Low Back Pain
This problem is more common in older adults.
General risk factors are:
- Certain activities, such as lifting, bending, or twisting
- Lack of activity
- Prior back injury
- Prior back surgery
Health problems, such as:
- Herniated disc —the cushions between the bones of the spine develop a bulge
- Degenerative diseases, such as arthritis
- Fractures due to trauma and osteoporosis
- Spinal stenosis —narrowing of the spinal canal
- Spondylolisthesis —slippage of a bone in the lower back
- Ankylosing spondylitis —an autoimmune disease involving the spine
- Cauda equina syndrome —compression of nerve roots at the base of the spinal cord
Job-related factors, such as:
- Bending, twisting, or reaching
- Heavy manual labor
Psychosocial factors, such as:
- Anxiety and depression
- Repetitive tasks
The main problem is pain in the low back. It may be worse with 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 also occur.
When Should I Call My Doctor?
Often, back pain improves with home care. Some problems may need care right away. Call the doctor if you have:
- Severe or worsening pain
- Pain that lasts longer than one week
- Problems walking, standing, or moving
- Pain that is worse at night or when you lie down
- Pain that spreads down your legs
- Pain or throbbing in your belly
Bain pain with:
- Numbness, weakness, or tingling in the buttocks, genitals, or legs
- Loss of bowel or bladder control
- Problems urinating
- Fever, unexplained weight loss, or other signs of illness
The doctor will ask about your symptoms and health history. A physical exam will be done. The exam will focus on the back, hips, and legs.
Imaging tests are rarely needed. They may be done for pain that is severe or does not get better with treatment. They may be taken with:
- MRI scan
- CT scan
Other tests may be done. It depends on what the doctor thinks may be causing the pain.
The goal of treatment is to ease pain. Choices are:
- Supportive care, such as resting the area for no more than 1 to 2 days, applying cold compresses, and avoiding things that may the pain worse
- Medicines, such as:
- Over the counter and prescription pain relievers
- Topical pain relievers that are applied to the skin
- Muscle relaxants to ease spasms
- Physical therapy to improve strength, flexibility, and range of motion
- Cognitive behavioral therapy to learn how to manage pain
Some people may need surgery, such as discectomy , laminectomy , or spinal fusion .
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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North American Spine Society http://www.spine.org
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
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