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Symptoms and Signs of Low Back Pain

Doctor's Notes on Low Back Pain Symptoms, Location, Causes, Home Remedies, and Treatments

Low back pain is pain usually located in the lumbar section of the spine; it is a symptom that may occur from many different processes. Is frequently intermittent and 85% of people with it will have no specific cause identified. Besides pain, other symptoms and signs of low back pain include radiating of pain down the front, side or back of your leg and may become worse with activity. Numbness and/or weakness of a leg may accompany the pain symptoms.

Common causes of low back pain include disease (for example, shingles, but infections, fibromyalgia, spondylitis) or injury to the muscles, bones, and/or nerves in the lumbar spine that damage or compress nerves. A common cause compression or nerve injury is a herniated lumbar disc that pinches or compresses a nerve that extends to your leg. Spinal stenosis can cause back pain and pain down both legs. Cauda equina syndrome, where the lower spinal cord is compressed, beside pain production, can produce signs and symptoms of possible loss of sensation and/or the inability to control bowel and bladder functions. The syndrome is a medical emergency.

Medical Author:
Medically Reviewed on 3/11/2019

Low Back Pain Symptoms, Location, Causes, Home Remedies, and Treatments Symptoms

Pain in the lumbosacral area (lower part of the back) is the primary symptom of low back pain.

  • The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
  • The pain may become worse with activity.
  • Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
  • You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.
    • This can cause an inability to plantar flex the foot. This means you would be unable to stand on your toes or bring your foot downward. This occurs when the first sacral nerve is compressed or injured.
    • Another example would be the inability to raise your big toe upward. This results when the fifth lumbar nerve is compromised.

Low Back Pain Symptoms, Location, Causes, Home Remedies, and Treatments Causes

Back pain is a symptom. Common causes of back pain involve disease or injury to the muscles, bones, and/or nerves of the spine. Pain arising from abnormalities of organs within the abdomen, pelvis, or chest may also be felt in the back. This is called referred pain. Many disorders within the abdomen, such as appendicitis, aneurysms, kidney diseases, kidney infection, bladder infections, pelvic infections, and ovarian disorders, among others, can cause pain referred to the back. Normal pregnancy can cause back pain in many ways, including stretching ligaments within the pelvis, irritating nerves, and straining the low back. Your doctor will have this in mind when evaluating your pain.

Picture of a herniated lumbar disc
Picture of a herniated lumbar disc
  • Nerve root syndromes are those that produce symptoms of nerve impingement (a nerve is directly irritated), often due to a herniation (or bulging) of the disc between the lower back bones. Sciatica is an example of nerve root impingement. Impingement pain tends to be sharp, affecting a specific area, and associated with numbness in the area of the leg that the affected nerve supplies.
    • Herniated discs develop as the spinal discs degenerate or grow thinner. The jellylike central portion of the disc bulges out of the central cavity and pushes against a nerve root. Intervertebral discs begin to degenerate by the third decade of life. Herniated discs are found in one-third of adults older than 20 years of age. Only 3% of these, however, produce symptoms of nerve impingement.
    • Spondylosis occurs as intervertebral discs lose moisture and volume with age, which decreases the disc height. Even minor trauma under these circumstances can cause inflammation and nerve root impingement, which can produce classic sciatica without disc rupture.
    • Spinal disc degeneration coupled with disease in joints of the low back can lead to spinal-canal narrowing (spinal stenosis). These changes in the disc and the joints produce symptoms and can be seen on an X-ray. A person with spinal stenosis may have pain radiating down both lower extremities while standing for a long time or walking even short distances.
    • Cauda equina syndrome is a medical emergency whereby the spinal cord is directly compressed. Disc material expands into the spinal canal, which compresses the nerves. A person would experience pain, possible loss of sensation, and bowel or bladder dysfunction. This could include inability to control urination causing incontinence or the inability to begin urination.
  • Musculoskeletal pain syndromes that produce low back pain include myofascial pain syndromes and fibromyalgia.
    • Myofascial pain is characterized by pain and tenderness over localized areas (trigger points), loss of range of motion in the involved muscle groups, and pain radiating in a characteristic distribution but restricted to a peripheral nerve. Relief of pain is often reported when the involved muscle group is stretched.
    • Fibromyalgia results in widespread pain and tenderness throughout the body. Generalized stiffness, fatigue, and muscle aches are reported.
  • Infections of the bones (osteomyelitis) of the spine are an uncommon cause of low back pain.
  • Noninfectious inflammation of the spine (spondylitis) can cause stiffness and pain in the spine that is particularly worse in the morning. Ankylosing spondylitis typically begins in adolescents and young adults.
  • Tumors, possibly cancerous, can be a source of skeletal pain.
  • Inflammation of nerves from the spine can occur with infection of the nerves with the herpes zoster virus that causes shingles. This can occur in the thoracic area to cause upper back pain or in the lumbar area to cause low back pain.
  • As can be seen from the extensive, but not all inclusive, list of possible causes of low back pain, it is important to have a thorough medical evaluation to guide possible diagnostic tests.

Back Pain Find Relief, Treat Your Back Pain Slideshow

Back Pain Find Relief, Treat Your Back Pain Slideshow

Back pain is extremely common. In fact, 80% of people will have significant back pain at some point. Back pain symptoms vary from individual to individual. They can be sharp or dull. Myths regarding back pain are also common. Can you recognize the myths and facts that follow?

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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