Understanding your pain
What low back pain is
Low back pain is pain in the lower part of your spine, called the lumbar spine. This part of your back supports much of your upper body’s weight, so it takes a lot of strain. The pain can be sharp or dull. It can stay in one spot or spread into the buttock or leg, and it can start suddenly or build over time.
Many people have back pain at some point. Some pain fades with rest and simple home care. Pain that lasts or keeps coming back is a good reason to find out why.
What may be causing it
Common causes of low back pain
Back pain has many possible causes, and the cause affects which treatment makes sense. Common ones include:
- Nerve irritation or compression. A bulging or herniated disc, spinal stenosis (narrowing of the space around the nerves) or spondylolisthesis (a vertebra that slips out of place) can press on a spinal nerve. When the pain travels down the leg, it may be sciatica.
- Injury. Falls, car accidents and sports injuries can strain muscles, sprain ligaments or injure a disc.
- Wear and bone changes. Arthritis, disc wear and osteoporosis can all cause back pain.
- The sacroiliac (SI) joint. This joint links the spine and pelvis, and problems there can feel like low back pain.
- Sources outside the spine. Kidney problems, pregnancy and fibromyalgia can cause pain in the back. Read more in our article on non-spine sources of back pain.
When to book a visit
When to see a pain specialist for back pain
Consider an appointment if your back pain:
- has lasted for weeks or keeps coming back;
- does not improve with rest and simple home care;
- gets worse over time or is severe;
- comes with numbness, tingling or weakness in a leg or foot;
- started after a fall, car accident or other injury.
When to seek emergency care
Get emergency care right away if back pain comes with loss of bladder or bowel control, sudden weakness in your legs, or a fever.
Your evaluation
How we evaluate back pain
Your visit begins with a conversation.
We listen
Your provider asks where the pain is, when it started, what makes it better or worse, and what treatments you have tried, and reviews any imaging or records you have.
We examine
Your provider examines your back and legs, which may include checking strength, reflexes and movement. Depending on the findings, imaging such as an X-ray or MRI may be used.
We find the source
Some procedures help find the source of pain as well as treat it. A discogram tests whether a disc is causing your pain, and a facet or medial branch block can show whether a facet joint is involved.
We explain
You will hear what may be causing the pain and which options might fit. If a procedure is recommended, the team explains the steps, the possible risks and what recovery looks like before you decide.
Your care options
Treatment options for back pain
Treatment depends on the cause, location and intensity of your pain. Many options are nonsurgical.
- Epidural steroid injections Place medicine near irritated spinal nerves to reduce inflammation.
- Facet and medial branch blocks Used to diagnose and treat pain from the facet joints.
- Radiofrequency ablation and rhizotomy Target the small nerves that carry pain signals from the facet joints.
- Sacroiliac joint injections Used to diagnose and treat SI joint pain.
- Spinal cord stimulation A device that sends mild electrical pulses that may change how pain signals reach the brain.
- Kyphoplasty A procedure for painful spinal compression fractures that also aims to stabilize the bone.
- Medication management A plan for using pain medicine carefully and safely.
Staying gently active, as your provider advises, and using heat or cold packs can also help some people at home. Not every option suits every person, and your plan will be based on your evaluation.
Common questions
Questions about back pain
Your provider can answer questions about your own care at your visit.
When should I see a pain specialist for back pain?
See a pain specialist if your back pain lasts for weeks, keeps coming back, gets worse, or does not improve with rest and simple home care. Pain with numbness, tingling or weakness in a leg is also a reason to be evaluated. Sudden weakness, loss of bladder or bowel control, or a fever with back pain needs emergency care.
What causes low back pain that doesn’t go away?
Long-lasting low back pain can come from irritated spinal nerves, disc problems, arthritis, spinal stenosis or a sacroiliac joint problem. Muscle and ligament strain can also linger, and sometimes the source is outside the spine. An exam and, when needed, imaging or diagnostic injections help find the cause.
What treatments are available for back pain without surgery?
Nonsurgical options may include medication management, epidural steroid injections, facet and medial branch blocks, radiofrequency ablation and sacroiliac joint injections. Some people with ongoing pain may also be considered for spinal cord stimulation. Which options fit depends on the cause of your pain, and your provider reviews them with you after your evaluation.
Do I need an MRI before my first visit?
Not always. Your provider starts with your history and an exam, and imaging such as an MRI may be used if it is needed to find the cause. If you already have imaging or reports, bring them or call 214-618-9600 to ask what would help.
Related care
Clinical references
This page shares general information. It is not medical advice and does not replace a visit with a qualified clinician.