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Low Back Pain

Low back pain is a common problem that can have many causes, from muscle strain to a herniated disc. You should see a doctor for low back pain that persists, is severe, or could mean nerve compression.

UPMC offers many treatments for low back pain. These include pain medication, steroid injections, physical therapy, lifestyle management, and surgery.

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What Is Low Back Pain? 

Low back pain can feel like a stabbing, burning, or aching pain. It may be constant, or it may come and go over the course of the day.

While most low back pain resolves over time, episodes of low back pain often return. You can treat and prevent low back pain with lifestyle changes, along with care from your doctor.

How common is low back pain?

Lower back pain is very common, with 75% to 85% of Americans getting it at some point in their lives, according to the American Association of Neurological Surgeons.

For some people, low back pain is chronic, meaning it lasts longer than 12 weeks or frequently returns. About 8% of Americans suffer from chronic low back pain, according to the National Center for Complimentary and Integrative Health.

What causes lower back pain? 

Low back pain can have many causes, such as:

  • A herniated disc.
  • A sprain or strain from overuse, repeated movements, or a single, awkward movement.
  • A tumor (this is a rare).
  • An infection (this is rare).
  • Ankylosing spondylitis.
  • Arthritis.
  • Lumbar spinal stenosis.
  • Osteoporosis.
  • Scoliosis, or a curve of the spine.

Your low back pain could also be from something not listed above.

What are low back pain risk factors and complications?

Low back pain is more likely in people over age 30. Chronic low back pain is especially common between the ages of 50 and 60, according to the National Library of Medicine.

Besides age, your lifestyle can contribute to low back pain.

Lower back pain risk factors 

There are risk factors that can make lower back pain more likely, including:

  • A misalignment in the bones of your spine, or vertebrae. This can be due to an injury or genetics.
  • A lack of exercise, as weak muscles in the abdomen and back can increase the risk of low back strain.
  • Age, especially if you're over 30.
  • Being overweight.
  • Engaging in frequent repetitive movements that put pressure on the lower back, like lifting, pushing, pulling, or twisting movements.
  • Having poor posture.
  • Sitting in a poorly designed chair for a long time, or driving for long periods without taking a break.
  • Smoking, which can increase the risk of health issues that cause low back pain, like herniated discs and osteoporosis.
  • Stress, including stress due to depression, anxiety, or poor sleep.

Complications of lower back pain

Left untreated, back pain can worsen over time.

People with low back pain may exercise less, increasing their risk of many diseases, including diabetes and heart problems.

Low back pain can also make it hard to engage with friends or family. It can impact your sleep and how well you're able to do your job, and make leisure activities less enjoyable.

Long-term or recurring back pain is a serious health problem that requires expert care.

How can I prevent lower back pain?

You can help prevent low back pain if you:

  • Avoid sitting or standing in one position for too long.
  • Avoid lifting things that are too heavy. Ask someone else to help you.
  • Eat a balanced diet to maintain a healthy weight.
  • Lift with a proper technique — bend at the knees and engage the legs when lifting.
  • Sit up straight, with both feet on the floor.
  • Strengthen the muscles in your abdomen, glutes, hips, and lower back. You can search online for exercises to prevent low back pain, or work with a physical therapist.
  • Using an ergonomic chair when you're sitting for long periods.

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What Are the Signs and Symptoms of Low Back Pain?

Depending on the cause, people with low back pain may experience 1 or more of the following:

  • A burning pain.
  • A sudden, sharp pain.
  • A dull ache.
  • Difficulty standing up straight.
  • Stiffness in the low back.

When should I see a doctor about my low back pain symptoms?

See your doctor if your low back pain doesn't go away after a few weeks, or comes with other concerning symptoms. You always should see a doctor if you have:

  • Low back pain after a fall or other injury, which could suggest a fracture.
  • Lower back pain that occurs with a fever or weight loss. This could be a sign of a more serious health problem.
  • Lower back pain that shoots down the leg.
  • Problems with bladder or bowel control. This may mean something is compressing the nerves in the spine and require medical attention to avoid nerve damage.
  • Severe back pain, such as pain that makes it hard to sleep or to focus at work or school.
  • Weakness, numbness, or tingling in 1 or both legs, which could be due to nerve compression.

