Lumbar / Back Pain

The lumbar spine refers to the lower back, where the spine curves inward towards the abdomen. It begins approximately five to six inches below the shoulder blades, connecting to the thoracic spine above and extending down to the sacral spine below. Conditions affecting the lumbar spine are a common cause of lower back pain, leg pain and sciatica.

Causes of Pain in the Lumbar Spine

There are many structures within the lumbar spine that can cause pain. Irritation or compression of the nerve roots as they exit the spine, joint problems, disc pathology, bony changes and muscular conditions can all contribute to lower back pain.

Many lumbar spine conditions are interrelated. For example, joint instability may lead to disc degeneration, which can then place pressure on nearby nerve roots. This may result in leg pain or sciatica, in addition to localised lower back pain.

The more common causes of lower back pain include the following:

Muscular Problems

The most common cause of lower back pain is muscle strain or other muscular problems. Strain caused by heavy lifting, bending or repetitive activities can be painful but typically improves within a few days or weeks with appropriate management.

Degenerated Discs

Intervertebral discs act as shock absorbers between the vertebrae of the lumbar spine. Degeneration of these discs can cause pain originating from the disc space itself. This condition is often referred to as degenerative disc disease and is a frequent cause of chronic lower back pain.

Lumbar Disc Herniation

Disc herniation is most common in the lumbar spine. It may occur suddenly following injury or heavy lifting, or gradually as part of age-related wear and tear. Compression of a nerve root can result in leg pain, commonly known as sciatica, which is the most frequent symptom.

Sacroiliac Joint Dysfunction

The sacroiliac joint connects the lower lumbar spine to the pelvis. Dysfunction within this joint, whether due to excessive or restricted movement, can cause lower back pain and may also contribute to leg pain or sciatica.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward over the vertebra below it, most commonly at the lower lumbar levels such as L4–L5 or L5–S1. If the slipped vertebra compresses a nerve root, symptoms may include leg pain and, in some cases, foot pain.

Osteoarthritis

Osteoarthritis of the lower back, also known as facet joint arthritis, develops due to age-related wear and tear. Degeneration of the cartilage within the facet joints can lead to joint swelling, bone spur formation and reduced movement, resulting in lower back pain and possible nerve compression.

Lumbar Stenosis

Lumbar spinal stenosis refers to narrowing of the spinal canal or the nerve root canals. This narrowing can compress the nerves, leading to leg pain, tingling, numbness and difficulty walking. Lumbar stenosis is often caused by arthritic changes such as bone spurs and joint thickening.

Sciatica and Leg Pain

The sciatic nerve runs from the lower back down each leg to the foot. Compression or irritation of this nerve due to lumbar spine conditions can result in burning pain, tingling or numbness radiating down the leg and into the foot. This pattern of leg pain is commonly referred to as sciatica.

A thorough assessment by a Spine Surgeon in Nottingham is important to accurately diagnose the cause of lower back pain, leg pain or sciatica and to guide appropriate treatment.