Lower Back Pain

Lower Back pain is a very common condition that affect all ages from children to seniors, specially affecting 23% of adults world wide.

Lower back pain can be categorized as acute, sub-acute, and chronic. Acute lower back pain last few days up to six weeks. Pain that last up to 12 weeks is considered sub-acute and pain that goes over 12 weeks is a chronic pain.

Fortunately lower back pain can be preventable with proper body mechanics, postural awareness, daily physical activity, and some lifestyle modifications.

What is lower back pain?

Lower back pain is characterized by muscle spasms, and stiffness in between the lower rib cage and above gluteal area. Pain can range in intensity from intermittent, to constant pain. Lower back pain can be described as dull, sharp, radiating, numbness/tingling, or shooting pain.

What causes lower back pain?

  • Repeated Strenuous Lifting, carrying or pulling.
  • Sitting or standing too long with poor posture.
  • Excessive stretching or strain.
  • Arthritis can lead to narrowing the space around the spinal cord causing lower back pain.
  • Increased lumbar lordosis or scoliosis create a muscle imbalance and lead to back pain.
  • Compression fracture specially in the elderly population.

Other causes

  • Kidney stones can produce pain in one side of the lower back.
  • Tumors that press the spinal bones, or spinal cord.
  • Pregnancy (lower back pain tends to go away after childbirth).

What are the risk factors for getting lower back pain?

  • Smoking: It decreases blood flow to the spine accelerating the degenerative bone process
  • Race: Black, followed by White, Hispanic, American Indian, with Asian being the lowest rate for lower back pain.
  • Age:It is most common between age 30 and 50 and becomes more common with aging.
  • Gender: Female sex are in higher risk.
  • Sedentary lifestyle: Sedentary people tend to have weak back and weak abdominal muscles and are prone to lower back pain.
  • Weight gain and obesity: Gaining weigh put extra stress and pressure in the lower back.
  • Poor body mechanics: Lifting with poor form using the back instead of the legs increase the risk of lower back pain.
  • Mental health: Anxiety or depression increase the incidence of having lower back pain.
  • Heavy backpacks in children: A heavy backpack can strain the back.
  • Related to work place: Any work that requires repetitive lifting, pushing, pulling, and twisting the back can lead to lower back pain. Prolong sitting with inappropriate back support or standing with poor posture contributes to back pain.

What does lower back pain tell you?

  • Pain near the lower back spine and irradiate to the hip and buttock is associated with lumbar disk condition.
  • Pain with cramping in the leg is associated with spine stenosis.
  • Pain that is aggravated with coughing or sneezing and decrease with rest is associated with degenerative joint conditions.
  • Pain that is aggravated with side-bending and arching the back is associated with facet joint condition.
  • Pain with walking or arching the back is associated with spinal stenosis

Consult with the Doctor if Lower back pain is accompany with:

  • Fever and chills
  • Urinary incontinence or urinary retention
  • Worse pain at night
  • Pain at rest
  • Progressive loss of muscle strength and loss of sensation
  • Sciatica in or weakness in both legs
  • Onset of urinary or fecal incontinence
  • Weigh loss without explanation
  • Use of oral steroids for long time


Physical Therapy is recommended in the acute phase for pain management, to speed up healing process, increase function and fast recovery. According to resent research 80-90% of cases improve and recover faster after six to eight weeks when they get physical therapy.

No Bed rest please: Bed rest delay the healing process, make the body stiffer, and the movements more restricted.


  • Hot and cold packs to reduce inflammation and for pain management
  • Avoid activities that increase pain and rest in positions that relief pain
    Stay active
  • Lower extremity stretches to increase flexibility
  • Improve posture and body mechanics with activities of daily living (click here for DIY lower back tips)
  • Improve abdominal and back muscle strength with hypopressives
  • Improve lower back and lower extremities flexibility
  • Eat smart and maintain a healthy weight
  • Quit smoking

Note: Lumbar back brace or shoe insole is not recommended for Lower back prevention

Healthy tips with sitting, standing and lifting

  • Sitting: Sit right with a good lower back support making sure that your feet are flat on the floor, and your hips and knees are level.
  • Prolong Standing: Place one foot on a foot stool to make the back work less to keep you upright. Don’t forget to alternate feet.
  • Lifting: Bend from the knees, never from the back. Bring the load close to your body, maintain the back straight and proceed to lift. Always ask for help if you know something is very heavy.

Are you still dealing with lower back pain? Make an appointment today. Doctor Alexandra can help you on you healing journey to meet your needs and goals.

The information in this blog is for educational and informational purpose only, Its content is provided based upon evidence-based medicine, knowledge, and experience as a doctor of physical therapy.