Stiffness of the Low Back

stiffness back
Stiffness is a common symptom of back pain.. Paul Bradbury / Getty Images

Back stiffness is usually caused by muscle spasm or lumbar arthritis. The best way to to differentiate the cause of lumbar spine stiffness is the onset of the symptoms. Patients with stiffness caused by lumbar spine arthritis usually have steadily increasing symptoms over years of a worsening problem. On the other hand, muscular stiffness is often caused by an acute event, that leads to the sudden development of back problems.

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.

Lumbar Spine Arthritis:  Arthritis of the back can lead to stiffness by wearing out the joints of the vertebrae. As arthritis progresses, cartilage and discs in the lumbar spine wear out and become less mobile. This leads to a stiff back. This may make movements such as bending, stooping and twisting quite difficult.

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:

  • Rest/Light Activities: The older style of treatment of severe back pain was to rest the back completely (bed rest) for a period of several days.  Seldom is this a recommended treatment any longer.  Most physicians and therapists now recommend light activity.  While patients should avoid lifting and twisting, performing light activity, even some light fitness activity, can actually be very helpful at relieving discomfort.
  • Heat/Ice Application: Heat and ice 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 relive some tension in the lumbar spine.
  • Medications: Oral medications can be helpful.  The simplest, and often most effective, medications can be over-the-counter anti-inflammatory medications (NSIADs).  There is a role for other medications such as muscle relaxing medications and other pain medications, although narcotic pain medications should not be used for typical low back stiffness.
  • Stretches and Exercises: 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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