Lower Back Pain Symptoms, Diagnosis, and Treatment

The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility.

However, this complex structure also leaves the low back susceptible to injury and pain. To help understand this complicated topic, this article presents a model for understanding symptoms, physical findings, imaging studies and injection techniques to come to a precise diagnosis. Once an accurate diagnosis of the cause of the lower back pain is attained, treatment options can be selected based on today’s best medical practices.

The Lumbar Spine, What Can Go Wrong The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.

Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain. There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.