What Causes Lower Back Pain?

Learn what causes lower back pain from physical therapist Eric Sampson in this Howcast video.


There are a number of causes for lower back pain. Of course, there are traumatic causes. Car accidents or falling, obviously, skiing falling or any falling, is certainly trauma. You also have your, sort of, secondary causes, which is more of a bending or lifting. Maybe, the box was too heavy or maybe, the thing that you were lifting was too heavy. So, you might pull or strain some tissue.

The biggest cause of your lower back problems is going to be an imbalance of mechanical forces on the spine. Our day to day is entirely, or almost entirely, spent in a flex position, whether we're sitting or bending, whether we're carrying or lifting things. So as a result of accumulation of those activities, there's going to be a stress to the soft tissues. It could cause some degenerative break down in the tissues, as well as, sort of, a bulging affect on your disks or the soft tissues of the spine. All those structures in the spine can hurt, but it is, typically, the soft tissues that are the first problem to start up, which can then lead to some pain, and some suffering, and some need to do something about it. The tissue itself isn't, exactly, filled with the pain fibers to cause the pain. But, if the disk is pressing into other structures, such as bone, ligament, or nerve tissue, that is, precisely, what ends up hurting the patient. And, the pain can be anywhere from the back, or into the buttock, or leg, or somewhere below.

I usually refer to the mechanical forces on the spine to an analogy that I use a lot in the clinic. And, that is just simply taking your finger and bending it back two-thirds or three-quarters of the way. Obviously, for a few moments, this will hurt. And if you release it, you're more or less fine. But if you sustain that load over an extended period of time, let's say an hour or so, eventually, the soft tissues of the side of your finger that is being stretched, is going to start to hurt. If you take it away, and again, you can, sort of, reduce in terms of pain.

However, if we keep it doing this over and over on a daily basis, eventually, you are going to create some mechanical changes in that tissue, which can lead to suffering. And the need to call upon a doctor or other service, like a physical therapist.

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