Lower back pain

The lower back is the lowest part of the back. Pain in the lower back is usually due to muscles, but can also be caused by intervertebral discs, vertebrae, joints and ligaments. Lower back pain can arise acutely, for example with a sudden twinge in the back or with a fracture, but also gradually due to, for example, overuse or a poor posture.

Anatomy of the back

The back is divided lengthwise into four parts: cervical vertebrae, thoracic vertebrae, lumbar vertebrae and the sacrum. The lower back includes the five lumbar vertebrae and the sacrum. The sacrum consists of five fused vertebrae. However, there are individual differences.

Between the vertebrae are intervertebral discs. These flexible discs provide cushioning and mobility of the back. In the lower back, the last intervertebral disc is between the lowest lumbar vertebra and the sacrum. A vertebra is a bony structure that consists of a vertebral arch and two articular processes.

The spinal cord runs through the entire spine. The spinal cord consists of nerve cells and nerve tracts. The spinal cord is well protected by the vertebrae through which it runs. Nerves exit from the spinal cord through the openings between vertebrae. The nerves run to all parts of the body.

Pain in the lower back

Pain in the lower back is a very common complaint. We often see these symptoms between the ages of 35 and 55. Back pain often goes away on its own, even without physiotherapy or other therapies.

With lower back pain, a distinction is made between back pain without neurological signs and with neurological signs. Neurological signs include, for example, muscle weakness, tingling and radiating pain.

Pain without neurological signs is mainly caused by postural problems. If the lower back is subjected to too great or prolonged loading, the back muscles can become over-fatigued. This then manifests itself as pain in the lower back.

When symptoms have been present for less than six weeks, we speak of an acute back complaint. The term 'acute back complaint' is often used incorrectly because people think that there is only an acute back complaint if the pain 'shoots in'. This does not have to be the case at all; 'acute back complaint' only indicates the time frame.

Back symptoms usually disappear again by themselves after a short period because the cause is often an overuse of the back. Overuse can mean that the load was too great, for example when lifting a heavy object. However, it also often happens that the load capacity is too low. This means that the back can tolerate less load than could be expected by nature. Insufficient physical condition of the back and abdominal muscles is the underlying problem here.

So-called locking of the back is in most cases not a problem of the vertebrae, but of the muscles. If it is in the vertebrae, there is an underlying medical diagnosis or deformity. It is cramped muscles that pull the vertebrae into a cramped position. The function of muscles is to move vertebrae relative to each other. If one muscle is pulled very hard, it pulls the vertebra excessively to one side.

Pain in the lower back with neurological signs is usually caused by a pinched nerve in the back. This can be due to an intervertebral disc that bulges out against the nerve, problems with joints or a combination of these. With these symptoms the pain area is larger than just the lower back and the symptoms can extend down to the foot.

Check your symptoms

To get a good first impression of the cause of the pain in your back, we advise you to do the online physiotherapy check. By first indicating where you have back pain and then answering the questions, your back pain is compared with the most common back complaints in physiotherapy. If necessary, you can contact a physiotherapist nearby for a professional examination.

Conditions

The conditions below can cause pain in the lower back. Each article is clearly illustrated and provides extensive information about the causes, symptoms and treatment options.