Burning Lower Back Pain: Causes & How to Get Relief

Key takeaways:

• Burning pain is often related to a condition affecting the nerves.
• If a rash appears at the area of burning back pain, you should see your doctor for antiviral medication.
• Pain that begins after a traumatic injury or a motor vehicle accident (MVA) should be evaluated immediately.

Burning lower back pain can be distressing and uncomfortable. The sensation can range from a mild and annoying ache to a sharp and intense pain that radiates through the lower back. Whether you are dealing with a recent injury or a chronic issue, understanding what might be causing this sensation can help you figure out how to manage it. In this article, we will review the common causes of burning lower back pain, how to relieve it, and when to seek medical attention.

Is burning lower back pain normal?

Burning lower back pain can be normal depending on the cause. Many instances are linked to common conditions like muscle strain or poor posture and can easily be corrected with strengthening. However, persistent or severe burning pain is not normal and may indicate a more serious underlying issue such as nerve compression.

Symptoms associated with burning lower back pain

If you are experiencing burning lower back pain, you should pay close attention to any other symptoms that may be occurring simultaneously. The addition of other symptoms can give clues as to the underlying cause.

Rash

If you are experiencing burning lower back pain as a result of shingles, you will also develop a rash. The rash associated with shingles is vesicular, or blister-like in appearance and will occur on only one side of the body.

Numbness and tingling

Numbness, tingling, a "pins-and-needles" sensation, or radiating pain in the lower back, hips, or legs may suggest nerve involvement known as radiculopathy. Herniated discs, spinal stenosis, sciatica, and piriformis syndrome can all lead to nerve compression.

Leg weakness

In some cases, burning lower back pain can be accompanied by weakness in the legs. This symptom often occurs when the spinal nerves that control muscle movement are compressed or damaged. Conditions like spinal stenosis, herniated discs, or nerve impingement can result in nerve compression that weakens the muscles in the legs.

Causes of burning lower back pain

The majority of causes of burning lower back pain are related to nerves or musculature within the spine. We will review some of the most common causes below.

Herniated disc

A herniated disc occurs when the soft inner portion of a spinal disc pushes through a tear in the outer layer and presses on nearby nerves. This can cause pain, numbness, tingling, and a burning sensation in the lower back which may even radiate down one leg. The pain and tingling that shoots down the leg from the lower back is called sciatica.

Shingles

Herpes zoster is a viral infection that is more commonly referred to as shingles and is a reactivation of the same virus that causes chicken pox. It usually presents with burning pain that occurs on one side of the midline of the body followed by the eruption of a blister-appearing rash. Individuals with shingles may also develop fever and general feelings of malaise.

Spinal stenosis

Spinal stenosis refers to the narrowing of the spaces in the spine which can put pressure on the nerves traveling through the spinal canal. This condition often causes burning pain that worsens with prolonged standing or walking, and it is commonly seen in older adults.

Cauda equina

Cauda equina syndrome is a medical emergency that involves compression or damage to the bundle of nerves at the end of the spinal cord known as the cauda equina. These nerves control many important functions, including sensation and movement in the lower limbs, bladder, and bowels. When the cauda equina is compressed, it can lead to a range of serious symptoms, including burning lower back pain, numbness, weakness, and incontinence.

Causes based on another symptom or situation

If you are experiencing burning lower back pain combined with other symptoms, this can provide more specific clues about the underlying cause.

Burning pain in the left lower back

​​Burning pain localized to the left side of the lower back may be due to muscle strain, kidney stones, a kidney infection, or shingles. A herniated disc compressing left-sided nerves can also cause the symptoms to be localized to the left side.

Burning pain in the right lower back

​​Burning pain localized to the right side of the lower back may be due to muscle strain, kidney stones, a kidney infection, or shingles. A herniated disc compressing right-sided nerves can also cause the symptoms to be localized to the left side. Although unlikely, appendicitis should also be ruled out.

Burning lower back pain and a burning sensation while urinating

When burning pain in the lower back is accompanied by a burning sensation while urinating, the symptoms are likely to be caused by a urinary tract infection or a kidney infection.

Burning lower back pain and abdominal pain

Burning lower back pain that occurs with abdominal pain may point to conditions such as a herniated disc, kidney infection, bladder infection, or issues with the gastrointestinal tract. In order to narrow in on a diagnosis, more information about the location of the abdominal pain may be useful.

