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Causes of Dull Lower Back Pain & How to Find Relief

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Last updated April 9, 2024

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Common causes of dull pain in the lower back include trauma from an injury, muscle strains, or poor posture. A herniated disk, or arthritis in the lower back can also cause aching pains. Read below for more information on causes and relief options.

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Dull lower back pain symptoms

Dull, nagging pain in the lower back that never really goes away is one of the most common health problems. Any sort of low back pain is a symptom, not a condition in itself. Therefore, you will need a definitive diagnosis to put you on the right path to treatment. Even if the underlying cause cannot be entirely cured, there's a good chance it can be managed. Dull lower back pain may commonly be called lumbago, backache, a bad back, or back trouble.

Common characteristics of dull lower back pain

Characteristics that are commonly associated with this type of back pain include the following.

  • Dull, aching pain in the low back: The pain may seem almost like numbness at times.
  • Exercise does not help: The pain may be sharp with exercise and dull with rest.

Duration of symptoms

Most cases of dull lower back pain begin gradually and are chronic in nature, meaning the pain lasts longer than three months and may worsen.

Who is most often affected?

You are most likely to experience this type of back pain if you fit into the following groups.

  • Older people: Men and women are equally affected, especially over the age of 50.
  • Sedentary people: Anyone who is not physically fit will end up with weakened muscles and a loss of circulation.
  • Smokers: Smoking inhibits oxygen and therefore restricts healing.

Is dull lower back pain serious?

Back pain varies in severity depending on the cause.

  • Not serious: Mild back pain that responds to conservative treatment is probably not serious.
  • Moderately serious: Constant pain that doesn't improve should be treated, especially if it interferes with your mobility or quality of life.
  • Serious: Dull lower back pain is serious if you lose control of the lower body, such as your legs or bowels.

Dull lower back pain causes

Many conditions can cause the symptom of dull lower back pain. The following details may help you better understand your symptoms. If your pain worsens or persists, however, you should see a physician.

Spine degeneration

Degenerative spine conditions are often related to aging.

  • Vertebral disc damage: This involves desiccation (drying out) or rupture of the cushioning material between the bones of the spine.
  • Narrowing of the spinal canal: Bone overgrowth, lost disc material, or thickened ligaments can crowd the canal. This is generally called spinal stenosis.
  • Loss of bone density: Thinning, weakening, and sometimes crumbling of the bones due to a loss of minerals may occur.

Poor physical condition

The back muscles and tendons will not have the strength and flexibility to support the back and its structures if you are overweight, are not physically active, or you sit for long periods of time.

Women's issues

Issues specific to women can result in dull lower back pain, such as late pregnancy/early labor contractions, ovarian cysts, or the abnormal growth of uterine tissue.

Bacterial infection

A bacterial infection may infiltrate the structures in and near the lower back, such as vertebrae, discs, reproductive organs, or the kidneys, causing pain.

Inflammatory causes

Inflammation may be present in various structures of the back, leading to dull lower back pain. The individual vertebrae or discs, the cushions between the vertebrae, can become inflamed.

Emotional and physical issues

Emotional and physical issues that are not well understood can sometimes manifest as physical pain in the lower back, including the following.

  • Anxiety and depression
  • Fibromyalgia: This is a syndrome of unexplained fatigue with muscle and connective tissue pain, including back pain.

Rare and unusual causes

Rare and unusual causes of dull lower back pain may include the following.

  • Abdominal aortic aneurysm (AAA): This is a life-threatening enlargement of the aorta, the main blood vessel supplying blood to the abdomen. It can cause pain throughout the abdomen or lower back. While gradual expansion may cause a dull pain, sudden leakage or rupture is associated with severe, often sharp pain, and signs of shock.
  • Tumors: Cancer may originate in another part of the body and spread to the back. Chronic low back pain can be a symptom of testicular, ovarian, or colon cancer. Tumors can also be benign but otherwise affect structures of the lower back, causing pain.

This list does not constitute medical advice and may not accurately represent what you have.

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.

PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.

Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.

Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.

Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.

Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.

Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.

To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.

