Most U.S. adults will experience lower back (also known as the lumbar spine) pain at some point in their lives. 

Many cases of lower back pain result from temporary muscle strains, which quickly get better on their own. But, patients should address more serious causes as early as possible — not treating issues in time can lead to long-term complications.

This guide from HealthTap covers the different causes of low back pain and the most effective treatments. 

What is low back pain? 

Back pain is one of the most common reasons people see their doctor. It keeps people from getting to work and school and interferes with their normal activities, like cooking and cleaning. 

Symptoms of low back pain can range from dull muscle aches to severe stabbing pain. Back pain can also radiate to other body parts, such as the glutes, hips, and hamstrings. 

While there are potentially serious causes of low back pain — some of which can result in long-term disability — most low back pain resolves independently in a few days or weeks. 

That said, it’s still important to understand the causes of low back pain and to consult a doctor when a patient experiences low back pain.

The following section goes over the many potential causes of low back pain. 

What causes low back pain?

The back is an intricate structure of bones, muscles, joints, ligaments and nerves. 

The spinal column is a structure made of bones at the center of the back, which stretches from the neck to the pelvis. The spinal column supports the spinal cord — a nerve-rich structure that carries signals from the back to the brain.  

The average person’s back contains 33 bones (also known as vertebrae) which form the spine. Each vertebra has a small hole in its center, which forms a narrow spinal canal that stretches all along the back. Small nerves enter and exit from the spine through spaces in the vertebrae. 

Spongy cartilage pads, called “disks,” cushion the spaces between the vertebrae, acting as shock absorbers throughout the spinal column while the body moves. 

Meanwhile, joints, ligaments, and tendons help to hold vertebrae in place while allowing them to stay attached to the spine. 

Low back pain can happen if these surrounding structures are injured — especially in the lower back (also known as the lumbar region). 

Here are some common causes of back pain. 

1. Poor posture

As more people own smartphones and spend their days in front of a computer screen, bad posture is becoming an increasing problem. 

Slouching can strain the lower back muscles, leading to tension, stiffness, and pain. How does someone know they have poor posture?

They can look for some of the following signs: 

• Hunched back. 
• Rounded shoulders.
• A forward slant or positioning of the neck and head.
• Tightness in the hips and glutes.
• Recurring headaches. 

2. Being sedentary

It may seem counterintuitive, but moving too little can also contribute to lower back pain.

Not getting enough general movement can lead to stiff and tense muscles, worsening pre-existing pain or causing new pain to develop. 

Not getting enough strength training — in the back and surrounding regions — can weaken some muscles. Other muscles may become strained to compensate, which can cause pain to develop. 

3. Muscle overuse 

On the flip side of being sedentary, muscle overuse may also lead to back pain. Overuse can happen due to any movement that puts too much pressure on the back, such as heavy lifting. It can also affect those who use repetitive motions in their jobs, such as playing a musical instrument. 

Pain or soreness from muscle overuse may include delayed onset muscle soreness (DOMS), which is most common for those beginning a new exercise routine. Even seasoned athletes can experience DOMS if they do too much.

Some symptoms of muscle overuse include: 

• Muscle fatigue or weakness.
• Pain in muscles, tendons, joints, or ligaments.
• Swelling.
• Numbness.
• Tingling.
• Limited range of motion. 

Anyone who experiences any of the above symptoms should consult a doctor right away. In some cases, symptoms of numbness, tingling or muscle weakness could be a sign of a medical emergency. 

4. Muscle strain or sprain

Both muscle strains and muscle sprains are types of injuries. Their main difference lies in which part of the musculoskeletal system they affect. 

A muscle strain affects the muscles or tendons (which connect muscle to bone). A muscle sprain involves injury to the ligaments. Ligaments are elastic bands of tissue which connect two bones together. 

Some strain or sprain symptoms to look out for include:

• Pain.
• Weakness.
• Swelling.
• Muscle spasms.
• Limited range of motion. 

Both strains and sprains in the lower back can happen due to strenuous physical activity, like lifting something heavy and not using the best technique. Fortunately, these injuries resolve fairly quickly (usually within several weeks). 

5. Nerve injury

The lower back has many nerves that carry pain signals to the brain. If the nerves are injured, such an injury may cause lower back pain.

Sciatica is one of the most common conditions that can affect spinal nerves in the lower back. It may occur when pressure is applied to the sciatic nerve, which extends from the lower back to the foot. Sciatica may cause back and leg pain. 

There are potentially many other causes of nerve root injury in the lower back. 

