Lower Back Pain When Bending - Causes and Solutions

Lower back pain when bending over can be a debilitating condition that affects many individuals. The ability to bend over is essential for daily activities, so those who experience pain may consider it a contributory factor to the decrease in their quality of life.

In this article, we will explore the causes of lower back pain when bending over and discuss various solutions to alleviate the discomfort.

Understanding the Anatomy of the Back

Up to 80% of Singaporean adults are impacted by low back pain, highlighting its widespread occurrence. To comprehend the causes of lower back pain when bending over, it's essential to familiarise ourselves with the anatomy of the back.

The lower back, also known as the lumbar region, consists of five vertebrae (L1-L5) that support the weight of the upper body. The intervertebral discs between the vertebrae act as shock absorbers, providing flexibility and cushioning. Additionally, the back muscles, ligaments, and tendons surrounding the spine provide stability and allow for movement.

Risk Factors Associated With Lower Back Pain

Several risk factors can contribute to lower back pain when bending over. Here are some of them:

Age

As people age, the discs in the spine lose some of their water content and become less flexible, which can lead to degeneration and herniation. The joints and ligaments in the spine can also degenerate over time, leading to stiffness and pain.

Older adults may also be more likely to have medical conditions or take medications that increase their risk of lower back pain. They may also be more likely to have experienced previous injuries or have a history of physical activity that can contribute to the development of back pain.

Sedentary Lifestyle

A sedentary lifestyle can put a person at risk of lower back pain due to several reasons.

When a person sits for long periods without adequate movement and exercise, it can lead to muscle imbalances, weakened core muscles, and reduced flexibility and strength in the back and abdominal muscles. This can put excessive strain on the spine and its supporting structures, leading to pain and discomfort in the lower back.

A sedentary lifestyle is also often associated with obesity and metabolic disorders, such as high blood pressure, type 2 diabetes, and hyperlipidemia, all of which can contribute to the development of lower back pain.

Poor Posture

Poor posture can put a person at risk of lower back pain in several ways:

Incorrect posture can result in stiffness, muscle weakness, and strain on the muscles, tissues, joints, and spinal discs. This can ultimately lead to discomfort and pain in the affected areas.

Unsupported postures can also cause the loads on the spine to disperse incorrectly, weakening the tissues in the lower back.

Poor posture can also result in muscle imbalances, weakened core muscles, and reduced flexibility and strength in the back and abdominal muscles.

Obesity

Obesity can put a person at risk of lower back pain due to several reasons:

Carrying excess weight puts pressure on the spine, leading to increased stress on the lower back. This pressure can cause strain on the muscles, ligaments, and joints in the lower back, resulting in pain.

Obesity can alter posture and body mechanics, which can further contribute to lower back pain. An altered posture can put additional stress on the spine and lead to muscle imbalances.

Obesity is associated with inflammation and disc degeneration, which can also contribute to lower back pain.

Heavy Lifting and Other Repetitive Motions

Age is a significant factor, as the natural wear and tear on the spine increases with time. Sedentary lifestyles and poor posture also play a role in the development of back pain. Obesity can put excess strain on the back, leading to pain and discomfort. Furthermore, individuals who engage in repetitive motions or heavy lifting are at a higher risk of experiencing lower back pain when bending over.

Underlying Medical Conditions Associated With Lower Back Pain

Various underlying medical conditions can cause discomfort and lower back pain when bending over. The following medical conditions may be the reasons behind someone's lower back pain:

Muscle Spasms, Muscle Pain, or Muscle Strain

Muscle spasms, muscle pain, and muscle strain can cause lower back pain when the muscles in the back are affected, leading to stiffness, limited mobility, and localised pain.

Muscle spasms occur when the muscles contract suddenly and involuntarily, leading to pain and discomfort. Muscle pain refers to the sensation of discomfort or soreness in the muscles, which can be caused by overuse, injury, or inflammation. Muscle strain, also known as a pulled muscle, occurs when the muscle fibres stretch or tear, usually due to excessive force or repetitive motion

Herniated Disc

A herniated disc, also known as a slipped disc or ruptured disc, occurs when all or part of a disc in the spine is forced through a weakened part of the spine. This condition is one of the most common causes of lower back pain and can also cause leg pain or sciatica.

The herniated disc can irritate nearby nerves, leading to symptoms such as pain, numbness, or weakness. The pressure placed on the nerves or spinal cord by the herniated disc can result in discomfort and limited mobility.

Spinal Stenosis

Spinal stenosis is a medical condition where the spinal canal narrows, resulting in compression and pressure on the spinal cord and nerve roots. It commonly occurs in the lumbar (lower back) and cervical (neck) spine.

