What is low back pain, and what causes it?
Strained muscles and ligaments are the most common cause of low back pain
and stiffness. This type of low back trouble generally goes away after 4 to 6
weeks of nonsurgical treatment.
Pressure on a spinal nerve can
cause sciatica symptoms, including back pain and/or leg
numbness, pain, tingling, weakness, or loss of reflexes. Causes of sciatica
Other serious causes of back pain, such as infection, a
tumor, or cancer, are rare. Only about 5% of low back pain cases are caused by
serious disease or cause nerve-related problems that could be corrected with
surgery. Imaging is helpful for diagnosing and planning treatment for these
types of conditions.3
What are the risks of not treating low back pain?
We very often don't know what causes low back pain and, fortunately, it
usually goes away on its own. But sometimes back pain is a sign of tight or
weak muscles, poor posture, stress, or being overweight. It can also be a
symptom of another condition, such as infection, a tumor, or a problem such as
a herniated disc or spinal stenosis. If your back pain is caused by one or more
of these problems and you don't take care of it, you could be in for more low
back pain, decreased function, or other health problems in the future.
If your pain hasn't begun to subside after a couple of days of home
treatment, see your doctor. After doing a
health history and physical exam for low back pain,
your doctor can recommend treatment, possibly including some physical therapy.
You probably won't have any imaging tests unless your doctor sees signs of a
serious condition or nerve problems.
What types of problems can magnetic resonance imaging (MRI) find?
An MRI is not a standard test for finding the cause of low
back pain. As we age, we all develop changes in our spines that appear
"abnormal" on an MRI , but in most people these changes don't cause
symptoms.4 A complete medical history and physical
exam are enough to diagnose and treat most low back pain.
Generally, an MRI is best used when your doctor suspects a specific
problem after completing your medical history and physical exam. An MRI
- Detect problems of the spinal discs, such as
a ruptured disc. The test will also help determine whether a disc is pressing
on a nerve.
- Detect areas of the spinal canal that are abnormally
narrowed (spinal stenosis).
- Detect tumors of the spinal cord. The
tumors that most commonly spread to the spine include those from prostate,
breast, or lung cancer.
- Further evaluate areas of joint
inflammation (arthritis) or abnormal bone loss discovered during an X-ray test
or a bone scan.
- Locate areas of the spinal cord that are not
receiving an adequate blood supply.
- Detect areas of infection
within the outermost layer of the spine and the spinal cord.
areas of nerve damage in the spinal cord caused by trauma or disease, such as
- Evaluate spinal
problems that have been present since birth (congenital).
For an idea of one type of problem an MRI can help
MRI images of the lumbar spine .
MRI alone may not accurately show the
source of your pain. Over time, we all develop changes in our spines that
appear "abnormal" on an MRI, though these changes don't necessarily cause
symptoms.4 Before you make a decision to have a
surgery, it is important that your symptoms, physical examination, and imaging
studies all point to the same source of back or leg pain.
If you need more information, see the topic
Low Back Pain.