Launching September 2027

Low Back Pain / Back Pain

Low Back Pain At A Glance

  • Low back pain is discomfort in the lower back that may feel like aching, tightness, stiffness, burning, or sharp pain.
  • Pain may stay in the back or travel into the buttock, hip, or leg, sometimes with numbness, tingling, or weakness.
  • Common causes include muscle or ligament strain, repetitive lifting, disc problems, arthritis, spinal stenosis, sciatica, fractures, and other medical conditions.
  • Most uncomplicated cases do not require immediate imaging and can initially be evaluated through medical history and a physical examination.
  • Treatment may include staying gently active, temporary activity changes, heat or cold, physical therapy, exercise, medications, and selected procedures when needed.
  • Most acute episodes improve within days to several weeks, although some people experience recurrent or chronic pain.

Table of Contents

Table of Contents

What Is Low Back Pain?

Low back pain is discomfort in the lower part of the back, usually between the bottom of the ribs and the buttocks. It may feel like a dull ache, tightness, burning, stiffness, or sudden sharp pain. Pain may remain in the back or travel into the buttock, hip, or leg.

Back pain is a symptom rather than one specific disease. It may develop after lifting, twisting, falling, prolonged sitting, or repetitive activity, but sometimes there is no clear injury. Acute back pain begins suddenly and generally lasts a few days to a few weeks. Pain lasting longer than three months is considered chronic back pain.

Learn More

Back Pain – NIH MedlinePlus

Provides patient-friendly information about causes, symptoms, treatment, and prevention.

Back Pain – National Institute of Arthritis and Musculoskeletal and Skin Diseases

Explains how back pain develops and describes common mechanical, structural, inflammatory, and medical causes.

How Common Is Low Back Pain?

Back pain is one of the most common medical problems. About 8 out of 10 people experience back pain at some point during their lives.

Low back pain can affect adults of any age. It becomes more common with age and may be associated with physically demanding work, prolonged sitting, previous injuries, limited physical activity, excess body weight, smoking, and certain health conditions. More than one in four working adults has reported low back pain.

Learn More

Living With Back Pain – NIAMS

Provides practical information about managing pain, staying active, and protecting back function.

What Symptoms Might You Notice?

Symptoms vary depending on the cause and severity.

Common symptoms may include:

  • Dull, aching pain
  • Sharp or stabbing pain
  • Burning or tingling
  • Back stiffness
  • Muscle tightness or spasms
  • Reduced movement
  • Difficulty standing straight
  • Pain after lifting, bending, or twisting
  • Pain after sitting or standing for a long time
  • Pain that improves or worsens with movement
  • Pain extending into the buttock, hip, or leg
  • Numbness or tingling in a leg or foot
  • Leg or foot weakness
  • Difficulty walking or completing daily activities
  • Sleep disturbance

Pain traveling down one leg may occur when a spinal nerve is irritated or compressed. This is commonly called sciatica, although not all leg pain is caused by the sciatic nerve.

How Is Low Back Pain Diagnosed?

A healthcare provider will ask about the pain and perform a physical examination.

They may ask:

  • When the pain began
  • Whether an injury occurred
  • Where the pain is located
  • Whether pain travels into a leg
  • Which movements improve or worsen symptoms
  • Whether numbness, tingling, or weakness is present
  • Whether bladder or bowel function has changed
  • Whether fever, unexplained weight loss, or night sweats are present
  • Whether you have osteoporosis or cancer
  • Whether you recently had an infection or procedure
  • Which medications you take
  • How symptoms affect sleep, work, and daily activities

The examination may include:

  • Checking posture and spinal movement
  • Testing leg strength
  • Checking reflexes and sensation
  • Watching you walk
  • Testing hip movement
  • Pressing on areas of tenderness
  • Performing tests that gently stretch the spinal nerves

Most uncomplicated low back pain can initially be diagnosed without immediate imaging. Imaging is more likely to be needed when symptoms suggest fracture, infection, cancer, severe nerve compression, or another serious condition.

Low Back Pain / Back Pain infographic – click to enlarge

What Causes Low Back Pain?

