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9 Types of Lower Back Pain: Which One May Be Affecting You?

October 4th, 2008 • Related • Filed Under

In no particular order, here are the top 9 types of lower back pain.  We dive deeper into each of these in other articles, but for now, each overview should give you a clear understanding of each low back pain condition.

degenerative disc disease 9 Types of Lower Back Pain: Which One May Be Affecting You?Degenerative Disc Disease (DDD): As you may already know, disc degeneration is a normal part of the aging process. Unfortunately there is a gradual deterioration of the “structure and function” of these tiny discs between your vertebrae (spine bones). Your discs can become thin and dehydrated, which decreases their ability to absorb shock.

As your discs weaken, tears can occur, resulting in pain. Your lumbar spine becomes less flexible and mobile in all directions. You may even have stiffness in the morning and following inactivity, a generalized low back ache, as well as pain following prolonged positioning, strenuous activity, and/or activities that increase the load on the low back. Degenerative changes can lead to osteoarthritis (OA), spondylosis, spondylolisthesis and stenosis.

facet joint syndrome 9 Types of Lower Back Pain: Which One May Be Affecting You?Facet Joint Pain: The facet (spinal) joints are another possible source of low back pain. These joints can be affected by a traumatic event or chronic (long term) changes. When your facet joints are forced to take on a higher load or an assymetrical movement, they can become aggravated and inflammed.

Extra pressure on the joints may result from repetitive occupational strain, activities requiring extension and rotation of the spine, abnormal posture, and degeneration of the disc.  Your facet joints are not meant to bear much weight, but if they do, you can develop osteoarthritis (OA) as the cartilage is damaged from wear and tear over the years. Patients suffering from OA commonly report stiffness in the morning and following periods of inactivity, specific movement restrictions, a constant ache in the low back area, pain that worsens with extension (leaning back) and eases by bending forward.

9852 9 Types of Lower Back Pain: Which One May Be Affecting You?Spondylosis: Spondylosis is another reason for low back pain.  Spondylosis is another type of OA that can affect your bones and soft tissues of your spine. Although spondylosis is the result of degenerative change, it is important to know that most of the associated problems are a normal part of the aging process.

The cardinal feature of spondylosis is an “osteophyte” (a bony outgrowth), which forms on a vertebra due to unusual stresses placed on the spine. An osteophyte can result in entrapment of a nerve and cause neurological symptoms, such as pain, numbness and tingling in the lower extremity, weakness, and decreased sensation. You may also feel stiff in the morning and following periods of inactivity, specific movement restrictions, and an ache in the low back area.

spondylolisthesis 9 Types of Lower Back Pain: Which One May Be Affecting You?Spondylolisthesis: This condition occurs when one vertebra in the spinal column slips forward on the vertebra below. Spondylolisthesis is really a form of spinal instability. It occurs most oten in the lower lumbar (low back) spine, especially between the L5 lumbar vertebrae and the sacrum. Pain is usually brought on with activities requiring back extension and those that place excessive load on the spinal joints (e.g., running, jumping, etc.). People commonly report an ache in the low back and pain radiating into both buttocks and thighs. Pain, in addition to numbness and tingling, radiating below the knee can be caused by a large slip and the associated spinal stenosis which occurred.

spondylolysis 9 Types of Lower Back Pain: Which One May Be Affecting You?Spondylolysis: Spondylolysis is a defect in the pars interarticularis (bony ring of a vertebra). This defect is most commonly thought to be a stress fracture that happens from repeated stress on the bony ring. If the back section of the bony ring separates from the main vertebral body, the bony connection between subjacent vertebrae will be lost, which can result in a forward slippage of one vertebra relative to another (spondylolisthesis).

stenois 9 Types of Lower Back Pain: Which One May Be Affecting You?Stenosis: Stenosis is a bony narrowing of the space around either the spinal cord (your spinal canal) or nerve roots (lateral recesses), with subsequent compression of these structures. Stenosis can be classified as congenital (developmental) or acquired. Acquired stenosis can be the result of degeneration (e.g., OA - enlargement of spinal structures, disc herniation, spondylolisthesis), post-surgery, trauma, or a systemic disease (i.e. Paget’s disease results in enlargement of vertebrae).

** Central Stenosis: This condition results from impingement of the dural sac (tissue encasing the spinal cord within the canal of the vertebral column), which commonly results in neurogenic claudication. Individuals suffering from neurogenic claudication commonly report an insidious (gradual) onset of intermittent, crampy, diffuse pain radiating into both (bilateral) lower extremities (buttocks, thighs and legs) with associated numbness and tingling, in addition to weakness in the legs. Neurogenic claudication pain is aggravated by prolonged standing and walking (especially downhill) and is eased by lying supine (on your back), sitting, and forward bending.

