Low Back Pain
Symptoms
The type, location, and severity of low back pain depends upon what is causing it.
Symptoms of a back sprain or strain generally include:
- Muscle spasms, cramping, and stiffness.
- Pain, mostly in the back and buttocks. The pain may develop quickly or over a longer period of time. Pain generally occurs in episodes. It is aggravated by weight-bearing or specific movements and is relieved by rest. The most severe pain usually lasts 48 to 72 hours and may be followed by days or weeks of less severe pain. The back is easily reinjured during this time.
Symptoms of nerve-root pressure generally include:
- Leg pain. If pain extends below the knee, it is more likely to be due to pressure on a nerve than to a muscle problem. Most commonly, the pain starts in the buttock and travels down the back of the leg as far as the ankle or foot. This pain pattern is known as sciatica
.
- Pain may come on suddenly or gradually. It may vary from mild to severe, and it can be constant or it may come and go. It is usually sharp and burning and is made worse by sneezing, coughing, or straining to pass stools. Some people describe it as a shooting pain. The pain usually affects only one leg.
- Depending on the cause of your low back pain, symptoms may be better or worse in various positions, such as bending forward (flexion) or backwards (extension). If bending forward increases symptoms, walking, lying down, and movements that straighten (extend) the spine usually relieve symptoms. The opposite is also true: if your symptoms are worse when you stand or walk, they are usually relieved by sitting down or lying down on your back with your knees bent, and by gentle exercises to bend your spine forward (flex).
- Pain can also be made worse by activities that cause you to forcefully contract the core muscles of your trunk, such as a cough, sneeze, or a difficult bowel movement, or if you hold your breath during an activity (Valsalva maneuver).
- Nerve-related problems, such as tingling, numbness, or weakness in one leg or in the foot, lower leg, or both legs. Tingling may begin in the buttock and extend to the ankle or foot. Weakness or numbness in both legs, or loss of bladder and/or bowel control, are symptoms of cauda equina syndrome, which requires immediate medical attention.
Symptoms of arthritis of the spine generally include pain and stiffness that are worse in the back and hip region. Arthritis pain starts gradually, gets worse over time, and lasts longer than 3 to 6 months. It is generally worse in the morning or after prolonged periods of inactivity. Arthritis pain gets better when you move around. Symptoms caused by arthritis and symptoms due to back injury are often similar and commonly occur together.
Symptoms of diseases that affect the spine vary depending upon the type of illness. They may include:
- Pain that is worse in the affected part of the spine (for instance, if there is a compression fracture, tumor, or infection).
- Pain that starts gradually, is constant, and may be sharp or a dull ache. Bed rest does not make it better and may make it worse (tumors on the spine often cause night pain). The pain lasts longer than 2 to 3 weeks.
- Fever.
- Sensitivity of the spine to touch and pressure.
- Pain that wakes you up from sleep.
Other symptoms or conditions that may occur with low back pain and require additional evaluation and treatment include:
- Depression.
- Drug or alcohol abuse. Use of intravenous (injected or IV) illegal drugs is especially risky.
- Use of steroids over a long period of time.
- Unexplained weight loss.
- Fever.
- A history of cancer.
- Bladder or bowel problems.
- An illness or condition that affects the immune system, such as diabetes, chemotherapy for cancer treatment, HIV (AIDS), or an organ transplant.
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| Author: | Shannon Erstad, MBA/MPH | Last Updated: February 6, 2008 |
| Medical Review: | William M. Green, MD - Emergency Medicine Robert B. Keller, MD - Orthopedics | |
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