Rarity: Common

Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain

Symptoms that always occur with pelvic inflammatory disease:fever, abdominal pain or unusual vaginal discharge

Urgency: In-person visit

Mechanical low back pain without sciatica

About 80 percent of people will experience mechanical back pain. Mechanical means that the pain comes from the spine or its supporting structures. Sometimes, people experience sciatica with their low back pain. Sciatica is a general term to describe pain that travels from the back into the leg. Most of the time, it is unclear to doctors what exactly causes the episode of low back pain. However, it is most often due to a muscle strain, or an injured tendon or ligament. A slipped or herniated disc is also a possible cause. Fortunately, in any of these cases, initial treatment is the same. Pain usually goes away within 4-6 weeks, often sooner.

Lower back arthritis

Osteoarthritis, most often simply called arthritis, is a disease of cartilage. In joints, where bones touch and move against one another, cartilage helps provide lubrication for smooth movement, and acts as a shock absorber. Cartilage is also present in between vertebrae, which are the bones comprising the spine. Osteoarthritis of the spine, also known as degenerative joint disease, happens when the cartilage between vertebrae dries out and shrinks. The vertebrae are thus not as able to move smoothly against one another. The ability to walk and perform normal daily activities can be impaired due to inflammation and pain in the lower back.

Rarity: Common

Top Symptoms: lower back pain, spontaneous back pain, back pain that gets worse when straightening it, back pain from overuse

Urgency: Primary care doctor

Low back strain

Low back strain

A strain is defined as a twisting, pulling, or tearing injury to a muscle, or to the tendon that connects the muscle to the bone. (A sprain is an injury to a ligament, which connects two bones together.)

Strains may be acute (happen suddenly) or chronic (show up gradually.) They are usually caused by overuse, improper lifting of heavy objects, or sports. Being overweight or having weak back muscles are both risk factors for back injury.

Symptoms may include a pop or tear at the time of injury; pain that is worse when moving; and sudden muscle cramping or spasm at the site of the injury.

Diagnosis is made through patient history, physical examination, and sometimes x-ray.

Treatment involves rest; ice packs; and over-the-counter pain relievers, followed by a gradual return to normal activities within two weeks. Prolonged immobility actually weakens the back and causes loss of bone density.

Proper lifting techniques, strengthening exercises, and good nutrition can be very helpful in preventing further injury.

Rarity: Common

Top Symptoms: lower back pain, back pain that gets worse when sitting, back pain that gets worse when straightening it, lower left back pain, lower right back pain

Symptoms that always occur with low back strain: lower back pain

Symptoms that never occur with low back strain: involuntary defecation, first time leaking urine, back numbness, toe numbness, foot numbness

Urgency: Self-treatment

Herniated (slipped) disk in the lower back

A herniated, ruptured, or "slipped" disc means that a vertebral disc – one of the soft pads of tissue that sit between each of the vertebral bones – has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.

The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to "slipping."

Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.

Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.

Diagnosis is made through patient history, neurological examination, and MRI scan.

Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.

Surgery to remove the herniated part of the disc – the part that was squeezed out of place – can also be helpful.

Rarity: Common

Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness

Urgency: Primary care doctor


Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

Chronic low back pain

Chronic low back pain is a common condition. It is defined by low back pain lasting more than six weeks. Unfortunately, a clear cause can only be found in twenty percent of cases. The rest of the time, it is believed to be due to strain on the bones and muscles of the back from heavy lifting, prolonged sitting, or bad posture.

For back pain persisting longer than six weeks, it is recommended to make an appointment with a physician. Treatments may include a program of back exercises, as well as pain medicine such as ibuprofen (Advil) and acetaminophen (Tylenol). It is also recommended to stay active and carry on with the things you usually do as much as possible, to help you recover faster. Sitting or lying still for long periods can actually make the pain worse. Your joints may become stiff which will make it harder and more painful to move your back.

Ankylosing spondylitis

"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine.

In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthritis, leaving the lower spine inflexible.

The exact cause is unknown. It is thought to be an inherited, abnormal immune response that is triggered following damage to the lining of the intestines.

Most susceptible are those with a family history of ankylosing spondylitis and a history of intestinal damage from illness. However, anyone can be affected at any age.

Symptoms include pain and stiffness in the back and hips, and sometimes in the neck and shoulders. The pain will be worse during sleep and rest.

Early treatment can help to manage the symptoms, prevent complications, and improve quality of life.

Diagnosis is made through physical examination and x-rays.

Treatment involves nonsteroidal anti-inflammatory drugs; new forms of biologic medications; physical therapy; and, in some cases, surgery to repair damaged joints.

Unexplained acute low back pain

Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.

Common causes:

  • Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
  • Ankylosing spondylitis, a form of arthritis.
  • Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
  • Certain types of cancer, in rare cases.

Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.

If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.

An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.

Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.

Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain

Symptoms that always occur with unexplained acute low back pain:lower back pain

Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever

Urgency: Self-treatment

Chronic low back pain of no specific origin

Low back pain is defined as pain, tightness, and stiffness between the lower end of the rib cage and the buttocks. "Chronic" means the pain has lasted for twelve weeks or longer, and "no specific origin" means the pain cannot be traced to any specific cause, incident, or injury.

Most susceptible are individuals who perform heavy physical work, especially when there is ongoing anxiety, depression, and emotional stress at the same time. The longer the stress and back pain continue, the more difficult it is to ease the symptoms and return the patient to normal functioning.

Treatment involves nonsteroidal anti-inflammatory drugs and sometimes opioid medications for pain, though both have risks when used long term. Antidepressants may also be tried, along with psychological counseling.

Corticosteroid injections for the back are effective for some patients, and fusion surgery is sometimes attempted. Lifestyle changes in the form of improved diet, exercise, and stress management are very helpful in most cases.

Rarity: Common

Top Symptoms: lower back pain, unintentional weight loss, back pain that shoots to the butt, fever, involuntary defecation

Symptoms that always occur with chronic low back pain of no specific origin: lower back pain

Symptoms that never occur with chronic low back pain of no specific origin: thigh numbness, buttocks numbness, lower back pain from an injury

Urgency: Primary care doctor

Dull lower back pain treatments and relief

As long as your pain is not severe, treatment can begin at home. See a doctor for a specialized treatment plan if your back pain is significantly affecting your life.

At-home treatments

You can try the following treatments at home to help relieve some symptoms.

  • Heat and cold: Use hot or cold packs depending on which seems more helpful to you.
  • Pain medication: Try non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) as long as your physician agrees.
  • Topical analgesics: Try those that have a heating or cooling sensation.
  • Stay active: Limit bed rest and time spent sitting.
  • Low-impact exercise: Try walking and swimming, which will improve strength, circulation, and flexibility.
  • Lifestyle improvements: Change your diet, exercise, sleep, and smoking habits to improve your overall health.

Medical treatments

If conservative methods do not provide relief, consult your physician for the following.

  • Prescription medication: Opioids and/or antidepressants may be an option.
  • Physical therapy: Such as stretching, strengthening, and yoga-type exercises specialized to your pain.
  • Chiropractic care
  • Alternative treatments: This includes acupuncture, biofeedback, or a transcutaneous electrical nerve stimulation (TENS) unit.

When lower back pain is an emergency

Cauda equina syndrome is a complication of a ruptured disc, where cushioning material is pushed into the spinal canal. This interferes with nerves and causes a loss of bladder and bowel control.

FAQs about dull lower back pain

Here are some frequently asked questions about dull lower back pain.

Can steroid injections help in cases of chronic low back pain?

In some cases, yes, especially when there has been a ruptured disc or when there is spinal stenosis — a narrowing or partial blockage of the spinal canal. However, steroid injections can only help short-term and cannot be continued indefinitely without other risks such as diabetes or bleeding disorders.

Is there a link between chronic dull lower back pain and depression?

Many medical providers feel that there is. Lack of exercise, opioid use, limited activities, and isolation can all contribute to both depression and low back pain. Emotional pain sometimes manifests as physical pain, which is why antidepressants can be helpful.

Can surgery help in chronic cases of dull lower back pain?

This depends but surgery is not usually recommended in these cases. Surgery can be effective in cases of acute injury with specific damage, but can't always improve chronic, nonspecific pain due to aging, loss of fitness, or depression.

Is dull lower back pain a sign of labor?

Low back pain is common during late pregnancy when the increasing weight of the growing baby puts a strain on the structures of the low back. Early contractions may begin at the same time as this abdominal strain and add to the dull ache in the low back. All of this is, of course, resolved after birth.

Is chronic dull lower back pain a sign of serious illness?

Most cases of chronic low back pain are not signs of serious illness but are the result of aging, inflammation, wear-and-tear, poor physical fitness, etc. However, low back pain can be a serious symptom if you also have a high fever, loss of bowel or bladder control, or signs of a cancerous process.

Questions your doctor may ask about dull lower back pain

  • Does your back pain radiate anywhere?
  • Were you lifting weights or straining yourself right before your symptoms started?
  • What is your body mass?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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