** Lateral Stenosis: This condition results from compression of a nerve root as it exits between two vertebrae. Individuals commonly report an insidious (gradual) onset of intermittent, diffuse pain radiating into one (unilateral) lower extremity (buttock, thigh and leg) with associated numbness and tingling, in addition to weakness in the affected legs.

Segmental Instability: Spinal instability is the term used to describe a loss of function of the supporting spinal structures (i.e., muscles, discs, ligaments, capsules, joints). Typically, the vertebral bones within a spinal segment move more than they should during normal activities. The excessive motion of the spine out of normal alignment can result in low back pain, the potential for progressive deformity and nerve irritation that can cause leg pain and weakness.

lumbar herniation 9 Types of Lower Back Pain: Which One May Be Affecting You?Lumbar Disc Lesions:

**  Bulging / Herniated disc: A disc bulge/herniation can occur following a traumatic event, or can be the result of age-related degenerative changes in the lumbar spine. The disc material slips out (prolapse or extrusion) out of place, which can impinge upon and irritate a nerve. Individuals commonly report pain that is usually sharp or throbbing and can cause mild to severe discomfort in your back and shooting (radiating) pain down one leg. Individuals may also experience numbness, tingling or weakness in the buttock, leg or foot. Other symptoms include a shooting/stabbing pain associated with coughing, sneezing or straining oneself, in addition to pain that may become worse after prolonged sitting and forward bending.

**  Annular tears: Injury to a disc (tissue between two vertebrae) can occur following a traumatic event (i.e., compression, twisting), or can be the result of age-related degenerative changes within the disc. The disc is composed of a tough outer layer (annulus fibrosis) that surrounds a semi-fluid gel centre (nucleus pulposus). A tear commonly occurs in the outer layer, which generally results in central low back pain. In the case of an acute injury, all spinal movements are restricted. However, throughout the recovery process, pain subsides and mobility improves as the tear heals over with scar tissue.

lumber sprain 9 Types of Lower Back Pain: Which One May Be Affecting You?Lumbar Strain/Sprain: One of the most common lower back problems, is a low back sprain or strain.  This injury can occur when a sudden stress is placed on the lumbar spine, which results in stretching or tearing of your muscle/tendon/ligament. The muscles are large in this area and when a strain occurs, severe low back pain can result. The low back pain from a sprain or muscle strain is in a broad area of the back and may be on either side, with consequent painful muscle spasms and marked restriction in range of motion.

Want to learn even more about lower back conditions? Watch our 4-minute back pain video here.  Have a question on your mind, leave it below, and one of our low back pain experts will be glad to give you an answer.

Looking for an effective way to end your frustrating pain? Consider PT Health Physiotherapy! We deliver a non-surgical, natural, and safe therapy services to end painful injuries. Every day across Canada, more than 7,000 people trust PT Health to provide pain relief solutions for them. Why? Because we get results! Why not let us do the same for you too? Book a complimentary consultation today, and let's discuss how we can help you - feel great again! Learn More About Free Consultation Option Here

There Are 10 Responses So Far. »

  1. Comment by elle on 12 September 2009:

    I fell in costco last september (water on the floor with no sign).I now hjave two bulging discs hernation and a tear resulting in severe sciatic pain physicl therapy sid not help not the shots.and I will not take drugs except tylenol and advil. would you recommend non-invasice surgery. I am miserable my massage therapist sees my contion as worsening ………My lawsuit i in litigation and I am an otherwise healthy 53 year mom with two kids who has aged and is in pain constantly…….what do you suggst…I have also been to chiropracters with no help

  2. Comment by PT Health Team on 18 September 2009:

    Wow. Sounds like you have tried everything. Typically we find that Physiotherapy can be a very effective treatment method for this type of injury. Further, research supports a solid course of Physiotherapy before even looking at surgery as an option. Assuming you have tried this already, a consultation with a surgeon may be an option. With the information I have I can not definitely recommend surgery. There are many factors a surgeon must consider when deciding whether or not to perform surgery. Whether its major or minor surgery there is always associated risk. So, what do I suggest? I think you have two options. First, I would suggest that you find a physiotherapist with an interest in back injuries and get re-assessed with your specific question in mind; “Do you think I should see a surgeon”. Second, I would speak with your family docotor about a referral to a surgeon. That way you could at least hear what they would suggest or if surgery is even an option.

    All the best,

    Andy B.

  3. Comment by ramona reardon on 23 September 2009:

    My husband suffers from many back problems. He had a fall on his cervical spine twenty years ago. He has all kinds of diagnosises. He also had a lower back strain about twenty years ago. Is his lower DDD more likely to be caused by the fall to the cervical spine, is it a direct reaction to that fall, or is it common to develop DDD from an untreated strain?