The condition can cause various symptoms, including pain, numbness, tingling, and weakness in the arms, legs, back, or neck. These symptoms can vary depending on the location and severity of the stenosis.

Spinal stenosis can be caused by ageing, age-related changes in the spine, injury, other diseases, or inherited conditions. Arthritis is also a common cause of this condition.

Sciatica

Sciatica is a condition characterised by irritation of the sciatic nerve, which is the longest nerve in the body. It typically causes pain that originates in the lower back or buttock and radiates down the leg.

The pain can be accompanied by symptoms such as numbness, weakness, and altered reflexes. The most common cause of sciatica is a herniated disc, but it can also be caused by spinal stenosis, inflammation, injuries, or certain diseases.

Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory condition that primarily affects the spine. It is a form of arthritis that causes long-term inflammation in the spine, starting from the sacroiliac joints and potentially spreading to the vertebrae joints.

The inflammation leads to symptoms like back and hip pain, as well as stiffness. Over time, the condition can cause new bone formations that fuse sections of the spine, resulting in rigidity.

Spondylolysis

Spondylolysis is a condition characterised by a stress fracture in one of the vertebrae, which are the small bones that make up the spinal column.

This stress fracture, also known as a pars fracture, commonly occurs in athletes and is particularly prevalent in young athletes who frequently bend backwards. The fracture typically affects the pars interarticularis, a bone structure that connects the facet joints of the spine.

Spondylolisthesis

Spondylolisthesis is a condition where one vertebra slips forward over the vertebra below it. It's often caused by spondylolysis, which is a stress fracture defect in the vertebrae, especially when left untreated.

The said conditions differ in various ways. For instance, spondylolisthesis can result in localised pain, nerve compression, and difficulties with balance or walking.

On the other hand, spondylolysis itself rarely causes pain, but when it does, it typically affects children and adolescents. It occurs in the lumbar spine and primarily affects the L5 vertebra.

Diagnosing Your Lower Back Pain

When experiencing lower back pain when bending over, it is important to seek medical attention for an accurate diagnosis. Physicians would want to determine the cause of the back pain, especially when it gets severe after sitting down, rising from the chair, or straightening the back after bending forward.

They will do a thorough history taking and physical examination and may request laboratory tests and imaging techniques.

Medical History and Physical Examination

A healthcare professional can diagnose lower back pain by taking a detailed medical history and conducting a thorough physical examination. During the medical history, the healthcare professional will ask about the onset, duration, and characteristics of the pain, as well as any accompanying symptoms. They may inquire about previous injuries, medical conditions, and lifestyle factors that could contribute to the pain.

During the physical examination, the healthcare professional will assess the patient's range of motion, muscle strength, and reflexes. They may perform specific tests to identify the source of the pain, such as the straight leg raise test for sciatica or the slump test for nerve-related pain. They will also palpate the back to check for tenderness or muscle spasms.

Based on the information gathered from the medical history and physical examination, the healthcare professional can make an accurate diagnosis and develop an appropriate treatment plan. However, in some cases, further diagnostic tests such as X-rays, MRI, or CT scans may be ordered to confirm the diagnosis or rule out other underlying conditions.

Laboratory Tests

Healthcare professionals can diagnose lower back pain through laboratory tests by conducting a comprehensive evaluation that may include blood tests. These tests can help identify possible causes of back pain, such as inflammatory or medical disorders.

A complete blood count and determination of erythrocyte sedimentation rate are common tests used to assess for infection or inflammation. Other specific tests may also be ordered depending on the suspected cause of the pain.

Imaging Techniques

A healthcare professional may request imaging techniques such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans to further aid in diagnosing a patient's lower back pain. These imaging tests can help identify any anatomical abnormalities or underlying conditions that may be causing the pain.

Treatment Options for Lower Back Pain

Fortunately, there are various treatment options available to alleviate lower back pain when bending over. For minor pain relief, non-surgical methods are highly recommended, while for severe and chronic pain, invasive procedures like surgical intervention may be resorted to.

Non-Surgical Methods

Non-surgical methods are often the first line of treatment and may include lifestyle modifications, such as strengthening exercises and weight management.

Over-the-counter medications, like nonsteroidal anti-inflammatory drugs (NSAIDs), can also relieve pain, especially for acute back pain. Physical therapy and physiotherapy may also be recommended to strengthen the muscles supporting the back and improve flexibility.

