Spinal stenosis
The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.
Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain
Urgency: Primary care doctor
Rheumatoid arthritis
Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.
Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.
Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.
Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.
If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.
Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.
There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.
Pelvic inflammatory disease
Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.
PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.
Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.
Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.
Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.
Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.
Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.
To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.
Rarity: Common
Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain
Symptoms that always occur with pelvic inflammatory disease:fever, abdominal pain or unusual vaginal discharge
Urgency: In-person visit
Mechanical low back pain without sciatica
About 80 percent of people will experience mechanical back pain. Mechanical means that the pain comes from the spine or its supporting structures. Sometimes, people experience sciatica with their low back pain. Sciatica is a general term to describe pain that travels from the back into the leg. Most of the time, it is unclear to doctors what exactly causes the episode of low back pain. However, it is most often due to a muscle strain, or an injured tendon or ligament. A slipped or herniated disc is also a possible cause. Fortunately, in any of these cases, initial treatment is the same. Pain usually goes away within 4-6 weeks, often sooner.
Lower back arthritis
Osteoarthritis, most often simply called arthritis, is a disease of cartilage. In joints, where bones touch and move against one another, cartilage helps provide lubrication for smooth movement, and acts as a shock absorber. Cartilage is also present in between vertebrae, which are the bones comprising the spine. Osteoarthritis of the spine, also known as degenerative joint disease, happens when the cartilage between vertebrae dries out and shrinks. The vertebrae are thus not as able to move smoothly against one another. The ability to walk and perform normal daily activities can be impaired due to inflammation and pain in the lower back.
Rarity: Common
Top Symptoms: lower back pain, spontaneous back pain, back pain that gets worse when straightening it, back pain from overuse
Urgency: Primary care doctor
Low back strain
Low back strain
A strain is defined as a twisting, pulling, or tearing injury to a muscle, or to the tendon that connects the muscle to the bone. (A sprain is an injury to a ligament, which connects two bones together.)
Strains may be acute (happen suddenly) or chronic (show up gradually.) They are usually caused by overuse, improper lifting of heavy objects, or sports. Being overweight or having weak back muscles are both risk factors for back injury.
Symptoms may include a pop or tear at the time of injury; pain that is worse when moving; and sudden muscle cramping or spasm at the site of the injury.
Diagnosis is made through patient history, physical examination, and sometimes x-ray.
Treatment involves rest; ice packs; and over-the-counter pain relievers, followed by a gradual return to normal activities within two weeks. Prolonged immobility actually weakens the back and causes loss of bone density.
Proper lifting techniques, strengthening exercises, and good nutrition can be very helpful in preventing further injury.
Rarity: Common
Top Symptoms: lower back pain, back pain that gets worse when sitting, back pain that gets worse when straightening it, lower left back pain, lower right back pain
Symptoms that always occur with low back strain: lower back pain
Symptoms that never occur with low back strain: involuntary defecation, first time leaking urine, back numbness, toe numbness, foot numbness
Urgency: Self-treatment
Herniated (slipped) disk in the lower back
A herniated, ruptured, or "slipped" disc means that a vertebral disc – one of the soft pads of tissue that sit between each of the vertebral bones – has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.
The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to "slipping."
Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.
Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.
Diagnosis is made through patient history, neurological examination, and MRI scan.
Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.
Surgery to remove the herniated part of the disc – the part that was squeezed out of place – can also be helpful.
Rarity: Common
Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness
Urgency: Primary care doctor
Fibromyalgia
Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.
The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.
Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.
Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.
There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.
Fibromyalgia does not go away on its own but does not get worse, either.
Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.
Rarity: Common
Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache
Symptoms that always occur with fibromyalgia: arthralgias or myalgias
Urgency: Primary care doctor
Chronic low back pain
Chronic low back pain is a common condition. It is defined by low back pain lasting more than six weeks. Unfortunately, a clear cause can only be found in twenty percent of cases. The rest of the time, it is believed to be due to strain on the bones and muscles of the back from heavy lifting, prolonged sitting, or bad posture.
