Lower Back Pain
Also known as: Lumbago، Chronic low back pain، Mechanical back pain
Lower back pain affects roughly 80% of adults at some point in life. Most cases are mechanical and improve with conservative care, but understanding the cause matters for the right treatment.
Common Symptoms
- Aching or stabbing pain in the lower back
- Pain that worsens with prolonged sitting or standing
- Pain radiating into the buttock or down the leg (sciatica)
- Muscle spasms in the back
- Limited range of motion — difficulty bending forward
- Stiffness, especially in the morning or after rest
- Numbness or tingling in the legs (if nerve involvement)
Causes & Risk Factors
- Muscle strain from lifting, awkward movement, or poor posture
- Disc problems (bulging, herniated, or degenerated discs)
- Spinal stenosis (narrowing of the spinal canal)
- Spondylolisthesis (one vertebra slipping over another)
- Facet joint arthritis
- Sedentary lifestyle and weak core muscles
- Obesity
- Poor sleeping position or mattress
Treatment Options
Lifestyle modifications and posture training
Address the root cause: ergonomic chair, hourly movement breaks, proper lifting technique, weight management, smoking cessation. Foundation of long-term improvement.
Core and glute strengthening
Targeted exercises: planks, glute bridges, bird dogs. 10-15 minutes daily. Reduces recurrence rates significantly. The most important long-term intervention.
Physical therapy
Spine-trained physiotherapist diagnoses your specific movement dysfunction and prescribes corrective exercises. McKenzie method especially effective.
NSAIDs and muscle relaxants
Short courses for acute flare-ups. Not for long-term use. Topical NSAID gels (diclofenac) safer for ongoing management.
Epidural injections (for nerve-involved pain)
When back pain involves leg pain from a compressed nerve, targeted injections can provide weeks to months of relief.
Surgery (rarely needed)
Less than 5% of patients with lower back pain need surgery. Reserved for: severe disc herniation with nerve compression, spinal stenosis with progressive symptoms, or instability not responding to conservative care.
When to See a Doctor
- Pain persisting more than 4-6 weeks
- Pain radiating into the leg with numbness or weakness
- Pain after significant trauma
- Pain with fever, unexplained weight loss, or history of cancer
- Loss of bladder or bowel control (URGENT — cauda equina)
- Severe pain that doesn't ease in any position
- Pain combined with stomach or chest symptoms
Frequently Asked Questions
What's the most common cause of lower back pain?
Muscle strain from lifting, awkward movement, or prolonged poor posture is the most common cause. Disc problems are second most common. About 85% of cases are mechanical (non-serious) and respond well to conservative care.
How long does lower back pain take to heal?
Most acute episodes resolve in 2-6 weeks with appropriate self-care. Chronic pain (>12 weeks) requires structured treatment but often improves significantly over 3-6 months.
Should I rest or stay active with back pain?
Stay gently active. Walking 15-30 minutes daily is therapeutic. Bed rest beyond 1-2 days worsens recovery. Avoid only the specific movements that worsen pain.
Will I need an MRI for back pain?
MRI is ordered when pain persists beyond 6 weeks despite treatment, when neurological symptoms are present (numbness, weakness, leg pain), or when surgery is considered. Most acute cases don't need MRI initially.
What's the best sleeping position for back pain?
Side sleeping with a pillow between the knees is best for most. Second-best: on your back with a pillow under the knees. Avoid stomach sleeping — it stresses both the neck and lower back.