Do you struggle with lower back pain but don’t know where your pain is stemming from? Several factors could be causing this pain. To learn more about nonspecific lower back pain continue reading below.
You wake up with an aching back that seems to have come out of nowhere. You didn’t lift any heavy packages, overdo it on the pickleball court, or manipulate your heavy vacuum cleaner into any hard-to-reach corners in your house. Yet somehow the pain has settled in, and you’re not sure what to do about it or why it happened in the first place.
“Of all the patients I see with back pain, I would say that 50% of them won’t have an identifiable cause they can attribute it to,” says David Essig, MD, a board-certified orthopedic surgeon at Northwell Health who is based in Great Neck, NY. “Patients will come in and feel like their back is ‘locked up.’ They can’t move, bend, or twist without pain.”
Why Your Back Hurts (There’s Always a Reason)
Age is the number one cause for back pain you can’t explain (which is known as idiopathic back pain), Dr. Essig says. You can thank degenerative disc disease.“After age 20, the discs in your spine start to age and lose their hydration,” explains Dr. Essig. This process continues as you get older. “And as a result, things that you would not think would cause back pain cause back pain,” Dr. Essig says. “It’s as if you are driving the car and the tire treads have worn out so you start to slip and slide.” Unfortunately, you can’t just switch out your discs the way you would change the tires on a car.
Lifestyle factors also come into play when it comes to back pain that seems to appear out of nowhere. For instance, if you smoke, you are at higher risk. “Nicotine increases the wear and tear on the discs in your spine,” says Dr. Essig. “It causes them to age faster than they would because it breaks down the collagen, which is an important part of the discs and which keeps the discs in your spine functioning.”If you are a bit out of shape, you are more likely to have back pain than someone who exercises regularly. And if you are overweight and obese, you run more of a risk of developing back pain than someone who is a normal weight.¹
Osteoarthritis (known as spondylosis when it affects joints in the spine) can also play a role in back pain, says Beth B. Froese, MD, a physical medicine and rehabilitation physician with Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. “All of us ultimately develop osteoarthritis of the spine,” she says. “We call it ‘gray hair of the spine’ as we discuss this with patients. It is a normal process.”Morning back pain may be caused by poor support while sleeping, Dr. Froese says. “A very unsupportive mattress can create muscle soreness in the morning,” she says.
- Poor Posture and Body Mechanics
And bad posture in general could be a cause for your back pain. “If you are working in an office in front of a computer all day, you may have back pain just because of the height of the computer or the chair,” says Venkat Ganapathy, MD, FRCS, FAAOS, an orthopedic spine surgeon and chief of Orthopedic Spine Service at the University of Arizona College of Medicine in Tucson.You may have lifted something that didn’t seem heavy at the time, or twisted in a way that was so minor you don’t even remember doing something to your back. Yet you could have a sprain or a strain, and either of these may cause back pain. A sprain tends to occur after trauma, such as a fall. A strain, which is a twist, pull or tear, can occur if you repeat the same motion over and over. Athletes who play a contact sport can get a strain, but so can non-athletes.
Call Your Doctor or Wait It Out?
Your back may well just get better on its own with time. “Most of the time, we don’t need the patient to rush in to see the doctor,” Dr. Essig says. “Go on a course of Motrin, Aleve, or Advil. These are preferred over Tylenol, which does not treat inflammation.”
Heat therapy is helpful as well. Moist heat is best, but if you prefer ice, that’s okay, too, Dr. Essig says. With heat or ice and an over-the-counter non-steroidal anti-inflammatory drug, just wait it out and chances are that your back pain will improve within a few days.
There are, however, certain red flags that should prompt you to put in a call to your doctor. These include:
- Severe shooting pains in your legs or severe numbness going down your leg. These could indicate sciatica or a herniated disc, Dr. Essig says. “This is not necessarily an emergency but if it is causing neurological symptoms you want to get it treated sooner rather than later,” he says.
- Weakness or loss of strength in your legs. “If you can’t move your foot or your knee, you should call the doctor,” Dr. Essig says.
- Fever that accompanies back pain. “This could be concerning for a potential infection of the spine,” Dr. Essig says. “We tend to see this more frequently in the winter months, often in older individuals and in those that are immunosuppressed.” Depending on the infection, you may need to be treated with an antibiotic.
- Incontinence. “If you have any symptoms related to your bowel or your bladder function, call your doctor,” Dr. Essig says.
How To Prevent Back Pain
Bear in mind that there is no way to avoid all back pain, Dr. Essig says. “That is like asking your doctor to have you never catch a cold again,” he says. “But you can reduce the incidence of your back pain by making some healthy lifestyle changes.”
Eat a healthy diet, with plenty of fruits and vegetables. Maintain a healthy weight for your height, and if you aren’t sure what weight you should be at, ask your doctor. Get regular exercise (check with your doctor first if you have not been exercising regularly.) And learn what self-directed exercises you can do on your own to strengthen your back, Dr. Essig says. “Some people may be doing their exercises but they are not doing the right core exercises that would target the spine,” he says.
“If you wake up with back pain, stretching is always encouraged,” Dr. Ganapathy says. “And activity and movement in general are encouraged. Just some gentle stretching before you get out of bed is very helpful. And being physically active throughout the day keeps your joints lubricated.”
Get smart about how you move through your day. “Lots of repetitive bending at the waist to pick up heavy objects is hard on your back,” Dr. Essig says. When you bend to pick up something, bend your legs and squat, then lift it. Avoid activities that involve a lot of twisting and torquing, both of which put a lot of rotational twist on the disc.
“A valuable way to keep excess pressure off the discs in your back is to avoid excessive lifting, in particular when combined with bending and twisting,” Dr. Froese says.
Be smart about cardio. Walking and biking on an upright bike are fine, as is swimming. “Jogging and running are rough on the joints in general,” says Dr. Essig. “Rowing is okay but many people cheat and rock their back. It’s okay to do light rowing but getting overly zealous with it can cause problems with your back.”
If you have osteoporosis, build some weight-bearing exercises like walking into your day. If you drink alcohol, do so in moderation. If you smoke, quit, and if you have been prescribed medication for osteoporosis, be sure to take it. And eat foods that are rich in vitamin D and calcium to help ensure good bone health.
And last but not least, invest in a good mattress. “I usually recommend a firm mattress with some kind of ‘forgiving’ cushion on top, like memory foam,” Dr. Froese says.