Where Does Lower Back Pain Come From?

Lower back pain usually develops when structures such as muscles, intervertebral discs, joints, or nerves become overloaded or damaged. The most common causes are a combination of posture, movement patterns, stress, and overuse. In this article, we answer the most frequently asked questions about lower back pain, so you can better understand what is happening in your body.

Which structures in the lower back can cause pain?

In the lower back, multiple structures can be the source of pain: muscles, tendons, intervertebral discs, facet joints, ligaments, and nerves. Lower back pain is rarely the result of a single problem. In most cases, there is an interaction between multiple structures that together cause complaints.

The intervertebral discs act as shock absorbers between the vertebrae. When a disc bulges or tears, it can put pressure on nearby nerves. This is called a herniated disc, and it can lead to radiating pain toward the buttocks or legs.

The facet joints connect the vertebrae to each other and provide stability and movement. When these joints wear down or become inflamed, a dull, deep pain develops in the lower back that often worsens when bending backward or standing for extended periods.

Muscles and ligaments also play a major role. A tense or overloaded muscle in the lower back feels stiff and painful, especially after physical exertion or an awkward movement. Ligaments can tear or overstretch with sudden movements, causing acute lower back pain.

What is the difference between muscle pain and nerve pain in the lower back?

Muscle pain in the lower back typically feels dull, stiff, or cramping and is localized, whereas nerve pain is characterized by a sharp, burning, or shooting sensation that radiates into the buttocks, leg, or foot. This distinction is important because the cause and treatment differ significantly.

Muscle pain arises from overuse, an awkward movement, or prolonged tension. The pain is easy to localize and often decreases with rest, heat, or gentle movement. There is no radiation to other parts of the body.

Nerve pain, also known as radiculopathy, occurs when a nerve becomes compressed or irritated. This can result from a herniated disc, a narrowing of the spinal canal, or a blocked vertebra putting pressure on a nerve root. Characteristic symptoms include tingling, numbness, or an electric sensation running down the leg. This pattern is also commonly known as sciatica.

It is entirely possible for both types of pain to occur simultaneously, for example when a compressed nerve also causes the surrounding muscles to go into spasm.

Why does lower back pain worsen when sitting or standing?

Lower back pain worsens with prolonged sitting or standing because both postures significantly increase pressure on the intervertebral discs and the muscles of the lower back. Movement distributes that pressure, while remaining still or sitting for long periods concentrates it on specific structures.

With prolonged sitting, pressure on the lumbar intervertebral discs increases considerably, especially when the sitting posture is not optimal. The hip flexors shorten, the back muscles weaken, and the spine loses its natural S-curve. This increases the risk of pain and stiffness, particularly after getting up.

With prolonged standing, the muscles and joints of the lower back must continuously support the body’s weight. Without sufficient movement, the muscles become fatigued and the facet joints become overloaded. This explains why people who spend the entire day on their feet, such as nurses or hospitality workers, more frequently suffer from lower back pain.

Regularly changing position, taking short walking breaks, and consciously maintaining a neutral spinal posture can help reduce complaints.

Can stress or tension cause pain in the lower back?

Yes, stress and mental tension can directly contribute to lower back pain. When the body is under stress, muscle tension reflexively increases, particularly in the neck, shoulders, and lower back. Chronic stress maintains this tension, leading to persistent pain without a clear physical cause.

This mechanism is well documented within healthcare. Stress activates the nervous system in a way that puts the body in a constant state of alertness. The muscles contract in preparation for action, but when that action does not come, the tension remains. In the lower back, this manifests as a dull, heavy feeling that is difficult to relieve with rest alone.

Furthermore, stress indirectly affects back complaints because people under pressure more often adopt poor posture, move less, sleep worse, and perceive more pain signals. It is therefore no coincidence that lower back pain often increases during busy periods at work or during times of personal stress.

A holistic approach that addresses both the body and the nervous system is therefore more effective for stress-related back complaints than a purely physical treatment.

When is lower back pain a cause for concern?

Most cases of lower back pain are harmless and resolve within a few weeks. However, there are warning signs that indicate a more serious underlying problem, in which case you should seek professional help promptly. Contact a specialist if you experience the following complaints:

• Radiating pain into one or both legs, combined with numbness or loss of strength
• Loss of bladder or bowel control
• Severe pain that is also present at night and does not improve with rest
• Pain following a fall, accident, or direct trauma
• Unexplained weight loss in combination with back pain
• Fever together with back pain
• Complaints that do not improve or worsen after six weeks

The above warning signs may indicate conditions such as a serious herniated disc, an infection, a fracture, or in rare cases a tumor. These situations require medical investigation. When in doubt, it is always wise to consult a specialist, even if the complaints appear to be mild.

How is the cause of lower back pain determined?

The cause of lower back pain is determined through a combination of a thorough medical history, physical examination, and, if necessary, imaging such as an X-ray or MRI scan. A good diagnosis always begins with a conversation about the pattern of complaints, medical history, and daily habits.

During the physical examination, the practitioner assesses posture, spinal mobility, muscle tension, and neurological function. Specific tests, such as the straight leg raise test, help detect nerve involvement.

Imaging is not always used immediately. For acute complaints without warning signs, a watchful waiting approach with targeted treatment is often the first step. An MRI scan provides the most detailed information about soft tissues such as intervertebral discs and nerves, while X-rays reveal more about bone structures and spinal alignment.

A good diagnosis looks beyond the location of the pain. Factors such as posture, movement patterns, stress, and lifestyle are all part of the overall picture.

How Ruggensteun helps with lower back pain

At Ruggensteun, we go beyond relieving pain. We look for the structural cause of your complaints and treat it in a targeted manner. Whether it involves a blocked vertebra, a compressed nerve, or chronic muscle tension due to stress, we offer an approach tailored to your situation. What we offer:

• Comprehensive intake and diagnosis in which we thoroughly map your complaint pattern, posture, and movement
• Chiropractic treatments aimed at restoring spinal alignment and improving nerve communication
• Y-Strap treatment, a specialized decompression technique for the intervertebral discs, performed by one of the few certified chiropractors in the Netherlands
• Dry needling for persistent muscle tension and trigger points in the lower back
• Preventive guidance to ensure complaints do not return after treatment

You do not need a referral from your general practitioner, and for acute complaints we ensure rapid availability. Would you like to know what we can do for you? make an appointment directly or contact us at our practice in Eindhoven or Valkenswaard.