Low Back Pain: Symptoms, Causes & Treatment

Low back pain is among the most common health problems of all, and most adults are estimated to experience it at some point in life. The lower back bears the body's weight and participates in most movements, so it is prone to strain. In the vast majority of cases the pain is mechanical and benign, that is, due to muscle strain, ligament strain, or mild wear, without a serious underlying disease, and improves on its own within days to weeks.

Causes of low back pain vary: it may result from a wrong posture, lifting a load improperly, prolonged sitting, weak trunk muscles, obesity, or inactivity. It may relate to a herniated disc pressing on a nerve causing pain radiating to the leg (sciatica), or to spinal canal narrowing in the elderly. Patients describe the pain in various ways: tightness, morning stiffness, or pain increasing with a certain movement or prolonged standing. In most cases there is no need for immediate imaging, because X-ray images may show common changes unrelated to the pain.

Although most cases are benign, there are warning signs requiring urgent evaluation, including: pain after an injury or fall, severe persistent pain at night not improving with rest, unexplained weight loss and fever, increasing weakness or numbness in the legs, or loss of control of urine or stool (an emergency). The basis of treatment in benign cases is to keep moving as much as possible and avoid prolonged complete rest, with simple painkillers when needed, strengthening and stretching exercises, and posture correction. Physical therapy is effective, and surgery is reserved for specific cases. Prevention (regular movement, trunk strengthening, proper lifting, a healthy weight) reduces recurrence.

• Pain or tightness in the lower back and morning stiffness.
• Pain increasing with a certain movement or prolonged standing or sitting.
• Sometimes pain radiating to the leg (sciatica) with numbness or tingling.

• Muscle or ligament strain (the most common, benign).
• Wrong posture, improper lifting, prolonged sitting, weak trunk muscles.
• A herniated disc pressing on a nerve (sciatica).
• Spinal canal narrowing in the elderly, obesity, and inactivity.

• Age: Risk increases with age, particularly after 30 years old.
• Gender: Women are more susceptible than men, especially due to osteoporosis.
• Obesity and weight gain: Extra weight increases pressure on the lower back and vertebrae.
• Physical inactivity: Prolonged sitting and lack of movement weaken the muscles supporting the spine.
• Nature of work: Jobs requiring heavy lifting or continuous sitting.
• Smoking: Reduces blood flow to intervertebral discs and accelerates degeneration.
• Psychological stress and anxiety: Increases muscle tension and pain perception.
• Pregnancy (in women): Alters weight distribution and increases pressure on the back.
• Family history: You may have genetic predisposition to certain spinal problems.

• Clinical examination of movement, strength, and sensation (often sufficient).
• No need for immediate imaging in benign cases without warning signs.
• MRI when serious nerve compression or an underlying cause is suspected.

Benign cases

• Keep moving and avoid prolonged complete rest.
• Simple painkillers when needed, and applying heat or cold.
• Strengthening and stretching exercises and posture correction.

Physical therapy

• Effective in improving pain and function and preventing recurrence.

Specific cases

• Interventions or surgery reserved for severe nerve compression or an underlying cause not responding to conservative treatment.

This content is educational and does not replace medical advice.

• Pain becoming chronic in some patients.
• Persistent leg weakness or numbness with nerve compression.
• Cauda equina syndrome (loss of urine/stool control) — a rare emergency.

• Regular movement and strengthening trunk muscles.
• Proper lifting of loads (bending the knees, not the back).
• Maintaining a healthy weight and correcting sitting and working posture.