Burning pain in lower back in females

For women, burning lower back pain may be linked to conditions such as endometriosis, pelvic inflammatory disease, or pregnancy-related changes such as sciatica or round ligament pain.

Burning pain in lower back in males

In men, burning lower back pain may be related to conditions like prostatitis or issues with the prostate gland.

How to get relief from a burning lower back pain

If you are dealing with mild symptoms, there are a few home treatments that may provide relief.

Hot and cold compresses

Applying heat or cold to the affected area can help reduce pain and inflammation. Cold packs can numb the pain and reduce swelling, while heat therapy can help relax tight muscles and improve blood flow which helps repair microtears within the muscles.

OTC medications

Over-the-counter pain medications such as acetaminophen or ibuprofen may help with mild to moderate pain.

Stretching

Gentle stretching exercises, particularly those targeting the lower back and hips, can help alleviate stiffness and improve flexibility. You should perform stretches slowly to avoid aggravating the pain.

How to prevent burning lower back pain

Taking proactive measures to strengthen your muscles and improve mobility can help prevent some causes of pain. It is important to note that some causes of burning lower back pain such as shingles are not entirely preventable.

Strengthening core muscles

Strengthening the muscles of the core can help support the spine and pelvis, reducing the risk of back and spinal nerve injury and inflammation.

Proper lifting techniques

When lifting heavy objects, you should always bend at the knees rather than bending at the waist. This helps to avoid straining and injury to the lower back. This is particularly important in cases of spinal stenosis and herniated discs to avoid further aggravation of the nerves.

Maintain a healthy weight

Excess weight can put added pressure on the lower back and core. Regular exercise and a healthy diet can help you maintain a healthy weight and reduce strain on these areas.

When to see a doctor about burning lower back pain

If your symptoms are not improving or worsen over the course of a few days, it may be time to see a healthcare provider.

You should see a doctor if:

• The pain lasts for more than a few days without improvement.
• The pain follows a traumatic injury or accident.
• You develop a rash at the site of the burning pain.

You should go to the emergency room if:

• You experience loss of sensation in the lower body or legs.
• You experience loss of control over the bowel or bladder.

Questions to ask your doctor about burning lower back pain

• What could be causing the burning sensation in my lower back?
• Do I need any imaging studies such as an X-ray or an MRI?
• What treatment options are available for my symptoms?
• Are there any movements or exercises I should be avoiding until my pain resolves?

How a doctor can help treat burning lower back pain

A doctor will be able to provide additional treatment recommendations if conservative treatment at home is not helpful.

Medication

Prescription nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers can help reduce pain and inflammation. Oral steroids and medications such as Gabapentin or Lyrica that help with nerve pain may also be prescribed. If you are diagnosed with shingles, an antiviral medication may be prescribed although this is dependent on how long the symptoms have been present.

Physical therapy

A physical therapist can guide you through exercises that strengthen and stretch muscles in the back helping to alleviate pain and prevent future issues. Physical therapy will be more helpful when the cause is related to the muscles rather than nerve compression.

Surgical procedures

If conservative treatments fail, surgery may be recommended for things such as herniated discs. Minor procedures like epidural injections may help. Cauda equina syndrome is a medical emergency that will require immediate surgical intervention.

Frequently asked questions: burning lower back pain

Here are answers to some of the most frequently asked questions about burning lower back pain.

How long can burning lower back pain last?

The duration of your symptoms will depend on the underlying cause. Pain from acute injuries is more likely to resolve within a few days to weeks whereas chronic conditions can take months to improve and may never fully resolve without surgical intervention.

What if you feel burning lower back pain while pregnant?

Pregnancy-related changes such as shifts in posture, increase in weight, and a growing baby can lead to lower back pain. A healthcare provider can recommend safe treatments during pregnancy, such as physical therapy.

What if you only experience burning lower back pain while sitting?

The piriformis muscle is located deep in the buttocks, and it can sometimes irritate the sciatic nerve and cause a burning sensation in the lower back and buttocks. This is known as piriformis syndrome and is usually triggered by prolonged sitting and compression of the nerve. Taking frequent breaks to stand and stretch may help.

Managing burning lower back pain

Burning lower back pain is not a symptom to overlook. While it can be caused by a simple muscle strain, nerve-related compression and inflammation are usually to blame for this symptom. If you are experiencing burning lower back pain that lasts more than a few days, worsens, or occurs in addition to other symptoms such as a rash or radiating tingling down the legs, speaking to your healthcare provider is a good idea.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

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