Lower Back Muscle Anatomy and Low Back Pain


Understanding lower back anatomy is key to understanding the root of lower back and hip pain. The human spine is composed of 4 sections of vertebrae. These sections are:

  • cervical (neck)
  • thoracic (upper and middle back)
  • lumbar (lower back)
  • sacrum (tailbone).

The lumbar and sacrum region make up the bone of the lower back anatomy. The spinal cord is contained within the spine's vertebrae, running through the vertebral foramen and branching out to the peripheries through the intervertebral foramen.  The muscles of the low back work together with the transverse abdominal muscles to increase intra-abdominal pressure.

To read more about a "catch" or locking sensation in your back, please read this informative ARTICLE.

Lower Back Muscles and Low Back Pain can be treated at JOIBack Muscles are often injured and cause pain

To learn more how to strengthen your core muscles to prevent back pain, please read this ARTICLE best core exercises. 

 What Are the Muscles of the Lower Back?

The quick answer is:

  • Multifidus
  • Longissimus
  • Spinalis, 
  • Quadratus Lumborum. 

However, there are many back muscles which can cause pain.   Please refer to the Lower Back Muscle picture below to see all of the muscles of the back. 

The pelvic floor muscles also help increase this pressure, which provides stability to the spine and trunk.  Common hip and back pain causes include injury to muscles from overuse, disc injury/degeneration, or spinal stenosis. To learn more about the lower back anatomy of the spine, please watch this video.

Anatomy of the Lower and Upper Back muscles with labelsLower and Upper Back Muscles

What Causes Muscular Lower Back Pain?

Muscle injuries of the lower back are commonly caused by an improper lift, lifting while twisting, or a sudden movement or fall, which may cause lower back pain. The multifidus muscle keeps the back straight and stable. Multifidus issues usually lead to other problems due to improper recruitment of other muscles to avoid pain. Signs that a muscle might be injured include sudden onset of pain, soreness, limited range of motion, swelling, muscle spasms, stiffness, and weakness. 

Muscle injuries may also occur due to prolonged improper posture, such as a forward flexed posture, which stretches out the back muscles. Lower Back pain from sitting is also very common. Always be aware of the positioning of your lower back anatomy. Proper lifting procedures and keeping a proper posture will reduce pressure to the hip and lower back structures and musculature. There are lower back stretches that can help.

Back Muscle Diagram With Lower Back Anatomy

This is a diagram of the larger and more surface muscles of the low back.  The anatomy of the spine is complicated.  To learn more, watch this VIDEO.

Lower back muscles anatomy back muscle diagram with highlighted piriformis muscles in redLower Back Muscle Diagram Anatomy

 

Does Degenerative Disc Disease affect the Lower Back Muscles?

Another common cause of lower back and hip pain is disc. A disk injury such as a disc herniation would be similar to the jelly filling of a donut pushing out the side. This “jelly filling” may press on a nerve and cause either muscular weakness or discomfort, such as sciatica.  Degenerative Disc Disease, or DDD, may also lead to lower back and hip pain. This is basically where the disk shrinks and decreases the space between each vertebra. This may lead to arthritis in the spine. Bone spurs and nerve compression may result from degenerative changes.

Anatomical diagram of spinal disc herniation with normal disc on the left and herniated disc on the right.Image of a Herniated Disc.
 

Does Stenosis of the Spine Cause Lower Back Muscle Pain?

Lower back muscles and hip pain may also be caused by stenosis in the spine. Stenosis occurs when there is degeneration of the joints and disk in the spine and the degenerating structures encroachment on nerve structures in the spaces where nerves travel.  This may lead to possible nerve compression. A patient may experience radiating pain and tingling down the legs and localized hip and back pain. Some patients may find relief with flexion exercises, reducing the pressure on the nerve structure being compressed.  Often, the lower back muscles will spasm due to the stenosis at the particular level of the spine.  The spasm of the muscles is your own bodies way to try to protect the area which is hurting. 


Did I Pull A Lower Back Muscle? How do you Treat a Pulled Muscle in the Lower Back?

