Lower Back Pain: Causes, Diagnosis and Treatment

Lower back pain can come from muscles, joints, discs, vertebrae, or nearby structures, and its treatment depends on the cause.

Pain may feel aching, tight, sharp, burning, or deep around the lower spine and pelvis. It can stay in the back or spread into the buttock, hip, or leg. Stiffness after rest, pain with lifting or turning, and discomfort during prolonged sitting are useful details. Numbness, tingling, weakness, fever, unexplained weight change, or pain after an injury add information that may change the urgency of assessment.

Seek urgent care for back pain with new bladder or bowel difficulty, numbness around the inner thighs or genitals, or significant or progressive leg weakness. Prompt assessment is also needed after major trauma, with fever or feeling very unwell, or when pain is severe and unexplained. These warning signs need a clinical examination rather than self-directed exercise alone.

The list is alphabetical and is not a likelihood ranking. A clinician uses the pain pattern, examination, age, activity, and history of injury or illness to narrow the possibilities.

A clinician asks when the pain began, what movements alter it, whether it travels, and whether there was an injury. Examination may include posture, walking, spinal movement, hip movement, muscle power, reflexes, and sensation. Imaging is not needed for every episode; it may be considered when warning signs, persistent symptoms, nerve findings, or a suspected fracture make the result useful for decisions.

For many mechanical patterns, staying gently active, pacing tasks, and using a progressive exercise plan can support recovery. Physiotherapy may address trunk, hip, and leg strength, movement confidence, and lifting habits. Nerve-related symptoms may need a different programme and medical review. Selected people may discuss manual care, osteopathy, chiropractic adjustment, or non-surgical spinal decompression with a qualified clinician after the diagnosis and suitability have been considered.

Change lifting, gardening, desk work, and sport loads in manageable steps rather than making sudden increases. Alternate positions, take movement breaks, and build strength for the trunk, hips, and legs. Learn which movements calm symptoms and return to valued activities progressively. A flare-up does not automatically mean new damage, but recurring or changing symptoms merit a fresh assessment.

Lower back pain may occur with buttock pain, leg pain, stiffness, muscle spasm, tingling, numbness, or weakness. Pain that worsens with coughing or straining can be relevant to nerve irritation. Pain focused near one side of the pelvis may point clinicians toward the sacroiliac region, while walking-limited leg symptoms may prompt assessment for spinal narrowing.

Assessment may lead to self-management advice, physiotherapy, medication guidance, imaging, or specialist referral depending on the findings. Keep track of function as well as pain: walking distance, sleep, sitting tolerance, and leg strength help show whether treatment is working. Seek review if symptoms progressively spread, weakness develops, or recovery stops moving forward.