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How Do You Diagnose Lower Back Pain?

Many providers can diagnose low back pain. You might see a primary care doctor, a physical therapist specializing in spine, a sports medicine doctor, or a surgeon.

What to expect during your visit

To help diagnose your lower back pain, the doctor will ask when the pain started. They'll want to know how the pain feels (sharp, burning, or aching) and what makes it better or worse.

They'll also ask about your daily activities to see if your lifestyle might be contributing to your back pain.

Your doctor may ask you to walk or do certain exercises. They may have you lie on a table while they move your legs, to see how this affects your pain. They may also examine your lower back and legs to look for signs of swelling or weakness.

Most cases of low back pain don't need imaging tests. The doctor can often diagnose the cause based on your symptoms, lifestyle factors, and the physical exam.

Tests to diagnose low back pain

For back pain that doesn't go away, is very severe, or comes along with other concerning symptoms, your doctor may order tests.

Your doctor will choose which test to run based on whether the problem seems related to the bones or soft tissues. Options include:

  • CT scan.
  • MRI.
  • X-ray.
  • A bone scan that uses a radioactive tracer to look for breaks, infections, or tumors that don't show up on an x-ray.
  • A bone density study to help diagnose osteoporosis.
  • Electromyography and nerve conduction velocity tests. These tests measure how electrical signals travel from the nerves in your back to other parts of your body.

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How Do You Treat Low Back Pain?

Treatment for low back pain depends on what's causing it. In many cases, low back pain requires more than 1 type of therapy.

Doctors usually start with lifestyle changes and medicine, and only consider surgery if those don't work. The goal of treatment is to dramatically reduce back pain and, ideally, resolve it completely.

Lifestyle changes

Your doctor will discuss your lifestyle and make suggestions for changes you can make to reduce your back pain. These may include:

  • Adjusting how you lift heavy objects.
  • Changing your sitting and standing posture.
  • Losing weight.
  • Stretching and exercising regularly.
  • Using an ergonomic chair and sleeping on a firm mattress.


Your doctor may suggest over-the-counter or prescription medicines. Non-steroidal anti-inflammatory drugs (NSAIDs) are helpful for lower back pain but may not be appropriate for everyone.

Physical therapy for low back pain

A primary spine practitioner is a physical therapist specializing in spine. They will teach you exercises to strengthen specific muscles in your back, abdomen, glutes, and legs. Over time, this will improve the support for your spine and prevent pain.


Your doctor may advise you to only sit or stand for a certain amount of time each day. They may also tell you to avoid certain movements, like lifting, and avoid sports until your pain resolves.

Steroid injections for low back pain

For pain that shoots from the lower back down the leg (sciatica), steroid injections can help. Studies show steroid injections at the base of the spine can improve pain for about a month or so. This can help in combination with lifestyle changes, which may take longer to work.


Sometimes, lower back pain requires surgery. Doctors only recommend surgery when other treatments don't work, or if it's needed to avoid nerve damage.

Various surgical techniques can help to stabilize the spine and prevent pain.

For example, the surgeon may replace worn or damaged discs that don't stay in place or properly cushion the vertebrae. They may fuse parts of the vertebrae together to make the spine more stable. They can also remove bone spurs that can grow in the spine and compress nerves.

While surgery can relieve pain for some, it carries risks, including infection and nerve damage. It also has a long recovery time, taking about 6 weeks before people can get back to light activity. That's why doctors only suggest surgery when it is likely to be successful and when it's necessary.

Other remedies

Some people find relief in remedies like massage, acupuncture, or heat (from a hot bath or heating pad). Psychological services can help when stress is adding to low back pain, or depression makes lifestyle changes difficult.

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