Back pain may result from an injury, gradual wear, inflammation, nerve compression, or another medical condition.

Common causes include:

  • Muscle or ligament strain
  • Repetitive lifting, bending, or twisting
  • Poor lifting technique
  • Sudden awkward movement
  • Falls or accidents
  • Herniated or bulging spinal discs
  • Osteoarthritis
  • Spinal stenosis
  • Degenerative disc changes
  • Sciatica or other nerve irritation
  • Vertebral compression fracture
  • Osteoporosis
  • Spondylolisthesis
  • Ankylosing spondylitis or another inflammatory condition
  • Scoliosis or other spinal alignment changes
  • Pregnancy-related changes
  • Kidney stones or kidney infection
  • Endometriosis or other pelvic conditions
  • Abdominal or vascular conditions
  • Less commonly, infection or cancer

Back pain often develops from mechanical or structural changes involving the spinal bones, discs, muscles, ligaments, tendons, joints, or nerves. In many cases, a single exact cause cannot be identified.

Learn More

Back Pain Symptoms, Types, and Causes – NIAMS

Explains common causes involving the spine, discs, muscles, ligaments, joints, and nerves.

What Can Make Low Back Pain Worse?

Factors that may worsen back pain or delay recovery include:

  • Prolonged bed rest
  • Remaining inactive for long periods
  • Heavy lifting
  • Repeated bending or twisting
  • Poor lifting technique
  • Returning to strenuous activity too soon
  • Prolonged sitting or standing
  • Poor posture
  • Weak abdominal and back muscles
  • Excess body weight
  • Smoking or nicotine use
  • Poor sleep
  • Emotional stress
  • Poorly controlled arthritis or osteoporosis
  • Ignoring progressive numbness or weakness
  • Taking more pain medication than directed

Extended bed rest is generally not recommended for uncomplicated low back pain. Limiting painful activities briefly while continuing gentle movement and gradually increasing activity usually supports recovery better than remaining in bed.

Prevention

Not every episode can be prevented, but healthy movement and workplace habits may reduce risk.

Helpful prevention measures include:

  • Exercise regularly.
  • Strengthen abdominal, hip, and back muscles.
  • Include flexibility and balance activities.
  • Increase exercise intensity gradually.
  • Warm up before strenuous activity.
  • Use safe lifting techniques.
  • Avoid twisting while carrying a heavy object.
  • Hold objects close to the body.
  • Ask for help with heavy or awkward items.
  • Change position regularly.
  • Use an adjustable workstation.
  • Keep frequently used items within easy reach.
  • Wear supportive footwear.
  • Maintain a weight recommended by your provider.
  • Avoid smoking and nicotine.
  • Treat osteoporosis when present.
  • Follow physical therapy recommendations.
  • Return to work and activity gradually after an injury.

Regular walking and continued core-strengthening exercises may help reduce future back injuries and support a safe return to work.

Learn More About Low Back Pain

The following video content is provided to help you better understand this condition. These resources are intended for educational purposes and should not replace personalized medical advice from your healthcare provider.

Labs

Most people with uncomplicated back pain do not need blood or urine testing.

Possible tests include:

  • Complete Blood Count: May identify infection, anemia, or another health concern.
  • C-Reactive Protein: Checks for inflammation.
  • Erythrocyte Sedimentation Rate: May support evaluation for infection or inflammatory disease.
  • Kidney Function Tests: May be ordered when kidney disease or medication safety is a concern.
  • Liver Function Tests: May guide safe medication use.
  • Urinalysis: May identify a urinary infection, blood in the urine, or possible kidney stone.
  • Blood Cultures: May be ordered when a spinal infection is suspected.
  • Calcium and Vitamin D Tests: May be considered when bone health is a concern.
  • Multiple Myeloma Testing: May be ordered when symptoms or imaging raise concern for a blood-cell cancer.
  • HLA-B27 Testing: May support evaluation for ankylosing spondylitis in selected patients.
  • Pregnancy Testing: May be needed before certain medications or imaging tests.

