Lower back pain, also known as lumbago, is extremely common. The lumbago area begins at the bottom of your ribcage ending in your hip region. Your spine in this lumbar region consists of five vertebrae named L1 to L5. One of the biggest causes of back pain is due to a disc/s between these vertebrae experiencing compression/irritation or rubbing occurring against the Sciatica nerve.
Sciatica is actually a symptom and not a condition. Its name is given as it is caused by pain from the sciatic nerve which is based in the lower back, also known as the lumbar region. In medical terms, sciatica is referred to as lumbar radiculopathy.
The sciatic nerve is the largest nerve in your body, and also, the longest. You have spinal nerve roots that join together to form the sciatic nerve in your lower back. The sciatic nerve then goes down through your buttocks, splitting to continue down both legs and feet. This is why, along with severe lower back pain, you also may experience pains and weakness down through your buttocks, legs, feet and even toes.
Symptoms can include shooting, stabbing or burning pains. Tingling sensations can also occur, similar to pins and needles. You may also experience a numbness or weakness. However, usually it only affects one side of the body.
Lower back pain can also be caused by a very diverse list of causes and is very much an individual experience. In order to break down what could be the cause of your back pain, we will discuss a multitude of possible reasons.
Lower back pain is usually located in the lower back, however, can also link to feelings anywhere along your spine from the base of your neck down to your hips. Pains can come on out of the blue or develop and worsen gradually over time. They can also vary from a dull ache to excruciating stabbing pains.
Causes
There are numerous possibilities. One of the most common being a herniated disc, putting pressure on your sciatica nerve. This is when a disc in your lower spine pushes out on to the sciatica nerve.
The bones that make up your spine are called vertebrae and in between each vertebrae is a small disc that serve as a cushion and shock absorber to prevent the bones from rubbing against each other. When a disc becomes worn down the interior ‘jelly’ pushes out through the hard exterior and this presses against the sciatic nerve. This is also known as a slipped, ruptured or bulged disc.
Other possibilities could be from a ligament or muscle strain.
For example, if you repeatedly lift heavy items or move suddenly so that you twist your spine it could jar your lower back. Carrying a heavy backpack, handbag or briefcase daily or regularly could contribute to lower back pain. Your lower back supports your upper body so if you give your upper body additional weight to carry, and particularly if that weight is only on one side, it could potentially strain your lower back.
Another way you could over extend your lower back muscles is through working out at the gym or playing sports. We should also point out that your chances of being affected are increased more so if you aren’t physically active during the week and then have a sports session at the weekend.
Being sat at a desk all day can also be a contributing factor. Many office chairs are unsuitable and can negatively affect your posture, making you slouch forwards, putting strain on your lower back. Being overweight can also contribute, as additional pressure is put on your lumbago region.
Be aware that if you experience severe back pain caused by an injury or fall you should visit your doctor to get an assessment.
Who gets Lower Back Pain? How Serious is it?
Lower back pain affects seven out of ten people at one time in their lives. In the case of sciatica, it has been noted to occur in those around 30 years old plus, as this is when your spinal discs begin to deteriorate. However, it is not age discriminate and can happen to those who are younger also. Those who run or walk a significant amount are considered at high risk too, as the piriformis muscle which is right above the sciatica nerve tightens during these exercises and can press against the nerve.
Extended spells of sitting, from desk jobs to watching TV for hours can cause risk, as your spine is compressed for long durations and this may irritate your spinal root. Lifting heavy loads has the potential of causing a herniated disc.
Being overweight can add pressure to your sciatica nerve. Pregnant women may also experience this as pressure from the growing uterus may push against the nerve. Diabetics are prone to nerve damage also.
In other cases, it can affect any sex at any age but is more likely in your mid-twenties onwards. Those in heavy lifting jobs, sports people, or those in jobs sat in uncomfortable chairs, slouching, can be more at risk.
How Does it Affect You?
