What causes lower back pain?

Lower back pain is one of the most common health complaints in the UK, affecting an estimated three in five adults (60%) at some point in their lives. Whether it’s a dull ache or a sharp, intense pain, it can disrupt daily activities and impact overall quality of life.

Understanding what causes lower back pain is key to finding effective solutions for relief and prevention. While the pain may seem overwhelming at times, recognising the root cause is an important step towards managing or even eliminating it.

In this article, we’ll explore the most common causes of lower back pain.

What causes back pain in the lower back?

Most cases of lower back pain can be alleviated with topical anti-inflammatory gels, which provide targeted relief by reducing inflammation and easing muscle soreness directly at the site of the pain. These gels work quickly to manage discomfort, especially for conditions like muscle strain or mild joint inflammation, so that movement feels less painful again..

However, while topical treatments offer temporary relief, other treatments may be necessary if:

Your back pain doesn’t improve after a few weeks of self-care treatment
The pain is severe or getting worse
You have other symptoms such as unexplained weight loss or a fever.

This blog focuses on the causes of lower back pain, and that’s because pain in different areas of the back can have different causes. In the event that your pain takes longer than expected to resolve, understanding where the pain originates can guide more effective, long-term treatment strategies.

Below, we discuss a range of possible causes for lower back pain.

Muscle strains

Muscle strains are one of the most common causes of lower back pain. They occur when the muscles or tendons in the lower back are overstretched or torn, often due to sudden movements, lifting heavy objects improperly or overexertion.

This can lead to localised pain, stiffness and limited mobility in the affected area. The pain from a muscle strain can vary from mild discomfort to sharp, intense sensations, especially when moving or bending.

Arthritis

Arthritis, particularly osteoarthritis, can cause lower back pain by affecting the joints in the spine. As cartilage breaks down due to arthritis, it can lead to bone-on-bone friction, causing inflammation, stiffness and pain in the affected area.

The degeneration of the spinal discs and joints can also result in a narrowing of the spaces between the vertebrae, which may irritate the nerves, leading to additional pain and discomfort. This type of pain is often persistent and worsens with movement or long periods of inactivity.

Trapped nerve (sciatica)

Trapped nerves such as sciatica can cause lower back pain, often resulting from pressure on the spinal nerves. When a nerve is compressed or irritated, it can cause pain, tingling, numbness or weakness in the lower back and sometimes radiating down the legs.

Sciatica specifically refers to pain that shoots along what’s known as the sciatic nerve, which spans from the lower back through the buttons and hips and down through the legs. It is usually caused by a slipped disc, bone spurs or narrowing of the spine (spinal stenosis), which puts pressure on the nerve.

The pain can be sharp and shooting, making movements difficult. Trapped nerves in the lower back can be aggravated by poor posture, heavy lifting or prolonged sitting. But, if the pain is isolated to your lower back and you’re not experiencing other symptoms such as tingling or numbness, sciatica is unlikely.

Slipped disc

A slipped disc, which can also be called a prolapsed or herniated disc, happens when one of the rubbery cushions (discs) between the vertebrae in the spine is damaged, causing the soft inner material to bulge outwards.

This bulging material can press on nearby nerves, leading to intense lower back pain. The pain may be sharp, sudden or persistent, and it can radiate down the legs if the sciatic nerve is affected (sciatica – see the section above).

A slipped disc often results from age-related wear and tear, but it can also be caused by lifting heavy objects improperly, sudden movements or repetitive strain. You may find that the pain worsens during certain activities like bending, twisting or lifting. In addition to pain, muscle weakness, numbness or tingling sensations can occur in the affected area.

Rare, more severe causes

While most lower back pain is caused by common issues like muscle strains or arthritis, there are rarer, more severe conditions that can lead to intense discomfort. These include:

• A broken bone
• Cancer
• Infections.

While these conditions can cause severe lower back pain, it’s important to emphasise that they are very rare and most lower back pain can be treated at home.

You should seek medical attention if:

• The pain is accompanied by a fever, unexplained weight loss or chest pain
• Your back is swollen or has changed shape
• You have chest pain
• You’re experiencing a loss of bladder or bowel control, or are finding it hard to use the toilet
• You have tingling, weakness or numbness in both legs, your genitals or your buttocks
• Your pain started after a serious incident like a car accident.

In the majority of cases, lower back pain can be effectively managed with gentle activity and targeted treatments like topical gels. However, understanding the potential causes, from common strains to rarer conditions, can help to guide the right approach for long-term relief and recovery.