Why do I have lower back pain?

It is estimated that more than half of the French population has experienced at least one episode of back pain in the last twelve months (source 1). But did you know that there are several types of back pain? When the pain occurs in the lower back, at the level of the lumbar vertebrae, we speak of low back pain. Four out of 5 French people will suffer from it during their lifetime. To prevent them as well as possible, it is still necessary to know their causes.

Lower back pain, also commonly known as « lumbago » or « backache » corresponds to intense pain at the level of the lumbar, located in the lower back. This pain occurs suddenly in the lower back and is accompanied by an intense contraction of the muscles. Depending on its intensity, it can prevent certain movements and prove to be very disabling.

There are three types of low back pain, depending on their evolution over time:

• the acute low back painwhich lasts for less than 6 weeks;
• the subacute low back painwhich lasts between 6 and 12 weeks
• and the chronic low back painwhich has been in place for more than 12 weeks.

Lower back pain is common and rarely linked to serious illness. Most of the time, It’s a « mechanical » problem., which involves one or more structures of the spine: joints, ligaments, muscles, intervertebral discs, etc. (source 2). We then speak of common low back pain. What are the causes ?

A brutal and unusual effort, during a move, a gardening session, etc. It can also occur through forced and repeated gestures, such as bending over regularly, lifting heavy loads, etc. This is why certain professions are particularly exposed to it: workers, movers, handlers, nurses and caregivers, cashiers, cleaning staff, farmers, etc. (source 3).

Lower back pain can be linked to disc degeneration due to:

• to old age,
• to a herniated disc,
• to a gynecological disorder,
• to a spinal slip
• or at a condition such as arthritis, osteoarthritis, or osteoporosis.

So-called « specific » or « symptomatic » low back pain can be caused by serious underlying diseases:

• scoliosis,
• ankylosing spondylitis,
• the fracture of a vertebra,
• a localized infection in the spine,
• a spinal tumor,
• etc

Children and teenagers are not supposed to have back pain (neither in the lower back, nor in the dorsal or cervical vertebrae). If so, see a doctor quickly. The pain may be related to excessively intense sports practice (such as gymnastics, horse riding, judo or rugby) which ended up crack the back of a vertebra. The latter can then slip forward (spondylolisthesis) and require specific care.

Depending on the location of the pain, and the way in which it manifests, one can also suspect a spondyloarthritisor even a Scheuermann’s diseasea common growth anomaly of the vertebrae, which may require the wearing of a brace.

Acute low back pain (less than 4 weeks) is the second most frequent reason for consultation in general medicine. Chronic low back pain (more than 3 months) occupies eighth place.

If you experience persistent lower back pain, start by making an appointment with your doctor. He will make the diagnosis based on the clinical examination and a precise questioning, taking into account your history.

If pain persists, see a rheumatologist, a specialist in diseases of the bones, joints, muscles and tendons. Depending on his diagnosis, he will refer you to several treatments: physiotherapy sessions, medication, spa treatment, etc.

Treatment for lower back pain depends on its cause. To relieve so-called « common » low back pain, the doctor may prescribe taking painkillers and anti-inflammatories. The so-called weak opioids (opiate drugs derived from morphine, such as codeine) can also be prescribed as third-line treatment, if no painkiller is sufficiently effective.

« Not to move is to rust »: the disappearance of pain paradoxically passes through reactivation. In the midst of a crisis, of course, it is better to stay lying down. The idea is not to do violence to yourself, but to try, a few hours after the lumbar blockage, to get up and walk, according to your possibilities.

To rehabilitate the back and prevent a relapse, physiotherapy sessions are recommended.

In the case of so-called « symptomatic » or « specific » low back pain (linked to a disease), only the management of the disease in question will relieve lower back pain.

Regular physical exercise modifies the perceptions of pain by stimulating the production of endorphins by our brain, with pain-relieving and euphoric properties. Depending on your preferences, opt for Nordic walking, yoga, or even swimming. From lower back exercisesrand can also relieve pain, as explained below by Dr. Martine Duclos, head of the sports medicine department at Clermont-Ferrand University Hospital.