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Want Relief? Low back Pain Causes and Treatment

Last updated: May 24, 2020

Low back pain results in 2.6 million visits to emergency departments a year in the United States. It is a major concern and cause of disability for many individuals. There are many causes of low back pain and low back pain which can include muscle strains, disc injuries, nerve injuries and joint issues.

Most of the time, muscle strains and soft tissue injuries were the most common cause of individuals in the emergency department because of low back pain. To be more specific, some muscular causes may be one or a combination of the following:

  • Strains – tears in the tendons or muscle. Tendons connect muscle to bone.
  • Sprains – overstretched or torn ligaments. Ligaments connect bone to bone.
  • Spasms – sudden contraction of a muscle or group of muscles

Quick Facts:

  • Most of the time low back pain goes away within one to six weeks. Most low back pain is not dangerous or serious and will generally get better within a few weeks.
  • Majority of low back pain is caused by soft tissue injuries (e.g., muscle, tendon, and ligaments)
  • Physical activity and exercise is the best treatment for low back pain.
  • Most exercises are fine for low back pain: There is little evidence to recommend that supports a particular exercise AND little evidence against any specific kind of exercise.
  • Exercise can help prevent re-occurrence of low back pain: Remaining physically active and participating in regular exercise may reduce the likelihood of recurrences and time frame of having low back pain.
  • Surgery is usually an option for a very small percentage of people with low back pain. It is not a solution for everyone. There are many risks and complications with surgery which typically outweigh the benefits of surgery.
  • Physiotherapists are the experts in helping prevent, assess, manage and treat muscle injuries and can help reduce the reliance on medications.

5 Research-Based Strategies to Treat Low Back Pain

1. Exercise

Performing general exercises such as stretches, strengthening major muscle groups and aerobic exercises was the best for treating lower back pain and improving function. Also, aerobic exercise is recommended to improve pain, disability and mental health in patients with low back pain.

For adults, the Canadian Physical Activity Guidelines recommends 150 minutes of moderate to vigorous aerobic exercise or activity each week. Moderate-intensity includes brisk walking and bike riding. Vigorous intensity includes activities such as jogging where you may sweat and cause you to be ‘out of breath’. Also, muscle and bone strengthening exercises should be performed at least 2 times per week.

IMPORTANT TIP: When you exercise with low back pain, start with a few (1-3) exercises that are simple and easy. It may feel a little uncomfortable but it should not hurt for more than 3-4 days afterwards. If it does, then you probably exercised too much. Also, if you’re thinking of making your exercises more challenging; try adding one exercise at a time to see how your body and lower back to adjusts. Remember: taking breaks are important when you exercise to allow your body to recover from fatigue and helps the body regain energy in order to continue performing the exercises.

Download this handout of lower back stretches you can try at home!

2. Topical creams are effective for pain

In the short-term, topical creams can help with managing recent onset low back pain. It is recommended that you use it for 3 months or less. Consult with your physician prior to using a topical cream to prevent any adverse side effects.

Popular creams that you can try include:

  • Voltaren gel – the active ingredient in Voltaren Gel is diclofenac. Diclofenac is a nonsteroidal anti-infammatory drug (NSAID) that helps relieve pain and inflammation in the area. Other popular over-the-counter NSAIDs include aspirin and ibuprofen.
  • Capsaicin creams – the active ingredient is Capsaicin. Capsaicin is the active ingredient in chilli peppers that makes them spicy. Capsaicin helps create a sensation of heat in certain nerve cells which reduces pain in the body (substance P).
  • Biofreeze gel – the active ingredient in Biofreeze is Menthol. Menthol helps the skin feel cool and then warm. This feeling on the skin distracts you from feeling pain in the muscles and joints.

3. Try a type of Complementary and Alternative Medicine

Evidence supports the use of acupuncture for short-term improvement and function for individuals with lower back pain. You can also try yoga which may offer some improvements in pain and function. Some physiotherapists have additional training and certifications in order to provide acupuncture and yoga.

4. Mental health is just as important as physical health

Emotions and mental health are important factors to consider when addressing pain and disability. For many decades, research has shown that negative emotions such as pain catastrophizing, pain anxiety, and pain-related fear can lead to greater pain, can trigger pain and can lead to poorer adaptability. Studies have shown that individuals with low back pain did better and had lower rates of disability when they received exercise, along with cognitive behavioural therapy and relaxation therapy a few times a week to help address negative motions and stress.

Try this:

  • Focus on mindfulness meditation to help keep your mind’s attention to the present moment and avoid having your thoughts drift into other worries or concerns.
  • Join a relaxation group or mindfulness group. CAMH has some great groups you can check out link here.
  • Try distracting yourself by counting, deep breathing, listening to music or reading. This will help focus your attention on other things than pain.

5. Understanding your back pain

Knowing what is happening to your back and understanding how you can manage and prevent future reoccurrence of low back pain is important. It is important to ask your physician, physiotherapist or any health care provider to share what they know and to help teach you how to manage it.

If you don’t understand what is happening in your back or what is causing your pain – how are you supposed to fix it and make it better?

If you would like to understand and have someone explain to you what your diagnosis is and how to treat it – Book an appointment today with one of our physiotherapists. Learn more about virtual/telehealth physiotherapy here. We are always available to help!


  1. Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., & Keefe, F. J. (2011). Pain and emotion: a biopsychosocial review of recent research. Journal of clinical psychology, 67(9), 942–968.
  2. Foster, N. E., Anema, J. R., Cherkin, C., Chou, R., Cohen, S. P, Gross, D. P., Ferreira, P. H., Fritz, J. M., Koes, B. W., Peul, W., Turner, J. A., Maher, C. G. (2018). Prevention and treatment of low back pain: evidence, challenges and promising directions. Lancet, 2368-83.
  3. North American Spine Society. (2020). Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care.
  4. Canadian Physical Activity Guidelines. (2020).

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