Lower Back Pain: Is It a Lumbar Injury?

Lower back pain?

Recently, I have been experiencing frequent pain in the area below my back and above my buttocks.
Sometimes, when I lie on my back while sleeping, I feel even more discomfort due to pressure.
Additionally, when I sit up straight, it feels like there is pressure on the lower part of my back.
Could this indicate a lumbar spine injury? What kind of examinations should I undergo? (About two years ago, I fell and injured the area near my buttocks, and I had a massage from a therapist at that time.
Could this be a residual effect from that fall?)

gasky, 20~29 year old female. Ask Date: 2007/03/24

Dr. Pan Yingda reply Rehabilitation

I apologize for missing your question.
The most common cause of your issue is likely due to poor posture, and I believe it is not significantly related to your injury from two years ago (if it were, you would likely be experiencing ongoing pain rather than recent onset; even with persistent pain, it is not closely related to that injury).
When lying flat, please bend your knees and keep them elevated; this will help relax the muscles in your lower back.
Avoid maintaining the same position for too long, especially prolonged sitting.
Are you very thin? Pay attention to your posture, particularly your spine.
Strengthening your abdominal and lower back muscles is important; I recommend practicing Pilates.
Strengthening your core muscles should help improve your back pain.
As for examinations, I would suggest starting with an X-ray; generally, young individuals should not have significant issues.
Wishing you a speedy recovery.

Reply Date: 2007/03/24

More Info

Lower back pain can be a common and debilitating issue, and understanding its potential causes is crucial for effective management. Based on your description, it seems that you are experiencing discomfort in the area just above your buttocks, which could indeed be related to a lumbar injury, especially considering your history of falling two years ago.

Possible Causes of Your Pain
1. Lumbar Strain or Sprain: This is one of the most common causes of lower back pain. It can occur due to overstretching or tearing of muscles or ligaments in the lumbar region. If your fall involved a significant impact, it could have led to a strain that may not have fully healed.

2. Disc Issues: While you mentioned that you had a fall, it’s possible that it could have caused some issues with the intervertebral discs, such as a bulging or herniated disc. These conditions can lead to pain that radiates into the lower back and may be exacerbated by certain positions, such as lying flat or sitting upright.

3. Sacroiliac Joint Dysfunction: The sacroiliac joint connects the spine to the pelvis. Dysfunction in this joint can cause pain in the lower back and buttocks, especially when transitioning between sitting and standing or during certain movements.

4. Coccyx Injury: Since you mentioned that you fell on your buttocks, it’s also possible that you could have sustained an injury to the coccyx (tailbone), which can lead to persistent pain, especially when sitting or lying down.

5. Postural Issues: If you have developed poor posture habits over time, this can contribute to discomfort in the lower back. Sitting with a slouched posture or lying in a position that puts pressure on the lumbar region can exacerbate pain.

Recommended Actions
1. Consult a Healthcare Professional: Given your history of a fall and the persistent nature of your pain, it would be wise to consult a healthcare professional, such as an orthopedic specialist or a physical therapist. They can perform a thorough evaluation and may recommend imaging studies, such as X-rays or MRI, to assess for any structural issues.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can design a tailored exercise program to strengthen the muscles supporting your lower back, improve flexibility, and address any postural issues.

3. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. However, it’s essential to use them as directed and consult with a healthcare provider if pain persists.

4. Rest and Activity Modification: While it’s important to stay active, you should avoid activities that exacerbate your pain. Gentle stretching and low-impact exercises, such as walking or swimming, can help maintain mobility without putting undue stress on your back.

5. Ergonomic Adjustments: If you spend a lot of time sitting, consider making ergonomic adjustments to your workspace. Using a chair that provides good lumbar support and ensuring that your workstation is set up to promote good posture can help alleviate discomfort.

Conclusion
In summary, your symptoms could be indicative of a lumbar injury or other related conditions stemming from your previous fall. It’s essential to seek a professional evaluation to determine the exact cause of your pain and to receive appropriate treatment. Early intervention can prevent further complications and help you return to your normal activities without discomfort. Remember, while some cases of lower back pain resolve on their own, persistent pain warrants a thorough investigation to rule out any serious underlying issues.

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