Lower Back Pain

Conditions & Symptoms

Low back pain is an exceptionally common condition that will affect 90% of us at some point in our lives. The most common cause is soft tissue injury- strain of the muscles, ligaments or tendons in the lumbar spine. Other causes include degenerative disc disease, facet joint syndrome, sacroiliitis, scoliosis, herniated disc and spinal stenosis. The most common symptoms are pain, stiffness and muscle spasm in the lower back. Pain, numbness and tingling into the leg and foot often occur with lumbar radiculopathy (sciatica). If you experience loss of bladder or bowel control or severe leg weakness (foot drop) you should seek urgent medical attention.

Examination & Diagnosis

Your doctor will conduct a thorough medical history and physical examination to determine the cause of your pain. In many cases, diagnostic studies are not necessary. X-rays are usually the initial study obtained. In some cases, magnetic resonance imaging (MRI), computerized tomography (CT scan) or bone scan is needed to diagnose your condition. Electrodiagnostic studies (EMG/NCS) are often obtained to evaluate for nerve damage or other neurologic conditions that cause pain.

Treatments & Procedures

The majority of cases resolve within 4-6 weeks. Initial treatment consists of relative rest, ice or heat and over-the-counter pain medications. Bed rest should be avoided and you should remain as active as possible within your limits of pain. Physical therapy is often prescribed to stretch and strengthen back muscles. Interventional pain procedures may also be helpful in certain conditions. In rare cases, surgery may be necessary.