True muscle strains (pulled muscles) are rare.  Most muscle pain in the lower back is due to muscle spasms from other Lumbar spine injuries.  Disk injuries are more likely.  If there is muscular pain, consider trying a warm shower or even an ice pack initially.  Gentle movement exercises may help, such as lying on the back, bending both knees, and gently rotating them together to each side, without pushing into pain.  Start with 5 to 10 reps.  Gentle yoga may be helpful once the acute symptoms improve.  Modalities such as ice or heat can certainly stop the back muscles from going into a spasm. 


Should I Wear a Back Brace?

the back of a man with no shirt wearing a back brace and resting his hands on hips.  Back braces are not needed in many casesback brace

The quick answer is that most people should not wear a back brace during normal daily activity.  The problem with back braces is that our bodies are inherently lazy.  When we provide external support like a back brace, the muscles that are supposed to keep the back stable, stop work properly. 

We have an internal back brace known as the abdominal muscles. The deepest abdominal muscle, the transverse abdominis works like a corset and provides stability for the spine.  If it works properly, it should provide all the support you need.  If it does not work properly, see a physical therapist to learn how to regain control of the core muscles. 

There are cases when a back brace is needed. These include:

  • immediately after some spinal surgeries
  • cases of severe instability
  • corrective scoliosis braces

Some companies require employees to wear a back brace when lifting heavy items. Whether this helps is controversial. 

Is Walking Good for Lower Back Pain?

Much of the time, Pain in the lower back is better in standing.  If your pain decreases in standing, a light walk may also be beneficial.  It is best to start with a short distance and see how the pain responds.  Sometimes, inflammation and pain increase several hours after an activity.  So, it is best not to overdo it initially, even if there is no initial increase in pain.  If pain increases in standing, it would be best to consult a physician or physical therapist before beginning a walking program.

Does Yoga Help the Muscles of the Low Back?

Yoga can be a helpful form of exercise to improve muscles' strength and flexibility in the lower back.  It is important to start slow and not push into positions that increase pain in the lower back.  Some yoga poses may irritate symptoms.  If you have low back pain, it may be necessary to consult a physical therapist before beginning a yoga exercise program.  

Yoga has other benefits, as well. Yoga can help with focus, relaxation, and balance. 

Is Pilates Good for the Low Back Muscles?

Pilates can help increase mobility and stability in the back.  This can be helpful with lower back pain.woman doing advanced Pilates
 

Pilates is a beneficial form of exercise for increasing control and strength in the lower back muscles.  Pilates engages core muscles and increases strength throughout the movements of the body.  As with yoga, in Pilates, you should start slow and work up to increase difficulty levels.  A skilled instructor is helpful when beginning a Pilates program.  If you have low back pain, consulting a physical therapist may be helpful before beginning a Pilates program.

Is Back Pain a Sign of Cancer?

Typically, back pain is caused by structures in the back. There are rare cases when pain in the back can be a symptom of another part of the body. Pain from cancer typically presents differently than pain from structures in the lower back. Consider the following:

  • Pain that wakes you at night for no reason.
  • Pain that is constant and does not change with position.
  • Pain that does not improve with treatment of the back.

These are signs that you should consult a medical professional to evaluate to determine whether the pain is mechanical, such as DDD (degenerative disc disease), systemic, such as rheumatoid arthritis, or something more sinister.

To read more about Robotic Spine Surgery, go to JOI Robotic Spine Surgery. 

Related Articles: Lower Back Pain and What is a Pinched Nerve in the Lower Back 

What Can I Do For My Lower Back Pain?

Low back pain can be caused by muscle strains, disc injury/degeneration, spinal stenosis, and many other structural sources in the Lumbar Spine.  The quick answer is to follow these spine tips to keep your lower back healthy. Exercises for Low Back Pain can be very helpful. If the lower back and hip pain persist, or it feels like there is a pinched nerve in the hip or leg, it is advised that you see a medical professional to determine the best course of treatment specific to your diagnosis and condition. Watch this VIDEO on why Back Pain Can't-Wait.  

To schedule with one of the 12 JOI Rehab Centers, please call 904-858-7045.  If you would like to schedule an appointment with a Back and Neck Orthopedic Specialist, please call 904-JOI-2000, or click the link below. 

Ehren Allen, DPT, COMT



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