Causes and Treatment of Low Back Stiffness

Back stiffness is usually caused by a strained muscle or arthritis in the lumbar spine. The lumbar spine is the area that consists of the five vertebrae in the lower back.

People with stiffness caused by lumbar spine arthritis usually have steadily increasing symptoms over years. A strain, on the other hand, is usually related to acute trauma (such as lifting a heavy weight incorrectly). This causes the back muscles to seize up and stiffen.

This article explains the differences between these two main causes of low back stiffness and how each condition is treated.

What Causes Low Back Stiffness?

Here are the differences between the causes of lumbar 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. Lifting a heavy box or doing an exercise the wrong way are two examples of activities that can strain the lower back.

Lumbar strains will occur in the muscles that support the spine, including the following:

• 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 healthcare provider will order an X-ray or magnetic resonance imaging (MRI) test to help figure out the underlying cause.

Lumbar Spine Osteoarthritis

Lumbar spine osteoarthritis is a progressive condition (one that gets worse over time). It is a result of damage to the vertebrae due to long-term wear and tear. As arthritis progresses, cartilage and discs in the lumbar spine begin to thin and disappear. This results in bone rubbing against bone, causing pain and stiffness. This can make movements such as bending, stooping, and twisting very difficult.

X-rays can diagnose osteoarthritis by detecting bone damage, bone spurs (osteophytes), bone remodeling (ossification), and the loss of joint cartilage that can occur over time. They may be less useful in early-stage arthritis when the signs are less visible.

An experienced clinician can often make a diagnosis of osteoarthritis even if X-rays don't show visible bone damage.

How Is Low Back Stiffness Treated?

Most of the time, lumbar strains and lumbar spine arthritis can be treated with simple measures you can do on your own. In some cases, lumbar arthritis may require surgery, but this is not common.

In general, most patients with back stiffness will benefit from the following treatments:

Light Activity

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 for anything but the most severe back injuries. However, most healthcare providers today recommend light activity rather than complete immobilization.

Light activities include walking slowly and doing light household chores such as putting away groceries or folding laundry.

Ice and Heat

Ice and heat applications can be very helpful for relieving pain due to back stiffness. Gently heating the spine with a heating pad or pack before activities can also help to loosen and relax sore muscles and relieve some tension in the lumbar spine.

Pain Relievers

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) can help relieve back pain and stiffness. In some cases, your doctor may prescribe muscle relaxers and prescription NSAIDs like Celebrex (celecoxib) if over-the-counter drugs aren't working.

Stretching and Exercises

Gentle back stretches and exercises can also help to relieve low back stiffness. Many patients also feel better when doing yoga or Pilates. Exercises to try include:

• Hip circles: Stand with your feet slightly wider than hips-width apart. With your hands on your hips, rotate your hips in a circular, hula-hooping motion. Move slowly, taking note of when you feel most stiff. If you find a particularly stiff spot, gently stretch your hips in that direction.
• Knee to chest: Lie flat on your back with your knees bent and feet flat on the floor. Clasp your hands around the back of one thigh and gently pull your knee to your chest. Try to keep your lower back on the ground. Hold for ten seconds then switch sides.
• Lower back rotation: Lie flat on your back with knees bent and feet flat on the floor. Keeping your shoulders flat on the floor, slowly roll your knees to one side. Hold for ten seconds then switch sides.
• Seated lower back rotation: Sit on a backless chair or stool. Cross your left leg over your right. Prop your right arm against the left side of your left knee, twisting the upper half of your body towards the left. Hold for 10 seconds, then switch sides.
• Bridge: Lie flat on your back with your knees bent, feet flat on the floor, and arms outstretched by your sides. Drive your shoulders into the ground and raise your hips towards the ceiling, creating a straight line from your hips to your knees. Hold for five seconds, then lower and repeat.
  

When to See a Healthcare Provider

If you have been experiencing back pain or stiffness for more than two weeks, or your symptoms are stopping you from participating in your normal daily activities, then it's best to see a healthcare provider.

If your pain seems especially severe or debilitating, make a visit to urgent care. The following symptoms are reasons to go to a hospital or urgent care immediately:

• Fever with back pain
• Back pain after a fall, car accident, or other trauma
• Loss of bladder or bowel control
• Loss of strength, numbness, or tingling in your limbs
• Unexplained weight loss with back pain

Your healthcare provider may recommend you to visit a medical specialist, such as a chiropractor or physical therapist. Whereas chiropractors focus on the alignment of bones and joints, physical therapists focus on full-body movement and functionality.

If, for example, your low back stiffness is caused by a car accident injury, a chiropractor may provide quick and temporary relief from stiffness, while a physical therapist will work with you consistently over time to gradually improve mobility.

Research shows that chiropractic care and physical therapy provide similar benefits for people with low back pain, although chiropractic care may be slightly more cost-effective.

Summary

Lower back stiffness is typically caused by arthritis in the lumbar spine or an acute injury caused by an activity that strains the back muscles. Most of the time, simple treatments like stretching and using ice and heat will provide relief.

Sometimes back pain doesn't go away or gets worse despite following the recommended measures. If this is the case, contact your healthcare provider, who can run diagnostic tests. In some cases, symptoms of low back pain and stiffness will require more intensive treatments.