Lower Back Pain When Walking

If you experience lower back pain when walking, you are not alone. Back pain is one of the most common reasons for visiting the doctor’s office, and it is estimated that 80% of the population will experience back pain at some point in their lives. Fortunately, back pain is usually short-lived and can be relieved with over-the-counter medications, stretches and exercises, and improved posture. A physical therapist can work with you to heal and prevent lower back pain when walking.

Understanding the Spine and Back Pain

The spine is integral for supporting the body while standing and protecting the nerves that allow the body to feel and move. The spinal column is made of dozens of bony segments called vertebrae. The vertebrae in the lower part of the spine (the “lumbar region”) are called lumbar vertebrae. Intervertebral discs between the vertebrae act as shock absorbers that prevent the vertebrae from rubbing together. Ligaments hold the vertebrae in place while tendons attach muscles to the spine. The hollow inside of the spine, called the spinal canal or spinal column, acts as a protective pathway for the spinal cord. The spinal cord includes dozens of nerves that transmit signals from the rest of the body to the brain.

Due to the important functions of the spine, back pain can disrupt many aspects of life.

What Causes Lower Back Pain

If you are experiencing lower or middle of back pain while walking, it could be due to disruption or damage to any of the structures in the lumbar region of the spine.

• Congenital spinal abnormalities, or spine issues that a person is born with due to their genetics, can result in lower back pain. The abnormalities can disrupt the structure of the spine and cause it to curve improperly or form incorrectly, leading to pain. Some of these irregularities include scoliosis, lordosis, kyphosis, and spina bifida. Since these issues are present early in life, newly experienced low back pain when walking is likely due to a different issue.
• Injuries that overstretch the ligaments in the spine can lead to a sprain, while tears in the tendons or muscles in the back result in a strain. Muscle spasms, or sudden and painful contractions of the muscles, can also cause back pain. Lifting something improperly or repeated strain on the back can lead to pain. Severe spine injuries from accidents like car collisions or falling can result in back pain and should be addressed by a medical provider.
• Degenerative problems are caused by the progressive breakdown or malformation of the spine. The normal stress and wear-and-tear on the spine can lead to degeneration of the intervertebral discs. Degraded discs do not cushion the vertebrae as effectively, so the vertebrae may rub together and cause pain. Discs may also become herniated or ruptured so that they bulge outward. A bulging disc compresses nerves near the spine, such as the sciatica nerve. Compression of the sciatica nerve results in pain that spreads along the path of the nerve, from the lower back into the leg. Spinal nerves are also compressed if the spinal column becomes too narrow (spinal stenosis), or if a vertebra slips out of its normal spot and pinches a nerve (spondylolisthesis).
• Infections of parts of the spine can cause pain.
• Diseases like osteoporosis (weakening of the bone) and inflammatory arthritis (like psoriatic arthritis and ankylosing spondylitis) can cause lower back pain.

Certain circumstances can increase the risk of experiencing back pain. These risk factors are:

• Genetics. Some people are born with spine irregularities that are genetically inherited.
• Health and fitness level. Muscles in the core of the body stabilize the spine. If these muscles are weak, the spine is not well supported and can cause pain. Being overweight also increases strain on the spine. A diet that lacks the bone-strengthening nutrients, calcium and vitamin D, can lead to the breakdown of the vertebrae. Smoking cigarettes can disrupt the flow of oxygen-rich blood to the intervertebral discs, eventually causing them to break down and lose their vertebrae-cushioning ability.
• Harmful physical activity. While many exercises can strengthen the muscles that support the spine, repeated heavy lifting, pushing, or pulling can be harmful to the spine, especially if done improperly. Activities like sitting at a desk all day with poor posture or frequently carrying heavy backpacks can also lead to muscle fatigue and pain.

How to Diagnose Lower Back Pain

Mild back pain from strain or muscle soreness is common. However, if the cause for lower back pain when walking is not known, doctors can use different diagnostic tools to find out.

• Blood tests can identify possible infections.
• Imaging tests allow doctors to see the spine and surrounding structures to determine if there is any damage. There are many different visualization technologies a doctor can use to examine the spine. An x-ray can show damaged bones and vertebrae. Computerized tomography (CT) scans show the soft tissues in the back, such as muscles and ligaments, and can be used to check for ruptured intervertebral discs, spinal stenosis, and tumors. Magnetic resonance imaging (MRI) can also show soft tissues as well as bony structures to identify damage or disruptions in the spine.
• Measuring electrical signals in the spine using different tests can tell a doctor if the spinal muscles and nerves are functioning correctly. An electromyography (EMG) measures electrical signals in the muscles, while nerve conduction studies (NCS) measure electrical signals in the nerves.

