Low back pain is pain in the lumbar vertebrae. It is one of the most common causes back pain. What are the symptoms and causes? How common is it? What treatments are available?
What is low back pain?
Low back pain, also known as backache, lumbago or back strain, is pain, often intense, in the lumbar vertebrae (the lower part of the spine) at the base of the back(1).
Common low back pain is both a public health problem with a major economic and social impact, and an occupational health problem that can lead to people losing their jobs.
Non-specific / common low back pain of local muscular or ligamentous origin
Common low back pain in adults is a public health issue because it is widespread (in around 90% of cases). It is also a frequent reason for consultation with general practitioners. In the course of their lives, 4 out of 5 people suffer from common low back pain (2). In the case of common low back pain, it is impossible to identify a precise cause linked to a specific disease or structural problem of the spine. In most cases, it is the result of damage to the muscles, ligaments and tendons that support the back.
Specific low back pain linked to another underlying disease (inflammatory disease, cancer, etc.) or a structural problem of the spine.
Whether common or specific, low back pain involves moderate to severe pain in the lumbar vertebrae. This pain can radiate to other parts of the body, particularly the legs, and lead to functional incapacity, sleep disorders and mood changes. By convention, common or specific low back pain is classified according to its duration into three categories:
Acute low back pain (short duration) of less than 6 weeks;
Sub-acute low back pain (average duration), lasting from 6 to 12 weeks ;
Chronic (long-term) low back pain lasting more than 12 weeks.
For acute low back pain (90% of cases), recovery occurs in less than 4 to 6 weeks. Subacute low back pain affects 3% of patients. Chronic low back pain affects 7% of patients(1).
Low back pain: did you know?
80%
It is estimated that 80% of the population will suffer from back problems in the course of their lives (7).
619 millions
In 2020, more than 619 million people worldwide suffered from back problems.
843 millions
It is estimated that this figure will rise to 843 million by 2050.
+ 36%
An increase of 36% in 30 years (8).
What are the symptoms of low back pain?
The most easily identifiable symptoms are:
Lower back pain
These pains in the lumbar vertebrae are often described as dull or sharp, or even as a sensation of electric shock.
Pain radiating to the legs if a spinal nerve root is affected
Leg pain can be accompanied by numbness or tingling and weakness of certain muscles. They are linked to the spinal column (sometimes called sciatica or radicular pain).
Stiffness and restrictions of movement
Muscle spasms
Faced with this pain, which can be acute, resting is a mistake that should be avoided at all costs. You should keep up your physical and social activities as close to normal as possible and consult your GP (2).
The doctor diagnoses common low back pain by observing the patient's symptoms and ruling out other possible causes. So-called "symptomatic" low back pain, i.e. due to an illness, fracture, infection or tumour, must be ruled out from the outset.
If the pain persists for more than six weeks, it is known as subacute low back pain. It is then advisable to consult your GP again. The latter may prescribe medical imaging tests if necessary. After twelve weeks, the condition is known as chronic low back pain. In this case, a medical consultation is essential in order to reassess the clinical situation, enrol the patient in a coordinated multi-professional care plan and inform him/her of possible surgical options.
What causes low back pain?
When it comes to low back pain, it is difficult to identify a single cause, as it often has a multifactorial origin. The most common causes of low back pain are:
Damage to the muscles, ligaments and tendons that provide support and function to the spine, often due to the handling of heavy objects or sudden movements.
Trauma
Ruptured discs, such as herniated discs, which can compress nerves (3)
Disc degeneration
Arthritis (4)
Bone irregularities such as scoliosis (Cause of specific low back pain)
Osteoporosis (5)
Bad posture
Sedentary lifestyle
Underlying medical pathologies (in the case of specific low back pain)
Low back pain is highly prevalent. At work, handling heavy objects, wrong movements, falls, exposure to vibrations, trauma and stress frequently cause low back pain. While occupational risk factors are important, others, such as personal predisposition, certain pathologies, risks taken in the course of domestic or leisure activities, and psychosocial risks, can be added to them: physical inactivity, obesity , smoking, vascular disorders or pregnancy can all cause low back pain. Stress at work, depression, anxiety and depressive syndrome are psychosocial risk factors for chronic back pain.
What are the treatments for low back pain?
Drug treatments
If the symptoms of low back pain are unbearable, the doctor treating the patient may prescribe painkillers or anti-inflammatories, the aim being to relieve the pain so that the patient can maintain physical activity and keep moving.
Physical activity
Your doctor may also advise you to do some exercises yourself to treat your back pain.
It is essential that you continue your activities, within the limits of your pain. This helps to prevent the condition becoming chronic. You need to be active, build up your muscle mass and adopt a healthy lifestyle. Physical activity is one of the pillars of treatment, as the CNAM awareness campaign reminds us: "BACK PAIN? THE RIGHT TREATMENT IS MOVEMENT!(2).