Lower back pain is very common and usually will improve or even heal itself within a few weeks or months. However, the pain can be quite debilitating, potentially preventing you from standing up straight or doing normal everyday things depending on how extreme your discomfort is. If your pain lasts for a duration of over three months this is considered chronic and you should seek medical attention. In addition, be aware that pain once gone can return repeatedly at later stages.
Equally, if you experience any tingling or numbness in the areas of your genitals or buttocks or see an abnormal swelling or lump form in your lower back, immediately seek medical advice. Immediately seek a consultation with your doctor if you were injured in an accident such as a car crash and find you have lower back pain due to this.
In the case of sciatica, it can heal between 4-6 weeks, or if it prolongs it can last months. Chronic sciatica can even last a lifetime, but it is very much an individual case by case situation. If the pain is severe you may find yourself unable to drive, sit, or walk about even. This, over an extended period, can lead to a feeling of hopelessness or even depression so trying to keep a positive mind set will really help.
Recommended Treatment
According to your pain threshold, if pain persists you may want to take anti-inflammatory painkillers such as over the counter painkillers such as ibuprofen, naproxen or acetaminophen for short term use. Muscle relaxers are another option.
If your pain has just begun, use cold packs placed on your lower back to ease the pain. Use these for a few days then switch to heat pads, keep alternating. Do not use hot water bottles as a heat pad as if your skin is numb you run the risk of potentially unknowingly scolding yourself. You may prefer pain relief creams, which can provide effective temporary relief. Warm baths can also help your lower back muscles relax.
In the case of Sciatica, anticonvulsants such as gabapentin or pregabalin can ease nerve pain and Diazepam works to reduce your muscle spasms. If you feel your pain is that extreme the option of an epidural injection administering corticosteroids could be a consideration for you too. But as always, discuss your options with your doctor.
Recommended Rehabilitation
As tempting as it is to feel sitting or lying down is the best form of recovery, in reality, it achieves the exact opposite. Movement and staying as active as much as your pain allows is recommended. Your body will tell you if you are pushing yourself too far. Gentle movement, stretching and exercise are best and will help you heal faster. Nutrients and fluids should be paired with the aid of light exercises such as shorts walks, stretches, pool therapy or gentle swimming. You could also try yoga or pilates.
In the case of Sciatica staying in the same position for a long period will aggravate the nerve in the same spot. Movement reduces the inflammation in that area and encourages stretching of the localised muscles.
Flexion and extension exercises for your lower back can be extremely beneficial. There are exercises that could also help you to gain core muscle strength, which in turn serve to give you stronger lower back muscles, abdomen, glutes and hips which helps support your back. It also can aid in an overall speedier recovery. There are some conditions where certain exercises will be unsuitable, so always check with your doctor or physical therapist. You may want to try some of these exercises to help lessen lower back pain:
Pelvic Tilt Exercise
Lie on the floor on your back with bent legs and your feet positioned flat and forwards. Imagine pulling your belly button towards the floor then push your pelvis upwards to the ceiling.
Tilt your pelvis forwards, whilst at the same time tightening your glute and hip muscles. Hold for 10 seconds or shorter as long as you feel comfortable. This helps strengthen your hips. Repeat these 20 times or less if you experience any discomfort.
Reclining Pigeon Pose
On a yoga mat, lay on your back and raise your left leg up to a right angle position.
Place both hands, interlocking your fingers behind the thigh of the raised leg and gently pull this towards you so you can feel a stretch.
Hold this position for 20 seconds or for as long as you can manage without causing discomfort. This stretches the very small piriformis muscle that can become inflamed and press against the sciatica nerve. Switch legs and repeat on the other side until you have completed 10.
Sitting Pigeon Pose
Sit on a yoga mat and stretch your legs out in front of you with your feet pointed upwards towards the ceiling.
