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Pain felt in the lower back may come from the spine, muscles, nerves or other structures in that region. It may also radiate from other areas like the mid or upper back, a hernia in the groin, or a problem in the testicles or ovaries.

What are the symptoms?
Patients may feel a variety of symptoms if they've hurt their back. They may have a tingling or burning sensation, a dull aching or sharp pain. They also may experience weakness in legs or feet.

Sometimes it’s not just one event that causes pain. Many things could contribute, such as standing, sitting or lifting for a long time. Then suddenly, one simple movement, such as reaching for something in the shower or bending from your waist, leads to the feeling of pain.

You are at particular risk for lower back pain if you:
-- Are over age 30
-- Are pregnant
-- Feel stressed or depressed
-- Have a low pain threshold
-- Have arthritis or osteoporosis
-- Have bad posture
-- Smoke, don't exercise or are overweight
-- Work in construction or another job requiring heavy lifting, lots of bending and twisting, or whole body vibration (like truck driving or using a sandblaster).

How is it diagnosed?
The specific structure in the back responsible for pain is hardly ever identified. Whether identified or not, there are several possible sources of low back pain:

-- Aortic aneurysm
-- Degeneration of the disks
-- Kidney problems, such as infections or stones
-- Muscle spasm (very tense muscles that remain contracted)
-- Other medical conditions like fibromyalgia
-- Poor alignment of the vertebrae
-- Ruptured or herniated disk
-- Small fractures to the spine from osteoporosis
-- Spinal stenosis (narrowing of the spinal canal)
-- Spine curvatures (like scoliosis or kyphosis), which may be inherited and seen in children or teens
-- Strain or tears to the muscles or ligaments supporting the back

Lower back pain from any cause usually involves spasms of the large, supportive muscles alongside the spine. The muscle spasm and stiffness accompanying back pain can feel particularly uncomfortable.

How is it treated?
Doctors will ask questions about the back pain, including how often it occurs and how severe it is. They will try to determine the cause of the back pain and whether it is likely to get better quickly with simple measures, such as: 

-- Ice
-- Mild painkillers
-- Physical therapy
-- Proper exercises

Most of the time, back pain will get better using these approaches. Sometimes patients will require injections of cortisone, an anti-inflammatory drug, or surgery.

What research is being done?
Researchers are examining the use of different drugs to effectively treat back pain, in particular, chronic pain that has lasted at least six months. Other studies are comparing different health care approaches to the management of acute lower back pain (standard care versus chiropractic, acupuncture or massage therapy). These studies are measuring symptom relief, restoration of function and patient satisfaction.

Some research compares standard surgical treatments to the most commonly used nonsurgical treatments to measure changes in health-related quality of life among patients suffering from spinal stenosis.

Read the National Institute of Neurological Diseases and Stroke for more information on back pain research.

Can it be prevented?
Exercise is important for preventing future back pain. Through exercise you can:

-- Improve your posture
-- Strengthen your back and improve flexibility
-- Lose weight
-- Avoid falls
-- A complete exercise program should include aerobic activity (like walking, swimming, or riding a stationary bicycle) as well as stretching and strength training.

To prevent back pain, it is also very important to learn to lift and bend properly. Follow these tips:
-- If an object is too heavy or awkward, get help.
-- Spread your feet apart to give a wide base of support.
-- Stand as close to the object you are lifting as possible.
-- Bend at your knees, not at your waist.
-- Tighten your stomach muscles as you lift the object up or lower it down.
-- Hold the object as close to your body as you can.
-- Lift using your leg muscles.
-- As you stand up with the object, do not bend forward.
-- Do not twist while you are bending for the object, lifting it up, or carrying it.

Other measures to take to prevent back pain include: 
-- Avoid standing for long periods of time. If you must for your work, try using a stool. Alternate resting each foot on it.
-- Do not wear high heels. Use cushioned soles when walking.
-- When sitting for work, especially if using a computer, make sure that your chair has a straight back with adjustable seat and back, armrests, and a swivel seat.
-- Use a stool under your feet while sitting so that your knees are higher than your hips.
-- Place a small pillow or rolled towel behind your lower back while sitting or driving for long periods of time.
-- If you drive long distance, stop and walk around every hour. Bring your seat as far forward as possible to avoid bending. Don't lift heavy objects just after a ride.
-- Quit smoking.
-- Try to lose weight.
-- Learn to relax. Try methods like yoga, tai chi or massage.

Sources:
-- MedlinePlus
-- National Institute of Neurological Diseases and Stroke

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