintain an erect stance while sitting, driving or standing, it can lead to unnatural strains on the spinal column and lead to pain.
  • Improper lifting technique – It is also important to keep the spine straight while lifting objects repeatedly.
  • Smoking – Smokers have higher tendency for a painful back as compared to non-smokers[2]. As per one theory, nicotine reduces the blood flow to the disc, which leads to lack of nutrient exchange for the tissue.
  • Medical problems like Arthritis – Certain type of arthritis affects the spinal joints like Ankylosing spondylitis.
Dr. Harnarayan Singh explaining Low back pain causes & prevention in Hindi

Low back pain prevention

If one understands the causes of this problem, it is not difficult to understand the ways to prevent it from happening. If you are already suffering from this problem, then these interventions may help to reduce the severity and frequency of episodes of disabling pain.

  • Regular exercise – Regular exercise will keep your muscles strong. Having a regular schedule of exercise 5 times a week really helps. It will also help you reduce weight if your are overweight for your height. If you already have back pain, one needs to pay special attention to back and core strengthening exercises.
  • Reduce weight – If you are obese or even overweight, you need to reduce your weight. This is important not only for your spine joints, but also for hip and knee joints, besides medical reasons.
Reduce weight to improve low back pain
  • Precautions during weight lifting – Keep your back straight and use your his and knees while lifting heavy objects from the ground level.
  • Quit smoking – Smoking causes many problems, back pain is perhaps the least worrisome. But is wise to stop smoking to maintain good overall health.
  • Posture – Work on your posture. Try to sit straight while working or while driving. Stand smartly, don’t stoop. Avoid sitting on a bed or cross-legged. Sleeping in a prone position(on your stomach) is very bad for the back. You can find a lot of posters on the web showing proper posture for doing different activities. We need to educate children as well about correct posture, right from the elementary school.

Red flags about low back pain

Mild back pain that settles with rest and home remedies if fine. But there are certain red flags which should not be ignored. If any of these are present, it warrants a clinical examination by a specialist doctor.

  • Persistent severe back pain– If the backache is not improving with rest, over the counter analgesics or other remedies that used to make it better earlier, you should consult a doctor.
  • Leg pain, numbness or weakness– If the backache is associated with radiation into one or both legs, numbness or weakness in leg, it points to compression of nerve root in the spine and warrants a visit to a clinician.
  • After fall or injury – If the pain started after a fall or trauma, it may be simple spasm or may indicate a more serious underlying fracture. One must visit a doctor if the pain starts after an injury of any magnitude.
  • Fever or weight loss – if the pain is associated with fever, night sweats, or weight loss, it indicates to an underlying infection or malignancy. These are serious conditions and should be immediately investigated.

Disclaimer- This is for the general awareness of the patients and cannot replace expert medical advice. Patient treatments need to be individualised and that can be decided based on clinical examination and evaluation by a trained physician.

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I am a Neurosurgeon and spine surgeon practising in Gurugram, India. Besides Neurosurgery, I love to read, travel and play tennis.

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