Bending over can place an increased strain on the lower back. Pain in this position may signal an underlying muscle weakness, area of damage, or more serious condition.

Almost 40% of adult Americans experience some degree of back pain. Placing increased pressure on the lower back due to improper bending and lifting can worsen symptoms.

In this article, learn about the causes and treatments of lower back pain when bending over, as well as some prevention tips. We also describe when to see a doctor.

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Some causes of lower back pain when bending include:

Back muscle injury

Injury to the ligaments and supportive muscles around the spine can cause back pain both during movement and at rest. Bending can put significant pressure on the lower back, causing the muscles and ligaments to stretch excessively.

Damage to muscles surrounding the spine can also cause inflammation, leading to muscle spasms.

People commonly use the term ‘back strain’ as an umbrella term for muscular injury around the spine.

Other symptoms

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.

Treatments

Resting the back for 1–3 days can help reduce muscle pain, as can taking nonsteroidal anti-inflammatory drugs (NSAIDs). Some over-the-counter (OTC) options include ibuprofen and naproxen.

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.

Herniated disk

Disks between vertebrae act as shock absorbers and help stabilize the lower back.

A herniated disk 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.

Other symptoms

A herniated disk can lead to weakness in one leg and numbness in the legs and lower back.

Rarely, a person with these symptoms loses control of their bowel or bladder functions. If this occurs, seek treatment immediately, as incontinence may result from a serious underlying condition.

Treatments

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 surgical intervention.

Sciatica

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 travels from the lower back down one or both legs.

Other symptoms

Sciatica can also limit the range of motion in one or both legs. If someone has sciatica-like symptoms and loses control of their bowel or bladder, they should seek medical attention immediately.

Treatments

A person may require surgery to remove the part of the disk pressing on the nerve, though this is rare. The American Academy of Orthopaedic Surgeons estimates that sciatica goes away without surgery in 80–90% of people with the condition.

Nonsurgical treatments include applying ice and heat, movement, and gentle stretching exercises to relieve inflammation.

Spondylolysis

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.

Other symptoms

A person may also experience pain in the buttocks and thighs, as well as pain that gets worse with activity.

Treatments

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 causes severe symptoms, the doctor may recommend surgery. This could involve spinal fusion, a procedure that secures the spine.

Arthritis

Many forms of arthritis can affect the joints in the back, causing pain.

  • Osteoarthritis: Osteoarthritis is the gradual degradation of cartilage and bone in a joint, causing inflammation. This can affect all joints in the body, including the back.
  • Rheumatoid arthritis: Rheumatoid arthritis occurs when the immune system mistakenly attacks tissues in the joint. It typically occurs in the hands, feet, and knees but can affect the spine.
  • Ankylosing spondylitis: This 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 discomfort when a person bends over.

Arthritic conditions can worsen over time. For example, degeneration from osteoarthritis may progress as a person ages. Rheumatoid arthritis, ankylosing spondylitis, and other inflammatory forms of arthritis can 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.

Other symptoms

A person with this condition may also experience pain when they press on their lower back and the area above the pelvic bones.

Treatments

Treatment may initially involve taking NSAIDs.

If symptoms worsen, a doctor may prescribe other medications, such as tumor necrosis factor blockers, which help reduce inflammation. Examples include adalimumab (Humira) and etanercept (Enbrel).

In addition, some people find that physical therapy helps improve their flexibility.

Correct lifting and bending techniques can help minimize back pain when bending over. These techniques include:

  • bending at the knees and hips instead of at the waist
  • 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

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 constitute a medical emergency that requires fast treatment to prevent further nerve damage.

If back pain worsens despite 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.

If someone has tried home care techniques and continues to experience back pain when bending over, they should talk with their doctor.

Learning to bend and lift safely can often help prevent further injury.