While lower back pain is a widespread symptom, some people only experience it when bending over.
A bent-over position places increased strain on the lower back. Resulting pain can reveal unrecognized injuries or other underlying medical issues.
In this article, learn about the causes and treatments of lower back pain when bending over, as well as some tips for prevention. We also describe when to see a doctor.
Some causes of lower back pain when bending include:
Lower back strain
Lower back strain is a common cause of back pain when bending over. The position can put significant pressure on the lower back, causing the muscles and ligaments to stretch excessively.
A strain in the area can also cause inflammation, which can lead to muscle spasms.
Stiffness in the lower back, muscle spasms, difficulty maintaining an upright posture, and a limited range of motion can all indicate a lower back strain.
Massage, applying ice and heat, and using electrical muscle stimulation therapies may also help. Physical therapy exercises can strengthen the back and help prevent further injuries.
The vertebrae in the back are cushioned by disks that act as shock absorbers and help stabilize the lower back.
A herniated disk is one that slips out of place and puts extra pressure on the surrounding nerves. Usually, this results from aging-related changes that cause the disks to degenerate, making it easier for them to shift.
A herniated disk can lead to weakness in one leg and numbness in the legs and lower back.
Resting the back and taking NSAIDs usually helps. Some people find relief from steroid injections in the space around the nerve, as these can relieve inflammation.
If symptoms are severe, the doctor may recommend a surgical intervention.
Sciatica is a condition that can result from a herniated disk. If the disk presses on the sciatic nerve in the lower spine, it can cause sensations of pressure, burning, or severe pain that travel from the lower back down one or both legs.
Sciatica can also limit the range of motion in one or both legs. If a person has sciatica-like symptoms and loses control of their bowel or bladder, they should seek medical attention immediately.
A person may require surgery to remove the part of the disk that is pressing on the nerve, though this is rare. The American Academy of Orthopaedic Surgeons estimate that sciatica goes away without surgery in 80–90% of people who have the condition.
Nonsurgical treatments can include applying ice and heat, movement, and gentle stretching exercises to relieve inflammation.
Spondylolysis is a stress fracture in a spinal vertebra that often occurs in younger athletes, such as those who play football or do gymnastics.
A person with spondylolysis may have difficulty maintaining a straight, upright posture, and the medical term for this is spondylolisthesis.
A person may also experience pain in the buttocks and thighs, as well as pain that gets worse with activity.
Resting the back and taking NSAIDs can usually help with low-grade stress fractures. Some people also benefit from physical therapy and a brace to support the back during physical activity.
If the injury is causing severe symptoms, the doctor may recommend surgery. This could involve spinal fusion, a procedure that secures the spine.
Ankylosing spondylitis is a chronic inflammatory condition that affects the spine, particularly the joints near the pelvis and hips. It can result in pain, stiffness, and other forms of discomfort when a person bends over.
Over time, ankylosing spondylitis can cause inflammatory changes that lead to the bones in the spinal joints fusing. Also, when it is severe, ankylosing spondylitis can cause changes in a person’s posture, giving them a hunched appearance.
A person with this condition may also experience pain when they press on their lower back and the area above the pelvic bones.
Treatment may initially involve taking NSAIDs.
If symptoms worsen, a doctor may prescribe other medications, such as tumor necrosis factor blockers, which also help reduce inflammation. Examples include adalimumab (Humira) and etanercept (Enbrel).
In addition, some people find that physical therapy helps improve their flexibility.
A person should seek immediate medical attention if they are unable to move any muscle or joint in their lower extremities or if they lose control of their bowels or bladder. Any of these situations constitutes a medical emergency that requires fast treatment to prevent further nerve damage.
If back pain worsens in spite of home care or does not resolve within 2 weeks, it may be a good idea to see a doctor. The doctor can help determine whether to consult a specialist, such as an orthopedic doctor or a neurosurgeon.
Practicing correct lifting and bending techniques can help minimize back pain when bending over. These techniques include:
- bending only at the knees and hips instead of at the waist, to reduce the risk of spinal fractures and muscle strain
- avoiding twisting the spine when bending to reach for something
- keeping the feet firmly planted shoulder-width apart to reduce the risk of falling forward
- refraining from carrying objects that are too heavy, for example, by taking multiple trips and using assistive devices such as rolling carts
- carrying objects as close to the body as possible and holding them at waist level.
In addition to practicing injury prevention techniques, a person who has back pain when bending over can also try these self-care measures:
- taking OTC NSAIDs, such as ibuprofen or naproxen, to relieve pain and inflammation
- resting the back for a few days, then engaging in gentle stretching exercises and low-impact physical activity, such as walking
- wearing a supportive device such as a back brace to prevent discomfort
If a person has tried home care techniques and continues to experience back pain when bending over, they should talk to their doctor.
Learning to bend and lift safely can often help prevent further injury.