Blood tests cannot diagnose most muscle strains or ordinary mechanical back pain. They are used when the history or examination suggests inflammation, infection, organ disease, or another underlying problem.

Learn More

Medical Tests – NIH MedlinePlus

Provides explanations of common blood, urine, and other laboratory tests.

Diagnostics

Imaging is not always necessary during the early stages of uncomplicated back pain. Many spinal changes found on imaging are also present in people without pain, so results must be considered together with the symptoms and physical examination.

Possible tests include:

  • X-Ray: Evaluates fractures, alignment, arthritis, and some bone changes.
  • Magnetic Resonance Imaging: Shows discs, nerves, spinal cord, muscles, ligaments, infection, and tumors.
  • Computed Tomography Scan: Provides detailed bone images and may identify complex fractures.
  • Bone-Density Scan: Evaluates osteoporosis and fracture risk.
  • Electromyography and Nerve-Conduction Studies: Evaluate nerve and muscle function when weakness, numbness, or persistent leg symptoms are present.
  • Bone Scan: May identify selected fractures, infections, tumors, or abnormal bone activity.
  • Myelogram: Uses contrast material to evaluate the spinal canal when MRI cannot be performed.
  • Diagnostic Injections: May occasionally help identify a specific source of persistent pain.

MRI or other advanced imaging may be recommended when there is progressive leg weakness, loss of bladder or bowel control, fever, history of cancer, major trauma, severe persistent pain, or other warning signs.

Learn More

MRI and Low Back Pain – NIH MedlinePlus

Explains when MRI may be appropriate and why it is not routinely needed for every episode of back pain.

Treatment & Management

Treatment Options

Treatment depends on the cause, duration, severity, and effect on daily activities.

Treatment options may include:

  • Remaining gently active
  • Temporary activity modification
  • Heat or cold therapy
  • Physical therapy
  • Stretching and strengthening exercises
  • Education about posture and movement
  • Nonprescription pain medication
  • Prescription medication
  • Massage
  • Acupuncture
  • Spinal manipulation in selected patients
  • Cognitive behavioral therapy
  • Mindfulness-based treatment
  • Yoga or tai chi adapted to the individual
  • Treatment of osteoporosis or inflammatory disease
  • Spinal injections in selected cases
  • Surgery for specific structural or neurological problems

For acute or subacute uncomplicated low back pain, nonmedication options such as superficial heat, massage, acupuncture, or spinal manipulation may be considered. Chronic pain treatment often combines exercise, rehabilitation, behavioral approaches, and carefully selected medications.

Learn More

Back Pain: Diagnosis, Treatment, and Steps to Take – NIAMS

Provides information about activity, physical therapy, medications, complementary treatments, injections, and surgery.

Lifestyle Changes

Helpful lifestyle changes may include:

  • Stay physically active within your limits.
  • Gradually return to normal activities.
  • Walk regularly if tolerated.
  • Strengthen the abdominal, hip, and back muscles.
  • Include flexibility and balance exercises.
  • Change position regularly.
  • Avoid sitting for long uninterrupted periods.
  • Use safe lifting techniques.
  • Keep objects close to your body when lifting.
  • Bend at the hips and knees instead of twisting the back.
  • Use supportive footwear.
  • Maintain a weight recommended by your provider.
  • Stop smoking or using nicotine.
  • Get adequate sleep.
  • Manage stress.
  • Adjust your workstation when needed.
  • Use assistive equipment for heavy or repetitive tasks.

Adults generally benefit from regular aerobic and muscle-strengthening activity, but an exercise program should be adjusted for pain severity, physical ability, and medical conditions.

Medications

Medication may reduce symptoms but does not always correct the underlying cause.