For back pain persisting longer than six weeks, it is recommended to make an appointment with a physician. Treatments may include a program of back exercises, as well as pain medicine such as ibuprofen (Advil) and acetaminophen (Tylenol). It is also recommended to stay active and carry on with the things you usually do as much as possible, to help you recover faster. Sitting or lying still for long periods can actually make the pain worse. Your joints may become stiff which will make it harder and more painful to move your back.
Ankylosing spondylitis
"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine.
In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthritis, leaving the lower spine inflexible.
The exact cause is unknown. It is thought to be an inherited, abnormal immune response that is triggered following damage to the lining of the intestines.
Most susceptible are those with a family history of ankylosing spondylitis and a history of intestinal damage from illness. However, anyone can be affected at any age.
Symptoms include pain and stiffness in the back and hips, and sometimes in the neck and shoulders. The pain will be worse during sleep and rest.
Early treatment can help to manage the symptoms, prevent complications, and improve quality of life.
Diagnosis is made through physical examination and x-rays.
Treatment involves nonsteroidal anti-inflammatory drugs; new forms of biologic medications; physical therapy; and, in some cases, surgery to repair damaged joints.
Unexplained acute low back pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
Common causes:
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
Urgency: Self-treatment
Chronic low back pain of no specific origin
Low back pain is defined as pain, tightness, and stiffness between the lower end of the rib cage and the buttocks. "Chronic" means the pain has lasted for twelve weeks or longer, and "no specific origin" means the pain cannot be traced to any specific cause, incident, or injury.
Most susceptible are individuals who perform heavy physical work, especially when there is ongoing anxiety, depression, and emotional stress at the same time. The longer the stress and back pain continue, the more difficult it is to ease the symptoms and return the patient to normal functioning.
Treatment involves nonsteroidal anti-inflammatory drugs and sometimes opioid medications for pain, though both have risks when used long term. Antidepressants may also be tried, along with psychological counseling.
Corticosteroid injections for the back are effective for some patients, and fusion surgery is sometimes attempted. Lifestyle changes in the form of improved diet, exercise, and stress management are very helpful in most cases.
Rarity: Common
Top Symptoms: lower back pain, unintentional weight loss, back pain that shoots to the butt, fever, involuntary defecation
Symptoms that always occur with chronic low back pain of no specific origin: lower back pain
Symptoms that never occur with chronic low back pain of no specific origin: thigh numbness, buttocks numbness, lower back pain from an injury
Urgency: Primary care doctor
Can steroid injections help in cases of chronic low back pain?
In some cases, yes, especially when there has been a ruptured disc or when there is spinal stenosis — a narrowing or partial blockage of the spinal canal. However, steroid injections can only help short-term and cannot be continued indefinitely without other risks such as diabetes or bleeding disorders.
Is there a link between chronic dull lower back pain and depression?
Many medical providers feel that there is. Lack of exercise, opioid use, limited activities, and isolation can all contribute to both depression and low back pain. Emotional pain sometimes manifests as physical pain, which is why antidepressants can be helpful.
Can surgery help in chronic cases of dull lower back pain?
This depends but surgery is not usually recommended in these cases. Surgery can be effective in cases of acute injury with specific damage, but can't always improve chronic, nonspecific pain due to aging, loss of fitness, or depression.
Is dull lower back pain a sign of labor?
Low back pain is common during late pregnancy when the increasing weight of the growing baby puts a strain on the structures of the low back. Early contractions may begin at the same time as this abdominal strain and add to the dull ache in the low back. All of this is, of course, resolved after birth.
Is chronic dull lower back pain a sign of serious illness?
Most cases of chronic low back pain are not signs of serious illness but are the result of aging, inflammation, wear-and-tear, poor physical fitness, etc. However, low back pain can be a serious symptom if you also have a high fever, loss of bowel or bladder control, or signs of a cancerous process.
Questions your doctor may ask about dull lower back pain
- Does your back pain radiate anywhere?
- Were you lifting weights or straining yourself right before your symptoms started?
- What is your body mass?
- Any fever today or during the last week?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.