Low Back Pain
by Elizabeth Smoots, MD
Low back pain is an ache or discomfort in the area of the lower part of the back and spinal column. The lower spinal column has many small bones and muscles that surround and protect the spinal cord and nerves. Low back pain is common and affects most adults at some point in their lives.
There are many possible causes for low back pain, but in most cases it is unknown. Some causes of back pain may include:
Low back pain in more common in older adults.
Factors that increase your chance of low back pain include:
General factors, such as:
Health conditions, such as:
Occupational factors, such as:
Psychosocial factors, such as:
Pain is usually restricted to the low back. It can get worse with back motion, sitting, standing, bending, and twisting. If a nerve is irritated, the pain may spread into the buttock or leg on the affected side. Muscle weakness or numbness may occur.
When Should I Call My Doctor?
Often, back pain improves with self-treatment. However, some serious symptoms may occur. They may require more immediate medical attention. Call your doctor if back pain:
You should call your doctor if you have back pain and a history of cancer or osteoporosis. You should also call if you have a history of recent infection, steroid use, or IV drug use.
You will be asked about your symptoms and medical history. A physical exam will be done. The exam will focus on your back, hips, and legs. The doctor may test for strength, flexibility, sensation, and reflexes.
Imaging tests are rarely needed. They may be done for pain that is severe or does not respond to treatment. If needed, imaging tests options include:
Your doctor may recommend other tests to help diagnose or eliminate any causes of your back pain.
Treatment options include:
Bed rest is not generally recommended. It may be suggested for no more than 1-2 days in those with severe pain. Certain activities may be restricted for a period of time and then resumed as soon as possible. Recovery time may be shortened by staying active and exercising.
Your doctor may advise:
Physical therapy may include:
Cognitive behavioral therapy is often used to help manage chronic pain and stress. It is a form of talk therapy that may be done individually or in a group. A therapist will help you identify negative thoughts and teach you to unlearn these thought patterns. You will also learn new, helpful habits to manage your pain with minimal disruption to your life.
Some people find pain relief from:
To help reduce your chance of low back pain:
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
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Last reviewed November 2018 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 5/23/2017
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