Most back pain can resolve on its own without the need for diagnostic tests. However, if a serious injury or disease is suspected that requires advanced treatment, diagnostic tests can help a physician choose the best treatment options.

How to Treat Back Pain

While identifying the source of back pain can help a physician determine a treatment plan in more severe cases, experts recommend starting with basic care for non-emergency back pain before pursuing advanced options. Treatment of back pain depends on the severity of pain and how long the pain has lasted. “Acute” lower back pain is short term, lasting only a few days to a few weeks. “Chronic” back pain lasts 12 weeks or longer, and treatment may require the help of a medical professional. While chronic pain may feel more disruptive, it does not necessarily mean that the injury is medically serious.

Acute back pain often resolves on its own with self-care. The American College of Physicians recommends starting with non-invasive, non-drug therapies such as massage, application of heat and acupuncture. Though you might want to hold still to relieve back pain, too much rest can actually make pain worse because the sedentary muscles can become stiff and sore. If pain is severe, short-term rest might be needed. However, simple movements, stretches, and exercises should be performed when possible. A physical therapist can create a stretching and exercise program to help relieve and prevent back pain. Medications such as analgesics (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs; ibuprofen, aspirin) can also provide relief for lower back pain.

Early treatment for chronic back pain includes non-drug practices such as stretches, exercises, and applying heat to the back. Medications to help with pain managements can also help relieve back pain, but should be used sparingly. This is especially true for the use of opioid drugs, which should be prescribed by a doctor and only used short-term (if at all) to prevent addiction. If lower back pain persists after these treatments, complementary and alternative approaches may provide pain relief. These treatments include dry needling, electrical impulses to block or modify what the pain feels like, and physical therapy.

If chronic lower back pain does not resolve after these treatments, a physician may recommend surgery as a last resort option. Though surgery has the possibility to repair damage in the spine that is causing back pain, it might not be successful, and there is usually a long recovery process. Surgery can remove or repair damaged vertebrae or discs, fuse vertebrae to prevent grinding, replace degraded intervertebral discs with artificial ones, or insert spacers into the spinal column to prevent nerve pinching caused by spinal stenosis. Physical therapy is an important part of recovering from surgery.

Current research is exploring new options for the treatment of back pain. Studies suggest that injecting platelet-rich plasma or certain cells into the spine area can help the spine heal and reduce back pain. The use of virtual reality has also been shown to help relieve acute and chronic back pain.

Certain back injuries require prompt medical attention. Contact your doctor immediately if lower back pain occurs with a fever, unexplained weight loss, or new bladder or bowel problems. Medical care should also be received for injuries to the spine or neck, like those suffered from a car accident or a fall.

Preventing Lower Back Pain

The best way to treat back pain is to prevent the possibility of it ever happening in the first place. Certain habits and techniques can help to properly protect and support the spine so that an injury is less likely to occur.

• A healthy lifestyle can prevent lower back pain. Exercises that strengthen the muscles surrounding the spine provide more support. Physical activity is also important for maintaining a healthy weight and being overweight can put extra stress on the spine. A healthy diet helps prevent back pain by providing nutrients like calcium and vitamin D, which support bone health to keep the spine healthy and strong. Following a healthy lifestyle also involves not smoking. Smoking can impair the blood flow to the spine, which may lead to degradation of the spinal tissues.
• Perfect your posture. Many people spend hours of their day hunched over a desk, which can lead to strain on the spine and lower back pain. Supporting the spine by sitting properly in a chair with back support and taking frequent breaks to stand or walk around can prevent excess back strain. Correct posture when walking can also help to support the spine.
• Support your back. If you are experiencing lower back pain when walking, your shoes may be to blame. Uncomfortable shoes with poor support or shoes with heels change the curvature of the spine, leading to pain. Wearing low-heeled, supportive shoes may help reduce back pain when walking. A firm bed mattress can also provide support to the spine to prevent back pain.

Physical Therapy for Back Pain

Are you experiencing back pain while walking? A physical therapist can help. Physical therapists are movement experts that create individualized exercise and stretching programs to strengthen the muscles that support the spine. They also use non-invasive treatment options like massage, laser, dry needling, electrical stimulation and heat/ice therapy to relieve pain. Patient education is one of the most important and effective aspects for treating lower back pain. Physical therapists will teach you what you need to know, like maintaining good posture and protecting your back.

Whether you currently have lower back pain or want to prevent future back pain, a physical therapist will work with you to reach your goal of leading a healthy, active life.

FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at FYZICAL.com. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!

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