Overview
Back pain is one of the most common reasons people see a doctor. It can come from muscles, ligaments, discs, the small facet joints of the spine, the sacroiliac joints or irritated nerves. Many episodes improve within a few weeks with activity modification and home care.
When pain lasts longer than a few weeks, keeps returning or travels into the legs, an evaluation can help identify the likely source. Our approach starts with conservative care and moves to procedures only when they are appropriate for you.
Watch: Back Pain explained
Video: “Low Back Pain Treatment” from OrthoInfo on YouTube. OrthoInfo is the patient site of the American Academy of Orthopaedic Surgeons. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Common symptoms
- Dull or aching pain in the back
- Pain that spreads to the buttock or leg
- Stiffness after sitting or sleeping
- Muscle spasm
- Pain that changes with bending, twisting or standing
Causes and risk factors
- Muscle or ligament strain
- Disc degeneration or herniation
- Facet joint arthritis
- Spinal stenosis
- Sacroiliac joint dysfunction
- Vertebral compression fracture
How it is diagnosed
Diagnosis usually starts with a conversation about your symptoms and a physical exam. Depending on what we find, your clinician may order X-rays, an MRI or CT scan, or nerve tests. Imaging findings are interpreted together with your exam, because many people have changes on an MRI that do not cause pain.
Treatment options
Care is stepped: most people start with self-care and physical therapy, and move to the next step only if pain continues. Some problems, such as nerve weakness, may skip ahead. Your exam, imaging and goals decide which options fit you.
Self-care and lifestyle
Keep moving within comfort. Walking, heat, gentle stretches and good sleep habits may help most back pain settle.
Physical therapy and medications
Physical therapy can build strength and flexibility. Your clinician may suggest anti-inflammatory medicine or a muscle relaxant for a short time.
Injections and nerve blocks
If pain is traced to a facet joint, SI joint or irritated nerve, targeted injections may help both diagnose and treat it.
Minimally invasive procedures
Longer-lasting options for confirmed sources include radiofrequency ablation, Intracept and spinal cord stimulation.
Surgical evaluation
A spine surgeon may evaluate you for nerve compression with weakness, instability or deformity.
Learn how we approach care: our care philosophy · nonsurgical options · second opinions.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, severe pain after a significant fall or accident, or pain with fever or unexplained weight loss.
Frequently asked questions
When should I see a doctor for back pain?
Consider an evaluation if pain lasts more than a few weeks, keeps coming back, wakes you at night or spreads into your leg. Seek urgent care for new weakness, numbness in the groin area, or loss of bladder or bowel control.
Do I need an MRI right away?
Not usually. Guidelines generally recommend imaging when symptoms persist, when there are warning signs, or when a procedure is being planned.
What treatments are available besides surgery?
Options include physical therapy, medication, injections, radiofrequency ablation and other minimally invasive procedures. Your clinician will explain which are reasonable for your diagnosis.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.