Possible medications include:

  • Nonsteroidal Anti-Inflammatory Drugs: Ibuprofen or naproxen may reduce pain and inflammation.
  • Acetaminophen: May provide pain relief for some patients but does not reduce inflammation.
  • Topical Pain Relievers: Products containing diclofenac, menthol, lidocaine, or capsaicin may help selected patients.
  • Muscle Relaxants: May be prescribed for a short period when muscle spasms are significant.
  • Duloxetine: May be used for certain cases of chronic low back pain.
  • Gabapentin or Pregabalin: May occasionally be used for selected nerve-related conditions but are not appropriate for all back pain.
  • Corticosteroids: Oral or injected steroids may be considered in selected inflammatory or nerve-related conditions.
  • Antibiotics: Used only when a bacterial infection is diagnosed.
  • Osteoporosis Medication: May reduce future vertebral-fracture risk.
  • Opioid Medication: Generally reserved for carefully selected cases when safer treatments have not provided enough benefit.

Nonsteroidal anti-inflammatory drugs may increase the risk of stomach bleeding, kidney injury, elevated blood pressure, and heart problems. Acetaminophen can cause severe liver injury if too much is taken or if several acetaminophen-containing products are combined.

Muscle relaxants and opioids may cause sleepiness, poor coordination, falls, breathing problems, dependence, or dangerous interactions with alcohol and sedating medications. Do not drive or operate machinery when a medication causes drowsiness.

Learn More

Pain Relievers – NIH MedlinePlus

Provides information about common pain medicines, safe use, side effects, and interactions.

Procedures

Most back pain does not require a procedure or surgery.

Possible procedures include:

  • Trigger-Point Injection: Places medication into selected painful muscle areas.
  • Epidural Steroid Injection: May provide temporary relief for selected cases involving nerve-root inflammation.
  • Facet-Joint Injection: May help diagnose or temporarily treat pain from selected spinal joints.
  • Medial Branch Block: Tests whether specific small nerves are carrying pain from a facet joint.
  • Radiofrequency Ablation: Uses heat to interrupt selected pain signals.
  • Vertebral Augmentation: May be considered for selected painful compression fractures.
  • Discectomy: Removes part of a herniated disc pressing on a nerve.
  • Laminectomy: Removes bone or tissue to relieve pressure caused by spinal stenosis.
  • Spinal Fusion: Permanently joins vertebrae in selected cases of instability or deformity.
  • Artificial Disc Replacement: Replaces a damaged disc in carefully selected patients.

Spinal surgery is generally considered when there is a correctable structural problem, significant nerve compression, progressive neurological impairment, spinal instability, or persistent disabling symptoms that have not improved with appropriate nonsurgical treatment.

What Should You Expect Long-Term?

Most episodes of acute low back pain improve within days to several weeks. Some people experience recurring episodes, while others develop chronic symptoms lasting longer than three months.

Long-term recovery may depend on:

  • The underlying cause
  • Whether nerve compression is present
  • Overall health
  • Physical activity level
  • Muscle strength and flexibility
  • Smoking or nicotine use
  • Sleep and stress
  • Workplace demands
  • Previous back injuries
  • Following rehabilitation recommendations

Persistent pain does not always mean that the spine is continuing to become damaged. Chronic pain may involve changes in movement, muscle conditioning, sleep, mood, stress, and the nervous system’s response to pain. Treatment often focuses on improving function and quality of life rather than completely eliminating every sensation.

What Can You Do At Home?

For uncomplicated back pain without warning signs:

  • Avoid prolonged bed rest.
  • Continue gentle daily activity as tolerated.
  • Temporarily avoid heavy lifting and painful movements.
  • Take short walks.
  • Change position regularly.
  • Apply a wrapped cold pack after a recent injury.
  • Use gentle heat for stiffness or muscle tightness.
  • Limit heat or cold applications to about 15–20 minutes.
  • Place a cloth between your skin and the heat or cold source.
  • Use medication only as directed.
  • Sleep in a comfortable position with supportive pillows.
  • Gradually restart normal activities.
  • Contact a provider if symptoms worsen or do not improve.

Cold may reduce pain after a recent injury, while heat can improve blood flow and relieve muscle stiffness. Remaining gently active is generally preferred over prolonged bed rest.

Avoid aggressive stretching, heavy lifting, or forceful spinal manipulation when pain follows major trauma or is accompanied by numbness, weakness, fever, osteoporosis, or other warning signs.

