What is the lumbar spine?

Your lumbar spine (lower back) includes:

• 5 vertebrae (spinal bones)
• discs (soft tissue that sits between your vertebrae)
• muscles
• ligaments
• blood vessels

Your lumbar spine is found below your thoracic spine (middle part of your spine) and above your sacrum (lowest part of your spine). It curves slightly inwards. The vertebrae in your lumbar spine are larger than the vertebrae in your thoracic spine and sacrum.

The vertebrae in your lumbar spine wrap around your spinal cord which protects it.

Nerve roots known as cauda equina travel from the end of your spinal cord, through your lumbar spine, to the lower part of your body.

There are 3 groups of muscles attached to your lumbar spine:

1. Extensor muscles — these hold up your spine and allow you to bend backwards.
2. Flexor muscles — these allow you to bend forwards and lift objects.
3. Oblique muscles — these help you rotate your spine.
   

Around 4 in every 5 Australians will have lumbar spine pain at some stage in their life.

What does the lumbar spine do?

Your lumbar spine has many important functions, including:

• supporting your upper body — your lumbar spine helps support your head, cervical spine (upper part of your spine) and thoracic spine. It also transfers body weight from your upper body to your legs, which allows you to lift and carry objects.
• allowing you to move your body — the muscles in your lumbar spine allow you to move your body in all directions. The cauda equina nerves control the movement and feeling in your legs.
• protecting your spinal cord and cauda equina nerves— the vertebrae in your lumbar spine wrap around your spinal cord which protects it.

What health conditions affect the lumbar spine?

Many conditions can affect your lumbar spine, such as:

• lumbar stenosis (when your vertebrae compress your nerves)
• herniated disc (when your disc bulges and irritates your nerves)
• osteoarthritis (inflammation of the joints in your spine)
• injury or trauma
• muscle sprain
• vertebral compression fracture (a fracture of one of your vertebrae)
• cauda equina syndrome (compression of your cauda equina nerves)

Non-spinal conditions can also cause lumbar spine pain, such as:

• pneumonia (lung condition caused by an infection)
• shingles (a viral infection)
• pancreatitis (inflammation of your pancreas)

Your lumbar spine can also be affected by congenital conditions (conditions present from birth), such as sacralisation. Sacralisation is when the L5 vertebrae (the lowest bone in your lumbar spine) is partly or fully joined to your sacrum.

What are the symptoms of lumbar spine conditions?

Conditions that affect your lower back can cause symptoms such as:

• low back pain
• sciatica (pain that radiates to your leg or bottom)
• reduced movement in your back or hips
• weakness, numbness or tingling in your back, hips or legs

How do I prevent lumbar spine injuries?

You can reduce your chances of having a lumbar spine injury by taking these steps:

• Be physically active — regular exercise improves flexibility, muscle strength and bone health. A physiotherapist or exercise physiologist can help create an exercise program that is right for you.
• Maintain a healthy body weight — if you are living with overweight or obesity, your spine carries an extra load.
• Quit smoking — smoking can increase your chance of having arthritis, osteoporosis and back pain.
• Practice safe manual handling — if you have a physical job, make sure you use safe techniques when lifting or moving objects. Ask your employer for guidance if you are unsure. At home when bending and lifting use the muscles in your legs rather than your back to support you. Ask your doctor or physiotherapist if you are unsure.
• Have good workplace posture — your work may require you to sit or stand for many hours. Make sure your workstation is set up to allow you to stand and sit in a way that supports your back.
• Manage your stress — when you’re stressed, the muscles in your body may become tense. Relaxation techniques can help manage stress and reduce muscle tension.

How are lumbar spine conditions treated?

Treatments for lumbar spine conditions include:

• regular exercise guided by a physiotherapist
• modifying your lifestyle and the way you do things
• maintaining a healthy body weight
• medicines, such as pain-relief medicines, muscle relaxants, anti-inflammatories or steroid injections
• relaxation techniques

Your doctor may recommend surgery if:

• your condition is urgent
• other treatments have not been effective
• your symptoms are getting worse

Read about preparing for surgery.

When should I see my doctor?

You should see your doctor if:

• your back pain is getting worse
• you are in distress
• you cannot move around well

When is back pain an emergency?

You should get emergency care if you have back pain as well as:

• any changes in your bladder and bowel movements
• sudden weakness or numbness
• pins and needles in your legs
• a fever, or any symptoms of infection
• pain that is worse at night
• a history of cancer

Resources and support

Visit WorkSafe Victoria to watch videos explaining manual handling in the workplace and how to prevent injury.

The Australian Physiotherapy Association has a search tool to help you find a physiotherapist to prevent or treat lumbar spine injury.

See the Musculoskeletal Australia website for information about how to prevent and manage back pain.

Visit the Arthritis Australia page for tips on how to manage lower back pain.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.