Back stiffness is usually caused by muscle spasms or lumbar arthritis . The best way to differentiate the cause of lumbar spine stiffness is by the appearance of symptoms.
People with stiffness caused by arthritis of the lumbar spine usually have symptoms that are constantly getting worse over many years of the problem. On the other hand, muscle stiffness is usually associated with an acute injury (such as improper weight lifting) in which the back muscles trap and immobilize the back muscles.
Both are common, in part associated with aging and increasing obesity. Nearly 80% of Americans will experience at least one lower back injury at some point in their lives, the frequency of which is second only to the common cold, according to one study .
When describing back stiffness, with or without acute pain, healthcare professionals often investigate two common causes: sprain and osteoarthritis of the lumbar spine.
A sprain in the lower back is the most common cause of back stiffness. This problem occurs as a result of an injury to the back muscles and the ligaments that support the spine. Patients may or may not remember the original event that caused the muscle spasm, but symptoms of a psoas strain can be severe.
The tension will occur around the muscles that support the spine:
- Extenders: back and gluteal muscles
- Flexors: abdominal muscles and thighs.
- Oblique or rotator abdominal muscles: lateral muscles.
A diagnostic test is usually not needed if the stiffness and pain persist for more than two weeks. If they do, your doctor will order an X-ray or MRI to help determine the underlying cause.
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Lumbar spine osteoarthritis
Lumbar spine osteoarthritis is a progressive disease in which the joints of the vertebrae are damaged by prolonged wear and tear. As arthritis progresses, the cartilage and discs of the lumbar spine begin to thin and fade, causing stiffness and pain as the bone rubs against the bone. This can make movements like bending, bending, and twisting difficult.
Although X-rays can confirm osteoarthritis by finding bone damage, bone spurs ( osteophytes ), bone remodeling ( ossification ), and loss of joint cartilage, they may be less helpful in early-stage arthritis when symptoms are less visible.
The experience of the physician is critical to making an informed diagnosis in the absence of definitive imaging data.
Treatment for the two conditions is different, and therefore it is important for patients to determine the cause of their symptoms before beginning any treatment program. In general, most patients with a stiff back will benefit from the following treatments.
Light activity is recommended to overcome back stiffness. In the past, bed rest was the first line of treatment, but this rarely happens with anything other than the most serious back injuries. Most healthcare providers today recommend light activity rather than complete immobilization.
While you should avoid lifting and twisting, light exercise can be very beneficial in alleviating discomfort.
Ice and heat
The application of ice and heat can be a very beneficial treatment for relieving back stiffness. In particular, gently warming up the spine before exercise can help loosen and relax sore muscles and relieve some tension in the lumbar spine.
Over-the-counter pain relievers can also be very helpful. The simplest and often the most effective are non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and Aleve (naproxen).
While prescription muscle relaxants and NSAIDs like celebrex (celecoxib) can be used if over-the-counter medications don't work, opioids should never be used if your lower back is often stiff.
Stretching and exercise
Gentle stretching of the back and exercise can also help relieve lower back stiffness. A simple schedule of therapy sessions can be helpful, or many patients benefit from activities like yoga or Pilates.
As mentioned above, there are specific treatments for the aforementioned conditions that can be applied if you have a clear understanding of the cause of spinal stiffness, but these simple treatments should help you move in the right direction.