A burning sensation in the lower back often feels like a warm, stinging, or hot discomfort, distinct from a dull ache or sharp pain. This common symptom can arise from various issues affecting the muscles, nerves, or other structures in the lumbar region. Understanding its potential causes is key to determining appropriate care. This article explores the common contributors to lower back burning, from muscle-related concerns to nerve involvement and other less frequent conditions.
Common Musculoskeletal Contributors
Muscle strains and sprains are frequent causes, often resulting from injury to lumbar muscles and ligaments. When these tissues are damaged, the body initiates an inflammatory response, increasing blood flow to promote healing. This increased blood flow and chemical accumulation can manifest as a burning sensation. Poor posture, prolonged sitting or standing, and repetitive movements can also lead to muscle fatigue, spasms, tension, and inflammation. This discomfort is typically localized and often improves with rest or by changing positions.
Nerve Compression and Irritation
Nerve involvement is a common cause of a burning sensation in the lower back, as irritated or compressed nerves send abnormal pain signals. This type of pain is often described as shooting, stinging, or electric shock-like. Neuropathic pain, which is pain caused by a lesion or disease of the somatosensory nervous system, frequently includes burning, coldness, or “pins and needles” sensations.
Sciatica
Sciatica is a prominent example of nerve-related burning pain, occurring when the sciatic nerve is irritated or compressed. This often causes pain radiating from the lower back or buttocks down one leg, commonly accompanied by burning, tingling, or numbness. Conditions leading to sciatica include a herniated disc, spinal stenosis, and piriformis syndrome.
A herniated disc occurs when the soft inner material of a spinal disc pushes through its tougher outer layer, directly pressing on nearby nerves. This mechanical compression, along with inflammatory chemicals released by the disc material, can create a burning sensation that often follows specific nerve pathways. Spinal stenosis involves the narrowing of the spinal canal, which can compress the spinal cord or nerve roots, leading to burning pain that may worsen with standing or walking and improve with sitting or leaning forward. Piriformis syndrome develops when the piriformis muscle, located deep in the buttock, spasms or tightens, irritating the nearby sciatic nerve and causing burning pain, tingling, or numbness that can travel down the leg.
Other Less Common Causes
Beyond musculoskeletal and nerve compression issues, certain distinct conditions can also cause a burning sensation in the lower back.
Shingles
Shingles, a viral infection caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox), can manifest with burning pain. This burning often appears before or along with a characteristic rash that typically forms on one side of the body, including the back. The virus affects nerve fibers, leading to this superficial, skin-level burning sensation.
Contact Dermatitis
Contact dermatitis, an inflammatory skin reaction, can also cause burning or itching in the lower back if the skin comes into contact with an irritant or allergen, contributing to surface-level discomfort.
Other Conditions
Other less frequent causes include spinal infections like vertebral osteomyelitis or discitis. Rarely, conditions like arthritis or certain systemic diseases affecting the nerves, such as diabetic neuropathy, may also present with burning pain in the back.
Important Considerations and When to Seek Medical Care
While many instances of lower back burning resolve with self-care, certain accompanying symptoms warrant prompt medical evaluation. These “red flag” symptoms include sudden severe pain, especially after trauma, or progressive weakness, numbness, or tingling in the legs or feet, indicating potential nerve damage. Loss of bowel or bladder control is a medical emergency signaling severe nerve compression like cauda equina syndrome. Unexplained weight loss, fever, or pain that doesn’t improve with rest or worsens at night also require a healthcare provider visit.
For initial self-care, rest from aggravating activities, apply ice or heat, and take over-the-counter pain relievers for less severe muscle strains. Avoid prolonged bed rest; engage in gentle movement as tolerated. If burning persists, significantly impacts daily activities, or includes any warning signs, consult a medical professional for diagnosis and treatment.