The most common cause of lower back pain when bending forward is muscle spasms and muscle strains. Those are really one and the same, a spasm just being a more severe experience of a strain.
There are many different underlying causes of a hurt low back and we’ll go into most of them in this article.
If you’re a parent and you’re having trouble bending over the crib, this article will help.
Also, read this article if you’re trying to solve your back spasms for the long term.
A Few Reasons Your Lower Back Hurts
Muscle spasms
These suck. I’m not gonna lie.
Muscle spasms in the lumbar spine can be absolutely debilitating and can often be triggered by movements that we are not used to performing.
There is a misconception that you can only get low back spasms if you bend forward and lift up something heavy.
Newsflash! You can get back spasms from picking a sock up off of the floor.
You can get back spasms from bending backward quickly.
You can get back spasms from rotating and twisting awkwardly, or not.
And then of course you can get back spasms from bending forward and lifting a heavy object.
If you assumed it could only happen from bending forward you are in good company… that’s how most of my clients view it.
Now that i’ve been a physical therapist for over 5 years, i’ve worked with 100’s of people with low back pain and spasms, and I can confidently say that spasms can happen from all of the above scenarios.
Why do muscle spasms happen?
There are physiological reasons why we cramp and spasm. I’ll post a link to a youtube video I did about that as I think it’s pretty interesting. If the youtube video is tl;dr, then here’s a summary:
Electrolyte imbalance and excessive heat.
If you are in excessive heat, sweating a ton, and not replenishing with a sports-type drink or eating food high with sodium, potassium, and magnesium, you’re at a higher risk of cramping.
Deconditioning and overexertion.
If you are performing harder manual work or doing workouts or just doing something that is difficult on your muscles and joints and you haven’t trained for it, it’s very common to get spasms.
Think about a “charlie horse,” or a calf cramp if you’ve ever gotten one of those. Usually, it’s from doing an activity that required a maximal contraction of your muscles.
I’m not going into the treatment of spasms so much in this article, however, one of the things that has been found to be helpful in reducing the recurrence of muscle spasms is to routinely resistance train.
What do I mean by that? Lift weights.
If you routinely teach your muscles how to contract maximally or close to maximal, your muscles will be used to it.
So, when you have to move something heavy or use your muscle groups with more force, they’ll be conditioned to this, making it a more enjoyable experience overall.
Lumbar Herniated Disc
You might fear a lumbar herniated disc, but did you know that most people will recover from this without surgery?
Although it sounds scary, and it can be very painful, there is a high likelihood that you will recover.
Red flags to look out for are numbness, tingling, weakness, and bowel, and bladder changes that are getting worse and not better, with time.
Why do herniated discs, happen?
No one really knows why discs herniate. There are theories, but no conclusive evidence.
Disc herniations can be really painful, but many people can have them and not even know that they have them.
And, if you have one, this does not put you at higher risk of having pain, just a heads up.
It’s hypothesized that excessive amounts of bending forward puts strain on the back of the intervertebral disc (IVD), and that if the force becomes large enough it can cause a tear in the outer layer of the disc, the annulus fibrosis.
The only problem with this is that folks can also have disc herniations from rotation, extension, and any other combination of spinal movements.
Muscle Strain
Why do muscle strains, happen?
In my mind, muscle strains, particularly mild ones, are a cousin of muscle spasms. You can have muscle spasms without muscle strains, and you can also have muscle strains without spasms, but they can often be connected as a severe enough muscle spasm can lead to the area feeling “strained.”
Muscle strains happen when you have overexerted or overstretched the muscle past its current tolerance level (physiological set point).
This set point is different for everybody and it’s really hard to predict who will strain a muscle and who will not.
My best advice on this is to similar to muscle spasms; make sure you are resistance training at least one time per week so your body is used to actually using the muscles and exerting.
Spinal Arthritis
Why does spinal arthritis happen?
Spinal arthritis, also knows as degenerative disc disease (not really a disease), is the normal and gradual process of the bones becoming less smooth over time, and for the intervertebral disc to slowly lose hydration, and therefore, height.
The space between the vertebrae decreases.
Our body is constantly undergoing apoptosis (scheduled cellular death). Eventually, the amount of repair doesn’t keep up with this process of cell death, and we start to have more degenerative changes show up.
I like to just call these aging changes, as degenerative has quite a negative connotation.
If you want some interesting reading that plows into the science a bit more, read this research article about chondrocyte apoptosis.
Consider reading this article if you are trying to figure out whether your back pain is muscular or skeletal.
Takeaways
- Muscle spasms most often occur due to electrolyte imbalance, deconditioning of muscles, and overexertion
- Muscle strains occur due to overexertion or overstretching
- Lumbar disc herniations can happen randomly and there is often no precipitating factors. This can happen with movement in any direction, not just bending forward.
- Spinal arthritis is a normal process of aging, and technically arthritis is not the greatest terminology as -itis is describing inflammation and usually pain associated. There is often not any pain associated with spinal changes due to aging.
