Low Back Pain

Overview

Low back pain is one of the most common medical complaints, affecting up to 80% of adults at some point in their lives. It can range from a dull, constant ache to sudden, sharp pain that makes movement difficult. Low back pain may be acute (lasting less than 6 weeks), subacute (6-12 weeks), or chronic (more than 12 weeks).

Common Causes

  • Muscle or ligament strain: From heavy lifting or sudden movements
  • Herniated or bulging discs: Pressing on nerve roots
  • Degenerative disc disease: Age-related wear and tear
  • Spinal stenosis: Narrowing of the spinal canal
  • Osteoarthritis: Joint degeneration in the spine
  • Spondylolisthesis: Vertebra slipping out of position
  • Sciatica: Compression of the sciatic nerve
  • Poor posture: Prolonged sitting or standing
  • Osteoporosis: Weakened bones leading to fractures
  • Fibromyalgia: Widespread muscle pain and tenderness
  • Kidney stones or infections: Can cause referred back pain
  • Endometriosis: In women, can cause cyclical back pain
  • Spinal infections: Rare but serious cause
  • Cancer: Primary or metastatic tumors (rare)

Diagnosis

Evaluation typically includes:

  • Medical history and physical examination
  • Assessment of pain characteristics and triggers
  • Neurological testing for nerve involvement
  • X-rays to check bone structure
  • MRI or CT scan for detailed imaging
  • Blood tests to rule out infection or inflammation
  • Bone scan if fracture or cancer suspected
  • Electromyography (EMG) for nerve damage

Treatment Options

  • Rest: Brief period of reduced activity (not prolonged bed rest)
  • Ice and heat therapy: Ice for acute pain, heat for muscle tension
  • Over-the-counter pain relievers: NSAIDs or acetaminophen
  • Physical therapy: Exercises to strengthen and stretch
  • Massage therapy: For muscle tension relief
  • Chiropractic care: Spinal manipulation
  • Prescription medications: Muscle relaxants or stronger pain relievers
  • Epidural steroid injections: For nerve-related pain
  • Cognitive behavioral therapy: For chronic pain management
  • Acupuncture: Alternative pain relief method
  • Surgery: For severe cases not responding to conservative treatment

Red Flag Symptoms - Seek Immediate Care

Contact emergency services or see a doctor immediately if you experience:

  • Loss of bladder or bowel control
  • Numbness in the groin or genital area (saddle anesthesia)
  • Severe weakness in legs or difficulty walking
  • Fever with back pain
  • Unexplained weight loss with back pain
  • Back pain after significant trauma
  • History of cancer with new back pain
  • Severe pain that doesn't improve with rest
  • Progressive neurological symptoms