Low Back Pain – What Is Causing The Pain?

updated 9/20/2024

Understanding Low Back Pain

Nearly everyone has experienced low back pain at some point in their life, and some people experience it often. Some people know what the underlying cause is, but not everyone does. There can often be different causes, some of which can occur simultaneously; however, they are distinct issues with different origins. It can be muscle related, disc irritation or injury and/ or connected to the sciatic nerve.

Low Back Pain: More Than Meets the Eye

Even though the pain is felt in the low back, the culprit is not always in the back itself. Often, the culprits are the Quadratus Lumborum, the Gluteal muscles, Psoas, Iliacus, and the Multifidus muscles. However, hip adductor and hip rotator muscles, as well as the hamstrings, an also play a part in the pain.

The Iliacus and Psoas: The Hidden Culprits

These two deep core muscles can play a significant part in low back pain. The iliacus originates on the inside of both of the pelvic bones and inserts near the top of the femur. The psoas originates on both sides of the lumbar spine and inserts on the femur just below the iliacus.  They are like workhorses; they do a lot of work and you rarely feel them or notice them. But, when they get tight or strained, you tend to feel it in your low back.

Sciatic Nerve Pain

The sciatic nerve is the longest and thickest nerve in the body, and is actually five nerve bundles that come off of the spinal cord. It runs through your hips and buttocks, and down the leg to just below the knee. After that point it splits into separate nerves that run all the way down to your feet. Sciatic nerve pain occurs due to irritation of the nerve, which can be caused by injury, it being compressed or an impingement. This can cause a shooting pain down the leg (usually a burning sensation or feel like an electrical shock) or a pins and needles (tingling) feeling, like when your leg is ‘asleep’. It can also cause numbness in your legs and muscle weakness.

The most common causes of sciatica nerve pain are an injury or a medical condition. The injuries are usually are a herniated disc, degenerative disc disease, spinal stenosis or a direct impact/injury to the spine during an accident or fall. The medical conditions are usually osteoarthritis, pregnancy and/or piriformis syndrome. Piriformis syndrome occurs when the muscle gets injured, inflamed or has scar tissue in it, which then presses on the sciatic nerve.

Sometimes It Is a Combination

While these conditions can occur independently, they can also coexist or one can lead to the other. Tight or inflamed muscles in one area can create a domino effect, causing tension and pain in surrounding regions. As they can cause other muscles to compensate and over work. A spinal injury that irritates the sciatic nerve can in turn cause muscles to weaken, and therefore other muscles to over work. An injury can cause you to sit or stand in a different position which can also cause an issue in the spine or the sciatic nerve to get impinged.

Common Causes of Muscle Tension and Inflammation

Various factors can contribute to muscle tightness or inflammation:

• Incorrect lifting techniques
• Extended periods of inactivity, such as sitting for long periods or being bed ridden
• Injuries
• Walking gait abnormalities and/or improper form during exercising
• Sudden movement after prolonged inactivity
• Over use
• Weak muscles, which can cause opposing muscles to over work

What Can Be Done to Relieve or Reduce the Pain?

Sometimes simply letting the muscles rest for a few days can help reduce or eliminate the pain. Avoiding the activities that seem to trigger the pain for a few days, may allow the muscle relax.

For self-care, there are a few things you can do to see if they help. Stretching the piriformis and the muscles near it may help and bring some relief and help the muscles relax. However, stretching the hamstrings may not help and could make it worse. As they are usually weak, and stretching them will not help with that. Self-administered trigger point work may provide relief. During the first few days of experiencing the pain, a cold or ice pack may help reduce the pain. Heat, more specifically moist heat and/or FAR infrared heat as they penetrate deeper into the muscles, may help reduce inflammation and increase circulation. A standard heating pad usually does not provide any lasting relief, as it does not penetrate the muscles enough. And sometimes alternating between heat and cold can be beneficial.

A good therapeutic massage may be able to help with relaxing some of the muscles that may be connected to the pain. If you would like to get a therapeutic massage to see if that will help, contact us today to get scheduled. Rachel provides a thorough and detailed massage, and has been able to help many clients with their back pain.

If the pain is severe or lasts longer than a week, or if self-care and/or massage have not provided enough relief, consulting with a healthcare professional for further evaluation may be the best route to go. As you may need physical therapy, a chiropractic adjustment, medication or other medical treatment or procedure.