Learn More

Taking Care of Your Back at Home – NIH MedlinePlus

Provides practical information about activity, sleep positions, exercise, heat, cold, and returning to normal routines.

Frequently Asked Questions

Is low back pain always caused by a slipped disc?

No. Muscle or ligament irritation, arthritis, joint changes, posture, physical workload, and many other factors can cause pain. A herniated disc is only one possible cause.

What is sciatica?

Sciatica describes pain caused by irritation or compression involving the sciatic nerve or its spinal nerve roots. Pain may travel from the back or buttock down the leg and may include tingling, numbness, or weakness.

Should I stay in bed until the pain is gone?

Usually not. Briefly reducing painful activity may help, but prolonged bed rest can increase stiffness and weakness. Gentle activity should be resumed as tolerated.

Should I use heat or ice?

Cold may help after a recent injury or when swelling is present. Heat may help stiffness and muscle spasm. Protect the skin and stop if symptoms worsen.

Do I need an MRI?

Most people with uncomplicated new back pain do not need immediate MRI testing. MRI may be appropriate when there are serious warning signs, progressive neurological symptoms, or persistent symptoms that could change treatment.

Can I exercise with back pain?

Gentle movement is often helpful. Avoid exercises that cause sharp pain, worsening leg symptoms, or new weakness. A physical therapist can develop an individualized program.

Can stress make back pain worse?

Yes. Stress may increase muscle tension, interfere with sleep, reduce activity, and make pain feel more intense.

Can back pain come from the kidneys?

Yes. Kidney stones or infection may cause pain in the side or back. Kidney-related pain may occur with fever, nausea, painful urination, frequent urination, or blood in the urine.

Can back pain be caused by cancer?

Cancer is an uncommon cause of back pain. Risk is higher when pain occurs with a history of cancer, unexplained weight loss, persistent night pain, or other concerning symptoms.

How long does low back pain last?

Many acute episodes improve over several days to a few weeks. Pain lasting longer than three months is considered chronic.

Questions To Ask Your Provider

Consider asking:

  • What is most likely causing my back pain?
  • Are there any warning signs of a serious condition?
  • Could a nerve be compressed?
  • Do I need an X-ray or MRI?
  • Which activities should I avoid temporarily?
  • Should I use heat or cold?
  • Which pain medication is safest for me?
  • Would physical therapy help?
  • Which exercises should I perform?
  • How can I safely return to work?
  • Should I adjust my workstation?
  • Do I need testing for osteoporosis?
  • Could another organ or medical condition be causing the pain?
  • When should I see a spine specialist?
  • What symptoms require emergency treatment?
  • What should I do if the pain returns?

Specialist Referrals

Many cases can be managed by a primary care provider.

You may be referred to:

  • Physical Therapist: Improves movement, strength, posture, flexibility, and body mechanics.
  • Physiatrist: Specializes in nonsurgical rehabilitation of muscles, nerves, joints, and the spine.
  • Orthopedic Spine Specialist: Evaluates structural problems, fractures, deformity, and possible surgical conditions.
  • Neurosurgeon: Evaluates spinal-cord or nerve compression and selected surgical conditions.
  • Pain Management Specialist: Treats persistent pain using medication, rehabilitation, injections, and other methods.
  • Rheumatologist: Evaluates inflammatory back pain and autoimmune disease.
  • Neurologist: Assesses unexplained weakness, numbness, or other neurological symptoms.
  • Urologist or Kidney Specialist: Evaluates suspected kidney-related pain.
  • Gynecologist: Evaluates possible pelvic or reproductive causes.
  • Oncologist or Infectious Disease Specialist: May assist when cancer or spinal infection is diagnosed.

Is Low Back Pain Curable?

Whether back pain is curable depends on its cause.

A mild muscle or ligament injury may heal completely. Infections, fractures, herniated discs, inflammatory disease, spinal stenosis, and other conditions require specific treatment and may have different long-term outcomes.

