Categories: Orthopaedics

Lower back pain during lockdown: Fixing your back problems

The global pandemic has brought the world to a standstill, with most of us stuck at home for months now. Working from home and being restricted to the indoors poses significant health challenges. Increased number of hours spent sitting, having an improper posture, lack of adequate exercise and the stress of the pandemic, can all cause lingering lower back pain.

While there are many home remedies that you can try to relieve your lower back pain, it is important to know the reason for your pain and identify when you require a doctor’s visit before treating yourself. Most common causes for lower backache include muscle strain, injury and overuse.

However, there can be more serious spinal issues such as a herniated disc, degenerative disc disease, spondylolisthesis, spinal stenosis or osteoarthritis.

What causes lower back pain?

Over 80% of the population experiences lower back pain or waist pain at one point or the other in their lifetime. The lower back or the lumbar spine is a complex structure of interconnected bone, nerves, ligaments and muscles. This arrangement allows flexibility and supports the upper back during bending, flexing and rotating. The nerves within the lumbar region supply the pelvis, lower abdomen and the lower limbs. However, the lower back is also susceptible to pain and injury.

Acute lower back pain is most often due to injury to the muscles, joints, ligaments or discs.

This is characterized by inflammation of the region along with spasm and shooting pain.

Symptoms associated with lower back pain

Specifically describing the associated symptoms helps the treating physician arrive at an accurate diagnosis. Lower back or waist pain is associated with symptoms like:

  • Spasms
  • Worsening after a night’s sleep
  • Radiating to the thighs and lower legs.

Lower backache symptoms that require immediate medical attention:

Rarely, lower backache can signal a serious underlying condition. Here are some red flags to keep in mind:

  • Recent weight loss not related to lifestyle changes like exercise or diet.
  • Loss of bowel or bladder control. This could mean serious nerve damage.
  • Associated fever and chills. Tuberculosis should be ruled out.
  • Severe abdominal pain.
  • Dizziness, confusion or loss of breath
  • Significant weakness or numbness of the lower body
  • Intense sudden back pain that doesn’t subside with rest.

Causes of lower back pains

  • Most often pain is due to a torn or pulled muscle or ligament. A muscle strain occurs due to overstretching and can be due to a sudden movement or can develop over time. A sprain is due to overstretching of ligaments of the lower back. These sprains or strains can be due to:
    • A sudden fall or movements that put stress on the lower back.
    • Lifting a heavy object, or twisting your spine while lifting.
    • Prolonged poor posture
    • Sports, especially movements involving twisting.
  • Chronic lower backache is defined by one lasting more than three months. This is often caused by:
    • A disc herniation. The herniation of a portion of the lumbar disc will lead to inflammation and compression of the nerve root. This can lead to severe pain.
    • Degenerative disc disease. Intervertebral discs lose their water content with age and may wear out. With time this may lead to tears and prolonged pain.
    • Joint dysfunction. This dysfunction can be due to damage to the facet joints that are present on either side of every disc, or the sacroiliac joint that connects the sacrum with the spinal cord to the pelvis on either side.
    • This is due to wear and tear of the facet joints or the disc and can occur at one or multiple levels of the lumbar spine.
    • Spinal stenosis. This condition causes narrowing of the spinal canal where nerve roots are located.
    • Trauma or compression fractures. A compression fracture occurs due to a sudden fall which causes the bone to cave in on itself.

Left lower back pain: What it means?

Left lower back pain is mostly due to damage to soft tissues supporting the spine such as muscles, ligaments and joints. Other causes could be due to problems with internal organs such as the left kidney, reproductive organs or the intestines.

Most often, over the counter painkillers, hot or cold packs or exercises may relieve left lower back pain. However, if the pain increases with daily activity, has occurred following an accident or serious injury, or is not relieved using other methods, it is recommended that you consult a doctor.

Right lower back pain: What you should know?

Right lower back pain can be due to any of the following reasons:

  • Spinal problems like damage to the facet joints or intervertebral discs.
  • Soft tissue injuries involving the ligaments, tendons or muscle that support the spine.
  • Problems involving the internal organs such as the kidneys or intestines.
  • Waist pain for females on the right side can be due to pelvic inflammatory disease or (PID). This may be gradual in onset and may be caused by sexually transmitted infections.

In most cases, the pain is due to a minor injury that will resolve with adequate rest and pain relievers. However, there are some serious conditions that must be looked out for.

  • Though classically presents as pain in the navel that shifts to the right flank, it can present as right lower back pain.
  • Abdominal aortic aneurysm. This is a serious condition which presents as severe pain which can be associated with nausea, fainting.

Tips to treat lower back pain

Are you suffering from lower back pain and finding it difficult to seek help amidst the pandemic? Here are some methods that will provide back pain relief that you can try at home in case of mild lingering pains:

  • Do back stretches: Stretching helps to loosen stiff muscles and relax them. Perform simple stretches every morning after having rested all night as well before you go to bed.
  • Get a gentle back massage: A massage helps in increasing blood flow as well as relaxing stiff muscles and joints.
  • Improve your posture: If your job requires you to be seated for long hours, make sure you sit upright with your computer screen at your eye level. Ensure that the chair you are using offers lumbar support.
  • Use a foam roller for your back: A foam roller is placed on the floor below your back and rolled back and forth over. This provides relief as it acts as a deep tissue massager.
  • Practise back strengthening exercises: Exercises such as back crunches, leg raises and sit-ups strengthen your back and support your spine better.

Physiotherapy for lower backache

Physiotherapy plays a very important role in relieving lower back pain. It is used both as a stand-alone mode of therapy as well as in addition to other treatments like heat therapy, traction and massage. Physiotherapy for back pain involves early mobilization, stabilization activities and manipulative exercises. Advice on ergonomic furniture and postural corrections is also offered.

Surgical treatment for lower back pain.

 Surgeries for back pain are usually advised if the pain is not relieved in 6 to 12 weeks. Procedures that are done include:

  • Decompression surgery. This surgery aims to remove the structure that is compressing a nerve leading to pain or neurological dysfunction. This could be a bone spur or a herniated portion of the intervertebral disc.
  • Lumbar spinal fusion. Spinal fusion aims to remove the soft tissue between two vertebrae and replace them with bone in order to immobilise the joint. This helps to heal the damaged bones and offers stability.

Dr.Jayavardhan YB | Consultant | Orthopaedics | Narayana Multispeciality Hospital, Mysore

Narayana Health

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