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Low back pain - chronic

Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low

Low back pain refers to pain that you feel in your lower back. You may also have back stiffness, decreased movement of the lower back, and difficulty standing straight.

Low back pain that is long-term is called chronic low back pain.

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Spinal stenosis
Backaches

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Causes

Low back pain is common. Almost everyone has back pain at some time in their life. Often, the exact cause of the pain cannot be found.

A single event may not have caused your pain. You may have been doing many activities, such as lifting the wrong way, for a long time. Then suddenly, one simple movement, such as reaching for something or bending from your waist, leads to pain.

Many people with chronic back pain have arthritis. Or they may have extra wear and tear of the spine, which may be due to:

You may have had a herniated disk, in which part of the spinal disk pushed onto nearby nerves. Normally, the disks provide space and cushion in your spine. If these disks dry out and become thinner and more brittle, you can lose movement in the spine over time.

If the spaces between the spinal nerves and spinal cord become narrowed, this can lead to spinal stenosis. These problems are called degenerative joint or spine disease.

Other possible causes of chronic low back pain include:

You are at greater risk for low back pain if you:

Symptoms

Symptoms may include any of the following:

Low back pain can differ from person to person. The pain may be mild, or it can be so severe that you cannot move.

Depending on the cause of your back pain, you may also have pain in your leg, hip, or on the bottom of your foot.

Exams and Tests

During the physical exam, the health care provider will try to pinpoint the location of the pain and figure out how it affects your movement.

Other tests you have depend on your medical history and symptoms.

Tests may include:

Treatment

Your back pain may not go away completely, or it may get more painful at times. Learn to take care of your back at home and how to prevent repeat episodes of back pain. This can help you continue with your normal activities.

Your provider may recommend measures to reduce your pain, including:

These other health care providers may also help:

If needed, your provider may prescribe medicines to help with your back pain:

If your pain does not improve with medicine, physical therapy, and other treatments, your provider may recommend an epidural injection.

Spinal surgery is considered only if you have nerve damage or the cause of the back pain does not heal after a long time.

In some patients, a spinal cord stimulator can help reduce back pain.

Other treatments that may be recommended if your pain does not improve with medicine and physical therapy include:

Some people with low back pain may also need:

Outlook (Prognosis)

Most back problems get better on their own. Follow your provider's advice on treatment and self-care measures.

When to Contact a Medical Professional

Call your provider if you have severe back pain that does not go away. Call right away if you have numbness, loss of movement, weakness, or bowel or bladder changes.

Related Information

Diskectomy
Foraminotomy
Laminectomy
Spinal fusion
Sciatica
Spine surgery - discharge

References

Abd OHE, Amadera JED. Low back strain or sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 48.

Dixit R. Low back pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 50.

Malik K, Nelson A. Overview of low back pain disorders. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 24.

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Review Date: 5/3/2021  

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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