Cause of Low Back Stiffness

Lumbar strain and arthritis are the prime suspects

stiffness back

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Back stiffness is usually caused by muscle spasm or lumbar arthritis. The best way to differentiate the cause of lumbar spine stiffness is the onset of the symptoms.

People with stiffness caused by lumbar spine arthritis usually have steadily increased symptoms over years of a worsening problem. On the other hand, muscular stiffness is usually related to acute trauma (such as lifting a heavy weight incorrectly) in which the back muscles to seize up and immobilize the back muscles. Both are common occurrences, related in part to advancing age and increasing rates of obesity.

According to a research from Duke University, nearly 80 percent of Americans will experience at least one lower back injury at some point in their lives, the frequency of which is only second to the common cold.

Causes

When characterizing back stiffness with or without acute pain, doctors will generally investigate two common causes: lumber strain and lumbar spine osteoarthritis.

Lumbar Strain

A lumbar strain is the most common cause of back stiffness. This problem occurs as a result of an injury to the back muscles and ligaments that support the spinal column. Patients may or may not remember the initial event that triggered their muscle spasm, but the symptoms of a lumbar muscle strain can be severe.

The strain will occur in around the muscles that support the spine:

  • Extensors (back and buttock muscles)
  • Flexors (abdominal muscles and hip muscles)
  • Obliques or rotators (side muscles)

Diagnostic testing is usually not necessary unless the stiffness and pain persist for more than two weeks. If they do, your doctor would order an X-ray or magnetic resonance imaging (MRI) to help identify the underlying cause.

Lumbar Spine Osteoarthritis 

Lumbar spine osteoarthritis is a progressive condition in which the joints of the vertebrae are damaged by long-term wear and tear. As arthritis progresses, cartilage and discs in the lumbar spine begin to thin and disappear, causing stiffness and pain as bone rubs against bone. This can make movements such as bending, stooping and twisting very difficult.

While X-rays can confirm osteoarthritis by detecting bone damage, bone spurs (osteophytes), bone remodeling (ossification), and the loss of joint cartilage, they may be less useful in early-stage arthritis when the signs are less visible.

Clinician experience is crucial in making an informed diagnosis in the absence of definitive imaging evidence.

Treatment

The treatment of these two conditions is different, and therefore it is important for patients to determine the cause of their symptoms prior to initiating any treatment program. In general, most patients with back stiffness will benefit from the following treatments:

  • Light activity is advised when overcoming back stiffness. In the past, bed rest was the first-line course of treatment but that's rarely the case in anything but the most severe back injuries. Most doctors today recommend light activity rather than complete immobilization. While you should avoid lifting and twisting, performing light activity can actually be very helpful in relieving discomfort.
  • Ice and heat application can be very helpful treatments at relieving back stiffness. In particular, gently heating the spine before activities can help to loosen and relax sore muscles and relieve some tension in the lumbar spine.
  • Over-the-counter pain medications can also be very helpful. The simplest, and often the most effective, are nonsteroid anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen). While prescription muscle relaxers and NSAIDs like Celebrex (celecoxib) may be used if the over-the-counter drugs fail, opiates should never be used for typical low back stiffness.
  • Gentle back stretches and exercises can also help to relieve low back stiffness. A simple program of therapeutic activity can be helpful, or many patients find benefit from activities such as yoga or Pilates.

As mentioned, there are specific treatments for the aforementioned conditions that can be pursued once you have a clear understanding of the cause of spine stiffness, but these simple treatments should get you started in the right direction.

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