Bend your right leg, so that your right ankle is just behind your left knee. Keep your legs in this position as you lean forwards and reach for the top of your left foot, or however far up your left leg you can manage. Do not over strain and only go as far as is comfortable. Hold this for 20 seconds or however long up until this time you can manage.
Switch and repeat with the other side until you have completed 10 in total. This helps stretch your lower back and glutes, relieving pressure.
Glute Bridge Exercise
Very much like the pelvic tilt exercise, the glute bridge exercise also helps strengthen your hips and your hamstring muscles.
Firstly, as in the pelvic tilt exercise, position yourself laying down on your back on the floor. Bend your knees and lie face up on the floor, with your knees bent keeping your feet flat and forwards on the ground.
Let your arms rest by your sides palms down. Then, proceed to lift your hips off the ground towards the ceiling, stopping when your hips and shoulder are in a straight line.
Hold this position for 10 seconds or shorter as long as you feel comfortable. This helps strengthen your hips. Repeat these 20 times, less if you experience any discomfort.
Bird Dog Pose
Firstly, gently position yourself on all fours – on both feet/knees and both hands. Then, stretch out your left leg, keeping your foot flexed and toes pointing to the floor. Do not raise your leg above the straight line of your back position, as this adds pressure to your lower back.
Then, carefully raise the opposite arm. In this case, your right. Remember to keep it in line with your straight back and leg. Lengthen your arm, as if reaching for something in the distance and point your hand as in the picture.
Hold this position for five seconds, then gently bring your arm and leg down to the floor again. Once you have full balance, repeat on the other side. This helps stretch and loosen the pressure on your lower back.
Knee to Opposite Shoulder
On a yoga mat or something equivalent that gives you support, lay on your back with your legs stretched out and feet pointing to the ceiling.
Gently bend your right leg, bringing your knee towards you. Interlock your fingers and clasp your hands around that knee. Now, move your right leg so it goes across your body as if trying to touch your left shoulder. Go as far as you feel comfortable. There should be no pain, only a stretch that will ease your gluteal muscles and the small piriformis muscle. This is the muscle, that when inflamed, can press against the sciatic nerve.
Hold this position for 30 seconds or as long up to this time you feel capable. Slowly, bring your knee back to its original position, then lower your back leg down again, repeating this process with the opposite leg and changing legs each time until you have completed 6 reps in total.
Alternative & Homeopathic Treatments
Acupuncture is a complimentary alternative treatment that originated from traditional Chinese medicine.
Thin needles are placed in specific points on your body to alleviate pain, pressure and discomfort. It can reduce inflammation as well as result in relief to that area, whilst giving an overall sense of wellbeing after a session. To promote ease of movement, you may also want to try Iyengar yoga, which focuses on improved posture and correct alignment through a series of stretches and positions, which in turn can take pressure off your sciatic nerve.
Physiotherapy
If your pain continues beyond two weeks you may want to consider physiotherapy. Other options that could help are visiting a massage therapist, osteopath or chiropractor. Each of these can help ease your pain and speed your recovery.
According to the stage of pain you are at, a good therapist can recommend specific appropriate treatment choices. Physical therapy can give you exercises to continue at home, which will help strengthen your lower back muscles together with potentially correcting bad posture
For this, you may want to find a therapist who specializes in back therapy. Visiting a chiropractor, osteopath or massage therapist that we previously mentioned could greatly help too as they can relieve pressure by using spinal manipulation techniques.
To help ease and aid you in your day to day life you could greatly benefit from support for when you are seated to help keep your spine stay in its natural position and to give support to your lower back.
Items such as a car wedge, chair/seat wedge can provide this. A Coccyx Sero Pressure Cushion is great for helping to ease pressure on the spine and supporting your lower back. Using wheeled briefcases or handbags also take the pressure off your lower back. Also, a low foot resting stool can greatly aid posture while sitting for long durations at a desk.
In addition, and particularly in the case of Sciatica, you can help alleviate pressure on your sciactic nerve by sleeping with a knee cushion.