Chronic degenerative or inflammatory conditions may not have a permanent cure, but treatment can often:

  • Reduce pain
  • Improve mobility
  • Strengthen supporting muscles
  • Protect nerve function
  • Improve sleep and daily function
  • Reduce future flare-ups
  • Delay or avoid surgery

Emergency Symptoms / When To Seek Immediate Help

Call 911 or seek emergency medical care immediately if back pain occurs with:

  • New loss of bladder or bowel control
  • Inability to urinate
  • Numbness around the genitals, inner thighs, or buttocks
  • Sudden severe weakness in one or both legs
  • Loss of consciousness
  • Severe trauma
  • Chest pain or difficulty breathing
  • Sudden severe abdominal or back pain
  • A cold, pale, or weak leg
  • Signs of a severe allergic reaction after medication

Loss of bladder or bowel control, urinary retention, saddle-area numbness, or rapidly worsening leg weakness may indicate severe compression of the lower spinal nerves and requires emergency evaluation.

Seek urgent same-day medical evaluation for:

  • Fever or chills with back pain
  • Severe pain after a fall or accident
  • Back pain in someone with osteoporosis
  • Progressive numbness or weakness
  • Difficulty walking or loss of balance
  • Unexplained weight loss
  • A history of cancer
  • Pain that is severe at night
  • Pain that does not improve with position changes
  • Recent serious infection
  • Recent spinal procedure or injection
  • Immune suppression
  • Long-term corticosteroid use
  • Pain with painful urination or blood in the urine
  • New back pain during pregnancy or shortly after delivery
  • Pain that is rapidly worsening
  • Severe pain that is not relieved by prescribed medication

Learn More

MRI and Low Back Pain – NIH MedlinePlus

Lists warning signs that may require urgent assessment and advanced imaging.

CALL 911

APNS does not provide emergency medical services. If you believe you are experiencing a medical emergency, including (but not limited to) chest pain, difficulty breathing, stroke symptoms, severe allergic reactions, anaphylaxis, uncontrolled bleeding, seizures, loss of consciousness, or any other potentially life-threatening condition, you are instructed to call 911 immediately or go immediately to the nearest emergency department.

Official Resources / External Links

Back Pain – NIH MedlinePlus

Patient-friendly information about acute and chronic back pain, causes, symptoms, and treatment.

Acute Low Back Pain – NIH MedlinePlus

Explains symptoms, recovery, self-care, and when to contact a healthcare provider.

Chronic Low Back Pain – NIH MedlinePlus

Provides information about persistent back pain, nerve symptoms, testing, and treatment.

Back Pain – National Institute of Arthritis and Musculoskeletal and Skin Diseases

Explains common causes, risk factors, symptoms, and types of back pain.

Back Pain: Diagnosis, Treatment, and Steps to Take – NIAMS

Provides guidance about evaluation, home care, exercise, medication, complementary care, injections, and surgery.

Taking Care of Your Back at Home – NIH MedlinePlus

Provides practical advice about activity, sleeping positions, exercise, heat, and cold.

MRI and Low Back Pain – NIH MedlinePlus

Explains when advanced imaging may be needed and why routine MRI is not always helpful.

This guide is intended for educational purposes only and should not replace medical advice, diagnosis, imaging, or treatment from your healthcare provider. Back pain may be caused by a muscle or ligament injury, spinal-disc problem, nerve compression, arthritis, fracture, osteoporosis, inflammatory disease, infection, kidney condition, abdominal or pelvic condition, cancer, or another problem requiring specific treatment. Consult a healthcare professional before beginning a new exercise program, taking pain medication regularly, or combining over-the-counter products. Avoid forceful spinal manipulation after significant trauma or when you have osteoporosis, progressive weakness, numbness, fever, or another warning sign. Seek urgent medical care for fever, serious trauma, rapidly worsening pain, progressive leg weakness, difficulty walking, unexplained weight loss, or a history of cancer with new back pain. Call 911 immediately for loss of bladder or bowel control, inability to urinate, numbness around the genital or buttock area, sudden severe leg weakness, chest pain, difficulty breathing, loss of consciousness, or another medical emergency.

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