Lower Back Pain: Causes, Diagnosis, and Treatment

Lower back pain is one of the most common reasons people in Burlington seek chiropractic, physiotherapy, massage therapy, and sports therapy treatment. From long commutes on the QEW to active weekends on the Burlington Waterfront Trail, the demands of daily life can take a toll on the lower back.

At Burlington Sports Therapy, we work with people of all ages to understand their back pain and help them return to movement with confidence. Although it is impossible to fully summarize lower back pain in a single blog entry, we’ll do our best to address some of the most common questions and misconceptions surrounding this condition.

Table of Contents

What is Lower Back Pain?

The lower back refers to the lowest part of your spine, known as the lumbar spine. There are five lumbar vertebrae, numbered L1 at the top to L5 at the bottom. Unfortunately, we weren’t designed perfectly. The lumbar spine is prone to age-related changes over time, and lower back pain is very common.

Statistically, over 80% of the population will experience lower back pain at some point in their lives. To put this into perspective, Burlington alone will be home to roughly 150,000 cases of lower back pain at some point in time.

What Are The Types of Lower Back Pain?

Lower back pain can take many forms and present differently from person to person. For some, it may feel sharp, while for others it may feel dull or achy. Stiffness is quite common, but the descriptors we hear from patients at Burlington Sports Therapy are endless.

One important distinction to make is between acute and chronic lower back pain, as this can influence management decisions. These terms are often misunderstood. They have nothing to do with the severity or quality of pain; they simply relate to the duration of symptoms.

It’s generally accepted that pain present for less than two weeks is referred to as acute lower back pain, while pain lasting beyond a month may be considered chronic. Definitions can vary slightly, but the key takeaway is that what works for someone with chronic lower back pain may not be appropriate for someone with acute lower back pain. This distinction matters when guiding recovery.

Why is Lower Back Pain So Common?

The lower back is both mobile and capable of withstanding significant compressive forces. The vertebrae protect the spinal cord while also serving as attachment points for many muscles. It is a complex structure, and the demands of daily life can challenge its tolerance.

For many Burlington residents, life involves prolonged sitting, standing, and activity. We may spend hours sitting at work, in the car, or working from home, then ask our bodies to suddenly perform. Lifting, running, gardening, and playing sports are all healthy and beneficial activities, but they can also irritate the lower back.

The mismatch between what the lower back is prepared for and what it’s suddenly asked to do is one of the reasons lower back pain is so common. When the lower back is taken beyond its capacity or tolerance, pain or injury can occur.

Common Causes of Lower Back Pain

Most cases of lower back pain are not caused by a single injury. Instead, the problem often develops gradually through an accumulation of stress on the area. Despite this, many people associate their pain with a specific incident.

You may have first noticed pain when bending to pick something up, but it’s likely the irritation had been building over time and that moment simply made it noticeable.

Genetics can also play a role. A family history of lower back pain can increase risk. Jobs, activities, past injuries, and trauma all contribute as well. Even everyday factors such as chairs, car seats, footwear, mattresses, and gym routines can influence lower back pain. The list of contributing factors is extensive.

What Structures Are Involved in Lower Back Pain?

The muscles surrounding the lower back are often involved in lower back pain. However, many patients present to Burlington Sports Therapy believing their pain is purely muscular, which is actually uncommon.

Although muscular irritation is often present, lower back pain usually involves multiple structures, with muscles being just one part of the picture. A true muscle strain typically requires a distinct injury, such as a sudden forceful movement. That said, muscles can still generate pain through prolonged stress, such as sitting in a slouched position for extended periods.

One of the most common scenarios involves mechanical irritation of a spine that has a normal amount of age-related change. This irritation can occur with prolonged sitting, household chores, or exercise. The nervous system may respond by increasing sensitivity in the surrounding tissues, creating a cluster of symptoms including stiffness, pain, reduced strength, and loss of function.

In many cases, muscles are not the primary source of the problem. Facet joints, discs, endplates, and spinal ligaments are all capable of generating pain. These structures can become sensitized and contribute to symptoms that eventually involve muscular tightness or guarding. It’s not possible to list every pain generator or diagnosis associated with lower back pain, but it’s important to understand that it is rarely just one structure.

A particularly important factor affecting prognosis is whether large nerve structures are irritated or compressed. Spinal nerves exit the spine between each vertebra and can become irritated, leading to pain that travels along the nerve’s pathway.

The most well-known example of this is sciatica. The sciatic nerve travels from the lumbar spine down the back of the leg to the foot. When irritated, it can cause pain, numbness, or tingling down the leg. Sciatica is not a technical diagnosis, but a commonly used term to describe this pattern of symptoms. It can be extremely uncomfortable and is one of the most common reasons people present to Joseph Brant Hospital with lower back pain.

Mechanical lower back pain is another commonly used term. It refers to pain that changes with movement or loading. For example, if bending forward or backward changes your pain, it is likely mechanical in nature. Similarly, pain that worsens with prolonged sitting or improves with movement often falls into this category. Most cases of lower back pain are mechanical and non-specific.

How We Assess Lower Back Pain at Burlington Sports Therapy

Assessment begins by listening to your story. We want to understand where your pain is, how it started, what aggravates or relieves it, and how it has affected your life.

A physical examination may include movement and posture assessment, range-of-motion testing, orthopaedic tests, and a neurological examination. Most cases of lower back pain do not require imaging such as X-rays or MRI.

While imaging can be helpful in specific situations, particularly when there are signs of serious injury or nerve involvement, many imaging findings do not change treatment decisions. Structural changes on imaging often do not correlate with pain. Some people experience significant pain with minimal findings, while others show degeneration without symptoms.

At Burlington Sports Therapy, Dr. Kevin and Dr. Leslie can review spinal X-rays and help explain which findings are considered normal for age. In many cases, imaging findings are not a reason to stop exercising or avoid normal activity. This is why evidence-based clinicians reserve imaging for specific indications rather than using it routinely.

Red Flags in Lower Back Pain

Although most cases of lower back pain are not dangerous, certain symptoms require prompt medical attention. These include loss of bowel or bladder control, progressive leg weakness or numbness, severe pain following a significant fall or accident, unexplained weight loss, fever, night pain, or a history of cancer with new or worsening back pain.

Lower Back Pain Treatment in Burlington

Lower back pain usually resolves. Although it can be frustrating and painful, most people recover and return to a normal, active life.

Research consistently shows that active, individualized care leads to the best outcomes. This often includes progressive exercise therapy, manual therapy when appropriate, education about pain and recovery, and a gradual return to normal activity.

At Burlington Sports Therapy, treatment focuses on restoring confidence in movement—whether that means returning to the gym, working comfortably, or enjoying walks through Spencer Smith Park without fear.

We offer chiropractic, physiotherapy, and massage therapy services to residents of Burlington and surrounding areas. Treatment options may include laser therapy, active release technique, Graston technique, acupuncture, and electrotherapy, among others.

We encourage patients to ask questions so they fully understand their condition and recovery plan. Treatment is always tailored to individual comfort and diagnosis. For example, spinal adjustments may be appropriate for some patients, but not for others.

There is no single solution that works for everyone. What is predictable is the value of carefully progressing activity under professional guidance, challenging the spine in a controlled way that allows recovery while building capacity. What works for a recreational runner in Aldershot may differ from what works for a desk worker in downtown Burlington. Personalization and patience matter.

If lower back pain is holding you back, the team at Burlington Sports Therapy is here to help you move better, feel stronger, and get back to doing what you love, right here in Burlington. Book an assessment today and take the first step toward lasting relief.