What are common causes for aching or pain in the lower back?

Aching and pain in the lower back (low back pain; lower back pain; lumbago) can be caused by a variety of factors, including:

Muscle strain or sprain or ligament strain: This is one of the most common causes of lower back pain and can occur due to lifting heavy objects, sudden movements, or poor posture.

Poor posture: Prolonged sitting or standing in a position that puts strain on the lower back can lead to muscle imbalances and pain.

Compression fractures: Fractures of the vertebrae, often due to osteoporosis or traumatic injury, can cause sudden onset of severe back pain, particularly in older adults.

Musculoskeletal disorders: Conditions such as fibromyalgia or ankylosing spondylitis can cause widespread musculoskeletal pain, including in the lower back.

Referred pain: Pain originating from other organs or structures, such as the kidneys, uterus, or digestive system, can sometimes be felt in the lower back.

Lifestyle factors: Obesity, lack of exercise, smoking, and poor posture can contribute to low back pain by placing added stress on the spine and supporting muscles.

Herniated or bulging discs: The discs between the vertebrae can bulge or herniate, putting pressure on nearby nerves and causing pain, numbness, or tingling that may radiate down the leg (sciatica).

Degenerative disc disease: Over time, the discs in the spine can degenerate, leading to decreased cushioning between the vertebrae and resulting in pain and stiffness.

Spinal stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to lower back pain and other symptoms including numbness, or weakness in the legs, particularly with walking or standing.

Spondylolisthesis: When a vertebra slips out of place and onto the vertebra below it, it can cause lower back pain and stiffness, as well as nerve compression symptoms.

Osteoarthritis: Degeneration of the joints in the spine can lead to osteoarthritis, resulting in pain and stiffness, and reduced mobility in the lower back.

Strain from overuse: Activities that involve repetitive bending, twisting, or lifting can strain the muscles and ligaments in the lower back, leading to pain.

Injuries: Traumatic injuries such as falls or car accidents can cause damage to the muscles, ligaments, or bones in the lower back, resulting in pain.

Medical conditions: Certain medical conditions such as kidney stones, infections, or inflammatory diseases can cause lower back pain as a symptom.

When you see us in neurosurgery consultation, we will check your symptoms, perform a thorough neurological exam, and evaluate your electrophysiological and imaging studies, to accurately diagnose the cause of your lower back pain, and to develop an appropriate treatment plan. 

A structural problem (such as disc herniation or nerve compression or spinal stenosis) may require surgical intervention to resolve. 

Surgery is always the last resort and will only be recommended if other treatments are not working, or if there is risk of permanent nerve damage without intervention.

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