Lumbar belts
Wearing a lumbar belt can help you get back to work as quickly as possible. We invite you to read our article on the benefits of wearing a belt for low back pain . Continuing to work is part of the treatment for low back pain (6).
In some rare cases, low back pain may be caused by an underlying pathology. Certain specific signs and symptoms traditionally referred to as "red flags" need to be identified, such as the onset of the first painful episode at an early or late age, recent major trauma, intravenous drug use, immunodepression, unexplained weight loss or extensive neurological disorders, etc. In such cases, emergency medical and surgical treatment may be required.
The prevention of low back pain is based on a multi-factorial approach: adapted physical activity, maintaining a healthy weight, ergonomics at work, stress management and stopping smoking. These measures help to reduce pressure on the lumbar spine and prevent recurrences.
FAQ about low back pain
Our medical team answers the questions you may have.
Studies do not provide conclusive scientific evidence that the use of a lumbar brace leads to trunk muscle weakness or muscle atrophy. The mode of action of lumbar belts is based on increasing intra-abdominal pressure by tightening the device around the spinal column. This distributes the load more evenly over the intervertebral discs, providing immediate pain relief without adversely affecting the muscles. (9) To find out more, read our article on the subject.
Although lower back pain is commonly referred to as 'lumbago', in reality the term 'lumbago' is often used to describe an acute, sudden onset form of lower back pain.
There are many causes of low back pain, depending on the type of pain.
Non-specific low back pain: This is generally due to mechanical factors such as poor posture, lack of exercise, excessive physical effort, stress, being overweight or carrying heavy loads. These factors can damage the muscles, ligaments and tendons that support the spine.
Specific back pain: In some cases, back pain can be caused by conditions such as herniated discs, lumbar stenosis, ankylosing spondylitis, or even more serious conditions such as cancer or infection.
A distinction is made between common lower back pain and so-called "specific" lower back pain, which is the result of an illness (tumour, fracture, infection). If the back pain heals in less than 4 to 6 weeks, the lower back pain is said to be "acute". If the pain persists beyond this period for up to 12 weeks, it is known as "subacute" low back pain. After 12 weeks, it becomes "chronic".
Although low back pain is often manageable with home treatments, some symptoms require medical attention. Consult a doctor if you feel :
Severe pain that does not improve with rest
Pain radiating down one or both legs, especially if it goes below the knee
Weakness, numbness or tingling in the legs
Unexplained weight loss
Pain associated with a recent injury or trauma
To find out more, read our article on the subject.
Low back pain is pain in the lower back. It is classified as acute, sub-acute or chronic depending on its duration. Each of these stages requires specific treatment.
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Assurance Maladie. (2017). Quelques éléments d'information destinés aux professionnels de santé concernant LE PATIENT ADULTE ATTEINT DE Lombalgie commune, après avis de la HAS (consulted on 16/10/2024)
Agius R, Fouquet N, Soullier N, Ohouo D, Schramm S, Chazelle É. Factors associated with the French population's adherence to recommendations for the prevention of chronic low back pain, following the Assurance maladie's general public campaign: "Mal de dos? The right treatment is movement". Bull Epidémiol Hebd. 2022;(13):222-8. http://beh.santepubliquefrance.fr/beh/2022/13/2022_13_1.html
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Shahvarpour, A., Preuss, R., Sullivan, M., Negrini, A., & Larivière, C. (2018). The effect of wearing a lumbar belt on biomechanical and psychological outcomes related to maximal flexion-extension motion and manual material handling.. Applied ergonomics, 69, 17-24 . https://doi.org/10.1016/j.apergo.2018.01.001.
Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007 May;25(2):353-71. doi: 10.1016/j.ncl.2007.01.004. PMID: 17445733.
Anders C, Hübner A. Influence of elastic lumbar support belts on trunk muscle function in patients with non-specific acute lumbar back pain. PLoS One. 2019 Jan 24;14(1):e0211042. doi: 10.1371/journal.pone.0211042. PMID: 30677095; PMCID: PMC6345453.
Azadinia F, Ebrahimi E Takamjani, Kamyab M, Parnianpour M, Cholewicki J, Maroufi N. Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J. 2017 Apr;17(4):589-602. doi: 10.1016/j.spinee.2016.12.005. Epub 2016 Dec 14. PMID: 27988341.
Takasaki H, Miki T. The impact of continuous use of lumbosacral orthoses on trunk motor performance: a systematic review with meta-analysis. Spine J. 2017 Jun;17(6):889-900. doi: 10.1016/j.spinee.2017.03.003. Epub 2017 Mar 18. PMID: 28323240.
Molimard J, Bonnaire R, Han WS, Convert R, Calmels P. In-silico pre-clinical trials are made possible by a new simple and comprehensive lumbar belt mechanical model based on the Law of Laplace including support deformation and adhesion effects. PLoS One. 2019 Mar 6;14(3):e0212681. doi: 10.1371/journal.pone.0212681. PMID: 30840688; PMCID: PMC6402703.
