Lower back pain is among the most common causes of pain among adults. It accounts for over 3% of emergency room visits.¹ When your back hurts, it can be uncomfortable, debilitating, and downright scary.
If you experience lower back pain when arching backward, don't panic. There can be many reasons for this type of pain, and learning what they are and how to avoid them can help improve or maintain your health and wellbeing.
Let's look at the reasons behind lower back pain and discuss what you can do about it.
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Your lower back consists of several parts:
Intervertebral disks (a form of cartilage)
If you experience lower back pain when bending, any one of these structures could be causing you pain. Poor movements or extra pressure through these parts of the spine may occur as you arch backward. Examples of common conditions which may cause lower back pain when arching backward include:
Arching or bending your back is a normal day-to-day movement. However, if you do this while lifting a heavy object or repeatedly, you may risk overstretching your lower back muscles. Especially if you’re exercising, try warming up beforehand.
Besides pain in the lower back, the common symptoms of pulled lower back muscles include:
Pain that worsens with movement
Stiffness that leads to difficulty walking or standing
Relief when in a resting position
Lower back pain from muscle strains can seem significant, but people with this injury will tend to recover within two to four weeks. However, intermittent pain flare-ups can continue for six weeks or even longer.
What can you do?
If you think that you pulled a lower back muscle, below are some potential treatment options:
Applying an ice pack for 10–20 minutes immediately after injury
Using a heat pack for 10–20 minute sessions during the back has spasmed
Walking around to reduce stiffness and increase blood circulation
Massaging the affected area after 24-48 hours after injuring it
If the problem doesn't go away after several days, consider contacting a doctor. You may require further investigations or pain relief to help your muscles heal.
If you experience lower back pain when bending forward and backward, you could have a herniated disk. This injury can occur over time or after an awkward movement, e.g., lifting something heavy, bending forward suddenly, etc. While herniated disks can cause pain when bending backward, they will usually be aggravated by bending forward.
Common symptoms of a herniated disk include:
Pain and stiffness, particularly bending forward
Sciatica symptoms, e.g., numbness, tingling, burning down the leg
Discomfort and pain when moving
Weakness down the leg
What can you do?
About 90% of people who sustain disk herniation in the lower back will stop experiencing symptoms after about six weeks, even without medical treatment.² You can relieve pain by:
Resting for a couple of days (especially the first 24–48 hours)
Taking over-the-counter anti-inflammatories or pain medication
Seeing a physical therapist
If symptoms don't go away after six weeks, you may need assistance from a healthcare professional, e.g., a physical therapist or doctor, for further investigation and treatment. In rare cases, you may need surgery.
Facet joints are located behind intervertebral disks and act as a connection between the spinal vertebrae. These joints connect between the bony parts of the back to form the spine. They help your spine bend backward and forward while preventing excessive rotation and keeping vertebrae from slipping. In short, these joints are like hinges that help stabilize your spine.
Problems of the facet joints are one of the common sources of lower back pain as you arch backward. Swelling of the facet joints from inflammation and aging can account for up to 45% of lower back pain cases.³
Symptoms of facet joint problems include:
Lower back pain, especially when bending backward or keeping upward
Stiffness in the lower back
Possibly sciatica symptoms, e.g., numbness, tingling, burning down the leg
Tight lower back or thigh muscles
What can you do?
Those that have been diagnosed with facet joint problems should consider:
Supportive brace for temporary use
Anti-inflammatory and pain-relief drugs
People who do not respond to these treatments may consider additional treatment, including injections and surgical procedures.
If you experience sharp lower back pain when arching backward, it could be due to spondylolysis. This occurs when there is a fracture of the ‘pars interarticularis’ — the bony part of the vertebrae between the joints above and below.
Up to 7% of Americans have been diagnosed with spondylolysis.⁴ It can occur when you repeatedly extend your spine, e.g., serving in tennis or performing a cobra stretch in yoga.
Besides sharp pain, you may experience:
Stiffness in the lower back
Discomfort when arching or bending backward
Pain that radiates to the back of your thighs and the buttocks
Pain that gets worse with activity, particularly when standing
Pain that improves with rest, particularly when sitting
Those who have been experiencing these symptoms for several weeks or months should contact a medical professional.
What can you do?
If you have been diagnosed with spondylolysis, below are some treatments that can help manage your symptoms:
Using ice or heat to ease pain and spasm
Limiting extension or backward arching movements, e.g., cobra, shoulder press, etc.
Over-the-counter medication, such as anti-inflammatories and pain medication
Attending physical therapy
In case the pain doesn't subside, contact your doctor. They may recommend stronger pain relief medications, steroid injections, and physical therapy. In rare cases, you may need to wear a brace for short periods to help with recovery.
When it comes to spondylolysis, the earlier you start the treatment, the better the outcome. If not treated promptly, the condition can lead to spondylolisthesis, where the fracture causes vertebrae to slip out of place.
Lower back pain when bending forward and backward can also be caused by:
Lumbar fracture - This injury can occur during trauma, especially if someone has osteoporosis. Postmenopausal women are especially at risk.
Pre-existing spinal condition – If you've had a previous injury, e.g., fracture or osteoarthritis, you are at a higher risk of stirring up your lower back pain.
Disease – Although rare, some conditions can cause lower back pain. Examples include kidney stones, infections, lupus, spinal tumors, and auto-immune diseases.
Whatever the causes of your lower back pain are, you may want to see a doctor about it. Some of these conditions could lead to serious consequences for your health and well-being when left untreated.
Keep these tips in mind to prevent lower back pain when bending backward or forward.
Bend your hips, legs, and squat before lifting heavy objects
Spend more time sitting forward rather than standing
Sleep with a pillow underneath the knee
Perform exercises to strengthen your core, lower back, and leg muscles
Do a complete warm-up before exercising
Stop smoking to reduce inflammation throughout the body
Be careful with your exercise routine. You may want to consult a physical therapist beforehand
If you feel lower back pain when arching backward, you should consider contacting a doctor if:
The pain is sharp and doesn't respond to over-the-counter medications
The pain lasts for more than two weeks and limits your day-to-day activities
You have to see a doctor immediately if:
You spike a fever after experiencing lower back pain
Experiencing difficulty urinating and with bowel movements
Losing your strength in your arms and legs
You notice serious swelling and redness on your back
Under these circumstances, the first point of contact is your primary care physician or family doctor. They can refer you to a specialist like a neurosurgeon and orthopedic surgeon for further treatment in rare cases. However, they may recommend seeing other healthcare professionals instead, such as a physical therapist or chiropractor.
If you experience lower back pain when arching backward, it could mean anything from a strained muscle to a spine fracture. Although you can manage some symptoms at home, you should also consider contacting a relevant health professional, particularly if the pain is not getting better.
While most symptoms disappear with treatment, some lower back conditions may need more specialized treatment, including stronger medications, injections, and even a referral to a surgeon. Your physician may recommend these options depending on your situation.
Ideally, regular exercise, weight management, and kicking bad habits should be the first option for tackling most lower back problems.
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