Lifestyle Modification

Lifestyle modifications can help relieve lower back pain by addressing various factors that contribute to the condition. Some effective changes include:

Managing stress: Stress can exacerbate back pain. Techniques such as cognitive behavioural therapy and meditation can help reduce stress levels and alleviate pain.

Maintaining a healthy weight: Excess weight puts strain on the spine, leading to back pain. Achieving and maintaining a healthy weight through proper nutrition and regular exercise can help relieve the pressure on the lower back.

Getting enough sleep: Poor sleep quality and inadequate sleep can worsen back pain. Practicing good sleep hygiene, such as maintaining a consistent sleep schedule and creating a comfortable sleep environment, can aid in pain relief.

Incorporating physical activity: Regular exercise strengthens the muscles that support the spine and improves flexibility. Low-impact exercises like swimming, walking, and yoga can help relieve lower back pain.

Making ergonomic adjustments: Ensuring a proper workstation setup and using ergonomic furniture can help maintain good posture and reduce strain on the back.

Over-the-Counter Medication

Over-the-counter medication, specifically nonsteroidal anti-inflammatory drugs (NSAIDs), can help relieve lower back pain. NSAIDs are commonly used for pain relief and reducing inflammation in musculoskeletal conditions like osteoarthritis and back pain. They work by blocking enzymes involved in inflammation, thereby reducing pain and inflammation. NSAIDs can be purchased without a prescription in lower doses and are suitable for mild to moderate pain and inflammation.

Hot and Cold Therapy

Hot and cold therapy can be effective home remedies for relieving lower back pain.

Applying heat for 15 to 20 minutes at a time, using methods like hot packs, baths, or showers, can help decrease pain. Moist heat is more effective than dry heat, and all-day heat wraps are also available.

On the other hand, cold therapy can help with pain, swelling, and inflammation. Ice packs, commercial cold packs, ice towels, or homemade slush packs can be used to ice the affected area for 10 to 15 minutes at least 3 times a day, particularly in the first 72 hours.

Physical Therapy

Physical therapy, which involves guided therapeutic exercises and hands-on care by a physical therapist, can be highly effective in relieving lower back pain. The goals of physical therapy are to decrease pain, improve function, and prevent future problems.

Physical therapists can diagnose low back pain through evaluation and physical exams, and imaging tests are often not necessary. Treatment may include manual therapy, exercise, and other techniques that can avoid surgery and medication.

Physiotherapy

Physiotherapy is a form of treatment that focuses on improving physical function and mobility through various techniques. It aims to reduce pain, improve range of motion, strengthen muscles, and promote overall healing and recovery.

Physiotherapists are experts in diagnosing the cause of pain and developing personalised treatment plans. They may use techniques such as massage, joint mobilisation, acupuncture, ergonomic advice, and exercise to alleviate pain and improve function.

Phoenix Rehab Singapore is one of the leading providers of holistic treatments, including physiotherapy, in Singapore. Our multidisciplinary team of healthcare professionals collaborates and offers different services, including back pain physiotherapy and chiropractic therapy, that can help provide pain relief through comprehensive and personalised treatment plans.

Surgery and Other Methods

In severe cases where conservative treatments fail to provide relief, surgery may be considered.

Surgical procedures can address underlying causes of lower back pain, such as herniated discs or spinal stenosis. However, surgery is typically reserved for cases where all other treatment options have been exhausted.

Minimally invasive techniques, such as steroid injections, microdiscectomy, or spinal fusion, may also be done, and are commonly performed to alleviate pain and restore function.

When to Seek Medical Attention from a Physician

It is crucial to know when to seek medical attention for lower back pain when bending over. Thankfully, the majority of Singaporeans understand the need to seek medical attention immediately especially when the pain persists for more than a few weeks, a condition referred to as chronic low back pain.

In fact, in a study on the impact of persistent back pain on the different aspects of the quality of life in Singapore, it was found that for those who reportedly experience chronic low back pain, 80.5% found treatments for their condition.

Other indications to seek immediate medical attention include:

Trauma or other injury precedes the severe back pain that the patient experiences

Severe pain with no pain relief even after resting

Severe lower back pain that extends to the legs, especially below the knee

Severe pain includes numbness, tingling, weakness

Severe symptoms accompany chronic back pain, including unexplained weight loss, fever, and bowel or bladder dysfunction

Final Words

Lower back pain, especially when bending over, can be distressing, but with proper understanding and management, it is possible to find relief. Additionally, seeking lower back pain physiotherapy when necessary and exploring various treatment options will contribute to your overall well-being. Remember, prevention and early intervention are key to maintaining a healthy back and enjoying a pain-free life.