Some symptoms to look out for include:

• Sharp pain that gets worse with movement.
• Numbness.
• Weakness.
• Tingling.
• Pain radiating to other parts of the body, like the glutes.
• Changes in sensation.

6. Disk disorders 

Vertebral disks are located between the vertebrae (bones) of the spine. The vertebral disks contain a gelatinous substance that allows them to cushion the spine. 

If anything damages the disks (like a sudden injury), their contents can begin to seemingly seep out — a condition referred to as a herniated disk. 

Disk herniation can put pressure on some structures in the lower back, causing pain — which is often the sole symptom of this condition. Pain due to disk disorders can also radiate to other areas of the lower back. 

7. Spinal stenosis 

Spinal stenosis happens when the spaces between the vertebrae narrow, which can put pressure on the nerves traveling through the spine. 

In many people, spinal stenosis doesn’t cause any symptoms. If symptoms are present, they can include:

• Lower back pain. 
• Numbness or tingling in the legs or feet.
• Cramping in the back, glutes, or legs — this may get worse after sitting for a long time. 

8. Osteoarthritis of the spine

Arthritis is a chronic condition in which joints are inflamed and irritated, often due to gradual degeneration or injury. In osteoarthritis of the spine, the joints connecting the vertebrae are the main structures affected. 

Some symptoms of osteoarthritis of the spine include: 

• Lower back pain (pain can also affect the middle/upper back and the neck).
• Stiffness. 
• Limited range of motion.
• Swelling and inflammation.
• Grinding sensation when moving the spine.

9. Fibromyalgia

Fibromyalgia is a chronic condition that causes pain all over the body. 

Doctors don’t completely understand this complex disorder. Some think that fibromyalgia affects how the brain perceives painful sensations. However, more research is needed to understand fibromyalgia. 

Some symptoms of fibromyalgia include:

• Dull, achy pain that can affect the entire body (including the lower back).
• Fatigue.
• Weakness.
• Brain fog.
• Headaches.
• Depression. 
• Anxiety. 

10. Stress 

Stress is something that affects the vast majority of adults in the U.S.

Aside from increasing someone’s risk of a mental health disorder, such as depression or anxiety, stress may also contribute to various physical health problems, including lower back pain. 

Lower back pain is a common side effect of stress because many stressed-out people tense up their muscles. Tensing the muscles can lead to excessive stiffness and reduced circulation, two factors that may contribute to pain.  

It’s important to recognize stress symptoms and address them with a primary care provider.

Common stress symptoms include:

• Feeling “on-edge.”
• Excessive worry.
• Difficulty concentrating.
• Memory problems.
• Difficulties falling or staying asleep. 
• Dizziness.
• Headaches.
• Muscle tension.
• Muscle pain (including the lower back).
• Stomach problems.
• Rapid heartbeat.
• Chest pain. 

11. Kidney stones

Kidney stones occur when there’s an excess of some minerals in the bloodstream — usually calcium — which can form stones. These stones must pass through the urinary tract (in the urine), which can cause sharp pain in the stomach, pelvis, and lower back. 

Some other symptoms of kidney stones include:

• Limited urine production.
• Blood in urine.
• Nausea or vomiting.
• High temperature. 

Often, kidney stones pass on their own. But if they’re too big, they may need to be broken up with a treatment like medication, shockwave therapy, or surgery. Anyone who may have kidney stones should see a doctor right away as this condition can be a medical emergency.

12. Kidney infection

A kidney infection happens when bacteria enters the bladder and moves into the kidneys. This condition is commonly the result of an untreated bladder infection (also known as a urinary tract infection or UTI). 

Because the kidneys are in the back, when they get infected, it often leads to pain in the middle of the back, which may radiate to the lower back. 

Some other symptoms of a kidney infection include:

• Painful urination.
• Dark urine.
• Blood in urine.
• Extreme fatigue.
• Fever.
• Nausea and vomiting. 

If a doctor does not promptly treat a kidney infection, it can lead to a life-threatening blood infection called sepsis. A kidney infection is considered a medical emergency. Anyone experiencing symptoms of a kidney infection should consult a doctor right away. 

13. Appendicitis

The appendix is a small organ shaped like a tube in the lower right side of the abdomen. If it becomes inflamed for any reason, it can lead to appendicitis. 

Some symptoms of appendicitis include: 

• Pain in the middle of the abdomen. 
• Pain in the right lower back.
• Loss of appetite. 
• Nausea or vomiting. 
• Constipation.
• Fever. 
• Diarrhea. 