  4. Comment by PT Health Team on 29 September 2009:

    HI Ramona,

    Thank you for your question. Based on the information you have provided I would suggest that the lower back DDD is not related to the neck injury. Although it is true that we are one big kinetic chain, meaning that damage to one part may affect another. It is unlikely that the neck injury would have been significant enough to cause the back to develop arthritic change to an appreciable degree.

    It may be that the lower back injury (untreated) lead to the degenerative process. That being said, depending on your husbands age it is expected that there will be general wear and tear on the joints.

    Regardless, if he is having issues in the lower back Physiotherapy has been demonstrated to have a significant affect on the prognosis for low back pain. Even with degenerative disk disease there is much he can do to improve his situation. I would recommend seeing your Physiotherapy for an exact impression of his condition. They are experts in symptom control and they will be able to work with him to develop a plan for the long term health of his neck and back.

  5. Comment by nicholas blake on 29 September 2009:

    My son has scoliosis with a 53% curvature. He has seen a specialist here in hamilton and said he needs surgery with no other options. I have asked for another opinion and its on June 21,2010 at st. micheals hospital in toronto. he is not in pain only when he sleeps at night on side and stomach. he does not take any pain medications. he is 20 yrs. old and healthy except this scoliosis diagnosis. noone mentioned therapy, chiroprictor or any form of therapy only surgery was suggested because this curvature will only get worse as he ages. this surgeon i found myself on the internet with good reviews. he has a long waiting list we will see what he says. in the mean time i want to know if there is anything that could be corrected without surgery or make it less of a curvature or is surgery the only way like this dr. mentioned in hamilton, which i found something wrong and he wanted me to schedule a date for surgery at the office without thinking about it.
    thank you, concerned mom
    nadia

  6. Comment by PT Health Team on 2 October 2009:

    Thank you for your question. First off with the information you have provided a consult with the surgeon is a good idea. Considering your sons symptom level and age I think a second opinion is well justified.

    There are many factors we look at to determine the appropriate treatment course for scoliosis. Generally speaking, age and degree of curvature are main factors. If an individual is physically matured and there is less then 40 degree curvature things may not progress and they would likely do well working with a physiotherapist for stability and back care education. In younger individuals with a significant curve we may look at bracing. Bracing has been shown to be effective with preventing progression of the curve but NOT correcting the curve.

    Given that your son is 20 years old (I assume physically matured) the progression of any curve will tend to be slow. There are not many studies looking into long term outcome with physiotherapy in people with more severe curves. That being said, intuitively it would make full physiological and anatomical sense that if your son learns to stabilize his spine he could help to prevent progression.

    Unfortunately is not likely that he will be able to correct the curvature via physiotherapy or chiropractic therapies. However, there are many things your son MUST do to prevent many of the future issues associated with scoliosis. He must learn appropriate stretches and techniques to maintain as much spinal mobility as possible. He must learn to stabilize the spine. He must learn to stabilize his hips and shoulders as well. If he can learn how to do this now, he can greatly improve the overall prognosis. Further, if he did ultimately choose surgery the more stable his spine is heading into surgery the better he will be coming out!

    All The Best Andy

  7. Comment by Ruth Pinder on 16 November 2009:

    I injured my spine last June when I crashed on my butt on cceramic tile at home, I had a CT sccan which showed two compression areas. I was in bed for 6 weeks rest and now wear a Bell Horn back brace. I wish to stop using the brace but my back is weak and I bend over forward after a while. I live on Abaco, The Bahamas, and there is no hospital or Physiotherapist here so I have to do the physio myself, prefereably with a video/s to guide me.

    Thank you

  8. Comment by Gurpreet on 14 January 2010:

    Hi, I have been suffering from lower back pain from couple of weeks. The hurt myself my overdoing abs on an incline abs table. I always felt tightness and strech in my right leg in the same areas that I am having pain now. I went for physiotherapy and was diagonzed with sciatica as inititally I had pain in my buttock and knee area without any pain in my back. Pain in Buttock is gone but now I have been feeling tightness and dull pain in my lower back and on the left side of right leg knee which comes and goes. My physiotherapist checked me again after couple of weeks of physio and said that the damage to my back is permanent and I would not be able to bend backward. What do you suggest I should do to get proper diagnosis and be pain free?

  9. Pingback by lower back pain injuries and conditions | PT Health Physiotherapy … | Health News on 23 January 2010:

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  10. Comment by Michael B. on 24 June 2010:

    I had injured my back recently by lifting up a ladder, then noticed that it didn’t feel right so I sat it down quick. Feeling great discomfort in my lower spine, 5 days later I haven’t been to mobile. Being 40 yrs, and active, what should I do?

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