Lower Back Pain

Lower Back Pain


The back is made out of blocks of bone called vertebrae. Between these blocks are intervertebral discs made up of softer tissue. At the back end of these blocks of bone there are joints called facet joints that permit movement. Through these blocks of bone pass the spinal cord and nerves. Between these structures are ligaments that hold the structures together, and surrounding them all are the paraspinal muscles.

Causes & Symptoms

Back pain can be divided into serious and non-serious causes, both of which can be extremely painful.


The overwhelming majority of back pain is due to excess weight, poor posture and lifting technique combined with wear and tear of the joints around the back. This is made worse by carrying extra weight and a sedentary lifestyle. Spasm can also set in making the whole experience even more painful. This kind of back pain is often referred to as functional back pain.

In the young and middle aged, one of the intervertebral discs may pop out its contents and touch a nerve. This is known as a herniated disc and the individual presents with back pain shooting down the back of one or both legs like an electric shock. There may be associated weakness and numbness in the leg.

A deformity in the shape of the spine (scoliosis, exaggerated kyphosis or lordosis) may cause back pain due to the muscle imbalance.

Young athletes in sports that involve repeated back movement (e.g. bowling in cricket) my experience lower back pain due to a shift in the bones around the lower back.


If an intervertebral disc herniates in a particular way, it can interfere with the nerves that supply the bladder, bowels and genital area. This is known as cauda equina syndrome and is an emergency. It manifests as severe back pain with bilateral leg weakness, problems with bladder (self-wetting or unable to urinate), bowels (constipation or incontinence) and loss of sensation in the genital area.

Tumours or an infection in or around the back may present as severe, unrelenting back pain, even at night, and is often accompanied by other symptoms such as weight loss, loss of appetite, fever, nausea and malaise.


Treatment largely depends on the cause of the pain. In functional back pain, we always start with lifestyle changes – weight loss, exercise including yoga to strengthen core muscles, avoiding sitting for long periods of time, ergonomic chair - and this can be supplemented with a short course of painkillers and muscle relaxants. If the pain persists then the surgeon may consider an MRI scan to look for an alternative source of your pain.

For more information on how to prevent backpain click here.