Why You May Have Lower Back Pain On Just The Left Side

From healthdigest.com

Most of us have dealt with low back pain at some point in our lives. In fact, the American Association of Neurological Surgeons reports that as many as 85% of people in the U.S. will deal with back pain at one time or another. A study published in the Mayo Clinic Proceedings found that back pain was the third most common reason for doctor's visits in the U.S., behind skin conditions and osteoarthritis. The 2019 National Health Interview Survey, which is conducted by the Centres for Disease Control and Prevention (CDC), found that back pain was the most prevalent kind of pain experienced in the U.S., with 39% of respondents reporting an episode of back pain within the three months prior to taking the survey.

Often, low back pain is felt on both sides of the body. However, according to the Cleveland Clinic, some people experience back pain that only impacts one side of the body. Lower back pain that's only felt on the left side of the body can be caused by a number of different ailments, ranging in severity from normal aches and pains to emergency situations. Here are some of the common reasons why your back pain might be localized to just the left side.

Muscle strain or sprain

The majority of low back pain is caused by damage to the muscles, ligaments, and tendons in the back, according to Dr. Anthony Romero, an orthopaedic surgeon at Cottage Health. Though the damage may be caused by a specific injury, it can also be caused by the strains of everyday life. Bending or twisting in just the wrong way, consistently poor posture, and repetitive movements can all damage the tissues in the back, causing low back pain. Orthopaedic surgeon and founder of the Alexander Bone & Spine Institute Dr. Lawrence Alexander wrote in Spine Health that low back pain can also be caused by standing or sitting for long periods of time, or even just sleeping in a weird position.

Because the back supports the entire body, it's prone to wear and tear, which makes the muscles, tendons, and ligaments vulnerable to injury. Luckily, low back pain from a strain or sprain will likely heal on its own within a few weeks. You can take some over-the-counter painkillers and rotate ice and heat on the injured area to get some relief (per Cottage Health). It's also important to stay active. Though this seems counterintuitive given the amount of pain you're likely in, keeping your body moving is essential to healing low back injuries.

Sciatica

The sciatic nerve, which begins in the low back and continues down the back of each of the legs, is responsible for sensation all the way down the leg to the foot, and for the muscle movements of the back of the leg and the knee. According to Penn Medicine, when the sciatic nerve is injured or gets compressed by the surrounding tissues, it can lead to sciatica. Symptoms of sciatica include pain, numbness, and tingling in the buttocks, low back, leg, and feet. Typically, these symptoms only occur on one side of the body because the sciatic nerve on that side is injured or compressed.

Sciatica is actually a symptom of another medical condition, so it's not really a cause of low back pain. Whatever's causing the injury or compression of the sciatic nerve is the actual culprit. Spinal injuries or conditions like stenosis or a slipped or herniated disc can either directly put pressure on the sciatic nerve or cause inflammation that puts pressure on the sciatic nerve. Fractures in the pelvis, tumours, or muscular injuries, especially to the piriformis in the buttocks, can also cause sciatica.

To treat sciatica, the underlying condition needs to be properly diagnosed and addressed. Sometimes this is as simple as controlling inflammation with over the counter medicines, heat, and ice. If the cause is related to the spine, more intensive treatments may be necessary.

Piriformis syndrome

The piriformis muscle is located in the buttocks and it connects the upper part of the leg to the lower part of the spine, per Harvard Health Publishing. To connect these structures, the piriformis muscle goes through the pelvic bone, right next to the sciatic nerve. When the piriformis muscle is damaged, the swelling can push on the sciatic nerve, causing sciatica. This leads to intense lower back pain that extends through the buttocks and down the back of the leg. Indeed, piriformis syndrome is the underlying cause in about 5% of cases involving leg and buttock pain, according to a review published in The Orthopedic Clinics of North America.

Piriformis syndrome has a few classic symptoms that differentiate it from other forms of low back pain. Pain that gets worse when you're sitting down, especially on one side more than the other, is a hallmark of piriformis syndrome (via Harvard Health Publishing). Pain in the buttocks or hips that radiates to the lower back and down the legs, as well as muscle spasms along the length of the piriformis muscle, also differentiate piriformis syndrome from other forms of low back pain.

Piriformis syndrome can be caused by a direct injury to the piriformis, a misalignment of the spine, prolonged sitting, extreme exercise, and irregular gait. Anti-inflammatories, physical therapy, and stretching are the recommended treatments for piriformis syndrome.

Sacroiliac joint pain

The sacroiliac joints (SI joints) are the joints on either side of the pelvis, right next to the spine, per Sacroiliac Joint Pain. Both of the SI joints are responsible for shifting the weight from the upper body to the lower body when performing movements like going from standing to sitting and walking, explains WebMD. The SI joints aren't actually meant to move that much to do their job. The joints are supported by ligaments and muscles to ensure that they stay in place.

When the SI joint or the muscles and ligaments surrounding it suffer a direct or overuse injury, the structures get inflamed. This inflammation can cause significant lower back pain, typically just on the side that's injured. Damage to the SI joint or the surrounding tissues can happen in several ways, including falls, sports injuries, physical activities that involve a lot of impact such as running, uneven gait, or arthritis. People whose legs are a different lengths are especially prone to SI joint dysfunction because the discrepancy usually impacts gait.

SI joint pain can often be resolved with physical therapy, chiropractic adjustments, and anti-inflammatory medications. When your medical professional determines that the lower back pain in your lower back is due to SI joint pain, they'll discuss which treatments fit your particular situation.

Herniated disc in the lumbar spine

The spinal column is composed of small bones called vertebrae, and between each set of vertebrae there are fluid-filled sacs called discs. Dr. David Wu, an anaesthesiologist and pain management specialist, explains on his blog that the discs protect the spine by absorbing the impacts created by the body's movements. Obviously, then, these discs are under a lot of pressure, literally and figuratively. As we age, the discs start to break down, and that degeneration can cause them to slip out of place or rupture. When they do, part of the disc starts to protrude between the vertebrae. This condition is called a herniated disc, or sometimes a slipped disc, according to the Mayo Clinic. Herniated discs are most common in the lower portion of the back, called the lumbar spine.

Herniated discs don't always cause pain, but when the bulging disc pinches a spinal nerve, it can hurt a lot. Typically, the pain is one-sided. The location and type of pain varies depending on where the disc is within the spinal column and whether it's compressing a nerve. If you're feeling pain on the lower left side of your back from a herniated disc, you'll probably feel pain in your buttocks as well. Some people also experience pain in their thigh and calf from a herniated disc. Since the pain is often nerve pain, some people also experience numbness and tingling in their back, buttocks, and leg.

When should you see your doctor about lower back pain?

Though back pain can seriously impact your day-to-day life and make you extremely uncomfortable, the cause usually isn't an emergency situation. As GoodRx discusses, relatively minor injuries to the tissues in the back are the most common cause of back pain. For the most part, back pain doesn't require a trip to the emergency room. 

However, if the pain in the left side of your lower back is accompanied by other symptoms, it might be time to head to urgent care. The most common sign that your back pain is caused by an infection is a fever. So, if you suddenly spike a fever, get someone to take you to the doctor ASAP. If your left-sided lower back pain is severe and you don't get any relief from standing up, sitting down, or lying down in any position, then it's time to get checked out. If both legs start to feel weak or numb or you lose control of your bowel or bladder function, get to an emergency room immediately. This is often an indication of a serious condition.

The bottom line is that back pain on the lower left side all on its own, even if it's pretty bad, usually isn't a sign of an emergency. Often you'll start to feel better with a little rest and remedies you can undertake at home.

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