Common Lower Back Pain Causes and How to Avoid Them

Here are some of the main lower back pain causes. I've tried to put them into tidy categories, but there is considerable overlap. Someone with spinal stenosis, a narrowing of the spinal canal, is more susceptible to back pain from a herniated disk or bone spur. Alternatively, the troublesome disks or bone spurs might be responsible for the narrowing of the spinal canal. Inflammation or muscle spasm might compound the effect. Keep in mind, too, that many of these conditions can be found in people with no back pain at all. Just because you have a bulging disk doesn't mean you'll be in pain.

Strains and Sprains

The most common causes of lower back pain by far, strains and sprains can be confusing. Even different types of doctors and medical dictionaries disagree. According to the Merriam-Webster Medical Dictionary and some physicians, strain involves an overstretching of muscles, tendons, or ligaments, while sprain involves a tearing of those tissues.

But ask an orthopedic surgeon, and you'll learn that a strain is a stretched or torn muscle or tendon, the cord or band of fibrous connective tissue that attaches the muscle to the bone; while a sprain is the violent overstretching or tearing of one or more ligaments, the tissue that attaches bone to bone.

Strains tend to occur when muscles are poorly conditioned and/or overworked. If, for example, you're out of shape and spend an entire weekend raking leaves in the garden, stretching to get into hard-lo-reach places, twisting to load the trash bags, and the next day you feel as if you cannot move a muscle, chances are you have a strain.

Chronic strains are caused by overuse (too many hours of work in a row). Acute strains are caused by direct injury or overstress (picking up something that's too heavy).

Sprains tend to happen when a sudden, forceful movement (a sudden or violent twist or wrench) injures a ligament, which is more susceptible if it's stiff or weak through poor conditioning or overuse. Ligaments are not as flexible as muscles and tendons, and are more susceptible to tearing.

When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. Sprains usually occur because of trauma - a fall, a twisting injury, or an accident - that ruptures blood vessels at the same time. They are recognizable by severe pain at the time of the injury, swelling, inflammation, and discoloration.

Both strains and sprains are categorized into three types, from Grade I (mild) to Grade III (severe). Mild strains (Grade I) involve a slightly pulled muscle without tearing of muscle or tendon fibers, and no loss of strength; moderate strains (Grade II) tear fibers in a muscle, tendon, or at the attachment to bone, and cause diminished strength; and severe (Grade III) strains rupture the muscle-tendon-bone attachment with separation of fibers.

Mild (Grade I) sprains involve the tearing of some ligament fibers, but no loss of function; moderate (Grade II) sprains rupture part of the ligament, causing some functional loss; and severe (Grade III) sprains cause complete rupture of the ligament or complete separation of ligament from bone.

If you're still uncertain about which is which, you're not alone. Even diagnostically, it can be difficult to differentiate the two. Both may cause pain or tenderness; with sprains and the more severe strains causing swelling; and redness or bruising either immediately or several hours later. If the pain gets worse on the second or third day, and then starts to improve, [a strain or a sprain] might be the cause. Other clues that it's a strain or a sprain: pressing the area hurts, pain is activated by a specific movement, or a massage or warm bath makes it feel better.

Here are some helpful hints for preventing and treating strains and sprains:

Lower your risk. Don't overtax yourself with more physical activity than your body is ready for. Maintain a good level of physical fitness and proper weight, and stretch muscles before and after exercise.

If necessary, use over-the-counter pain relievers. Acetaminophen or ibuprofen can help reduce the pain.

Avoid repeat performances. You might not be able to figure out exactly which tendon or ligament is hurting, but narrowing down the cause to the new workout routine, office chair, or even that new pair of high heels can prevent recurrence.

About 80 percent of back pain is musculoskeletal, which means it will probably go away on its own. But whatever you did to make it happen - do it again and it will happen again.