Appendicitis is a medical emergency because the appendix may burst and then spread its infected contents throughout the abdomen. Patients who may have symptoms of appendicitis should seek medical attention right away because a ruptured appendix is considered a medical emergency and may be life-threatening. Doctors often recommend surgery to remove the appendix (also called an appendectomy), although sometimes treating appendicitis with antibiotics is also an option.

14. Endometriosis

Endometriosis is a condition that affects women. It happens when uterine tissue accumulates outside the uterus. When too much of this tissue accumulates, it may lead to pain in the pelvic region which can radiate to the lower back.

Some other symptoms of endometriosis include: 

• Severe premenstrual pain. 
• Pain during or after sex.
• Constipation.
• Diarrhea.
• Blood in urine during menstruation.
• Fertility problems. 

15. Testicular torsion 

Testicular torsion only affects men. It happens when the spermatic cord — which carries blood to the testicles — becomes twisted. Testicular torsion can cut off circulation to the testicles. 

Symptoms of testicular torsion include: 

• Sudden and severe pain in the scrotum (the “bag” that holds the testicles).
• Lower abdominal pain.
• Lower back pain.
• Nausea and vomiting. 
• Fever.
• Frequent urination. 

Testicular torsion is considered a medical emergency. If left untreated, it can cause the testicles to become irreversibly damaged. 

How is low back pain treated? 

Low back pain treatment depends, first and foremost, on the underlying cause. 

Once a healthcare professional gives their patient the right diagnosis, they may direct them to the best treatment for their condition. Diagnosis may require imaging studies such as X-ray, MRI, and CT scans. 

Since most cases of low back pain are musculoskeletal (involving the muscles or bones), the following are some of the most common treatment options: 

1. Painkillers

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a common first choice for lower back pain relief. 

These medications — aspirin, ibuprofen, and naproxen — usually have minimal side effects, making them a safer option than many other pain relievers. That said, some people will have more serious reactions to NSAIDs. In addition, NSAIDs are available over-the-counter, which means they don’t require a doctor’s prescription. It’s always best to consult a doctor before taking any over the counter medications.

Unfortunately, NSAIDs and acetaminophen don’t work for all patients. In such cases, doctors can choose to prescribe stronger painkillers for acute low back pain or chronic low back pain.

2. Muscle relaxants 

Low back pain is often associated with stiffness, which can make someone move less — a factor that can worsen the pain. Some doctors may prescribe a muscle relaxant in addition to painkillers to increase mobility.

If a doctor recommends a muscle relaxant, they may choose to prescribe one of the following: cyclobenzaprine (Flexeril), tizanidine (Zanaflex), and metaxalone (Skelaxin). 

3. Physical therapy

Physical therapy is one of the most popular treatments for low back pain that doesn’t involve medication. It can involve stretching and strengthening exercises and heat and cold application. 

Physical therapy can help to improve flexibility, restore mobility, and boost circulation to painful areas. 

Some doctors don’t recommend physical therapy in the first few weeks of back pain because it may go away independently. However, if it doesn’t, physical therapy is an excellent way to reduce pain while preventing the pain from coming back in the future. 

It can also be something to consider for chronic lower back pain that doesn’t respond to other treatments. 

4. Chiropractic adjustment (or spinal manipulation)

Chiropractors attempt to fix joints in the spine, improving the range of motion in the back and increasing mobility. Chiropractors can adjust the spine using either their hands or a small instrument. 

Chiropractic adjustment can provide modest improvements in lower back pain, which makes it less effective than medication or physical therapy. However, for those who don’t respond to other treatments, a chiropractic adjustment is an option to consider. 

5. Lifestyle changes 

Lifestyle changes are incredibly important for reducing lower back pain. While bed rest might sound like the best option, movement may help relieve back pain.

In the first place, it’s important to promote general health. Getting regular exercise, healthy weight loss, sleeping a sufficient amount every night, and practicing stress reduction are all important components of back pain management. 

In addition to improving general health, it’s also important to improve back health. This means practicing good posture, improving lower back flexibility with stretches, and using resistance training to strengthen the back. 

Treating lower back pain with HealthTap 

Low back pain affects most adults at some point in their lives. In many cases, it goes away on its own without any treatment. 

However, some causes of low back pain — such as disk disorders, arthritis, or kidney infection — are more serious and require medical treatment. Failing to address these causes can lead to more serious complications. 

If you experience lower back pain, don’t delay treatment. HealthTap can connect you with a provider over our virtual platform so you can get treated quickly. 

Schedule your first visit today.