Lower Back Pain: Common Causes, Relief and Warning Signs

6 min read · Conditions · By the Asthra Health Care team

Why lower back pain is so common

Lower back pain is one of the most common reasons people see a doctor or miss work. The lower back carries much of the body's weight and moves with almost every bending, lifting and twisting action. Long hours at desks, two-wheeler rides on bumpy roads, lifting heavy buckets or children, and poor sleep can all strain it.

In most people, no serious cause is found. This is called non-specific or mechanical back pain, coming from muscles, ligaments, discs and small joints of the spine. It can be very painful, but it usually improves on its own within a few weeks, and it rarely causes lasting damage.

Common causes of lower back pain

Knowing the likely cause helps you choose the right care. Most short-term back pain follows a sudden awkward movement or heavy lifting, but it can also start without any clear reason. Common causes include: Stress and poor sleep can also make back muscles tense and pain feel worse. Serious causes are uncommon, but they matter, so learn the warning signs listed below.

• Muscle or ligament strain from lifting, twisting or sudden movement
• Poor posture during long sitting at desks, phones or while driving
• Slipped or bulging disc pressing on a nerve, causing sciatica (pain running down the leg)
• Age-related changes in the spine (spondylosis)
• Being overweight, inactive or having weak core muscles
• Less often: infection, kidney stones, osteoporosis fractures, inflammatory arthritis or cancer

Symptoms of lower back pain

Mechanical back pain is usually felt as an ache or spasm across the lower back, sometimes spreading to the buttocks. It often gets worse with certain movements, bending or sitting for long, and eases with rest or changing position. The back may feel stiff in the morning.

Sciatica causes a sharp, shooting or burning pain from the back or buttock down one leg, sometimes below the knee, with tingling or numbness. Coughing or sneezing may make it worse. Most sciatica also settles over weeks with simple care, but weakness in the leg needs prompt review.

Do I need a scan?

Most people with back pain do not need an X-ray or MRI. A doctor can usually tell what is going on from your history and examination. Scans often show age-related changes even in people without pain, and these findings can cause unnecessary worry or treatment.

Your doctor may order tests if there are warning signs, if pain lasts more than several weeks despite treatment, or if surgery or an injection is being considered. Blood tests may be done to look for infection, inflammation or other conditions when the doctor suspects them.

Self-care that helps

Keep moving as much as you can. Bed rest for more than a day or two slows recovery. Short, frequent walks are better than lying down. Use a warm pack or hot water bag on the painful area for comfort, and change positions often. Gentle stretches, like knee-to-chest and pelvic tilts, can ease stiffness.

When lifting, bend your knees, keep the load close to your body and avoid twisting. Set up your desk so the screen is at eye level and your back is supported. Once the pain settles, regular exercise such as walking, swimming, yoga or core strengthening helps prevent it from returning.

Medicines and other treatment

Pain relief helps you stay active. Anti-inflammatory gels, and over-the-counter painkillers such as ibuprofen or paracetamol, may help; follow the label or your pharmacist's advice. Anti-inflammatory tablets are not suitable for everyone, especially people with stomach ulcers, kidney or heart disease, the elderly and pregnant women.

Doctors sometimes prescribe a muscle relaxant for a short period, or other medicines for nerve pain in sciatica. These are only on a doctor's prescription and can cause drowsiness. Physiotherapy is very useful for pain that lasts or keeps returning. Surgery is needed only in a small number of people with specific nerve problems.

Special groups and long-term pain

Back pain in pregnancy is common; gentle exercise, good posture and a pillow between the knees help, and you should check with your doctor before taking any painkiller. In older adults, sudden back pain after a minor fall may be a fracture due to weak bones. Back pain in children is less common and should be checked by a doctor.

If pain lasts beyond a few weeks, keeps returning or affects your work and sleep, see a doctor. Stress and low mood can make pain feel worse, and treating them helps too. For advice on safe pain relief, speak to your doctor or pharmacist.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.