Have you ever woken up one morning and felt an ache in your back or felt a twinge in your back after a strenuous workout? One of the most common reasons why individuals come into the office is BACK PAIN.


Low back pain is one of the leading causes for disability.  Many individuals will experience this symptom in their lifetime.

Your spine is composed of bones, ligaments, muscles, nerves that provide support and strength to the upper part of your body. The lumbar section or low back assists with actions such as bending and rotating the hips with movement.  The nerves in the lumbar spine provide sensation to the pelvis and lower part of the body.

Often acute low back pain is not serious and may be from an injury or strain to the vertebrae or disc, muscles or ligaments.  Most acute back pain can last for a few days and can resolve on its own with time or with rest and some medications or physical therapy.   Sometimes back pain can continue on for weeks or up to three months. Finally, back pain may become a more severe and chronic musculoskeletal condition, lasting more than three months.

Patients may come into the office complaining of these SYMPTOMS

  • Palpable dull muscle ache, muscle spasm or contraction
  • Burning pain radiating to the buttocks, back of thighs or down calves or legs ( sciatica or possible spinal nerve root inflammation)
  • Pain with activities like twisting, lifting, bending, walking, prolonged sitting or standing
  • Acute shooting pain in area
  • Pain improved with certain positions like leaning forward
  • Pain with activities like twisting, lifting, bending, walking, prolonged sitting or standing
  • Acute shooting pain in area
  • Pain improved with certain positions like leaning forward

“RED FLAGS” to look out for and seek IMMEDIATE medical attention:

  1. Fever
  2. Problems with urinating or new bowel issues
  3. Unexplained weight loss
  4. Muscle weakness
  5. Numbness or tingling down one or both legs
  6. Localized bone pain in the back
  7. No improvement with rest
  8. Pain at night
  9. Increase age (more than 50 years old)
  10. History of severe trauma


Your physician should take a complete history asking questions about trauma or fall, history of cancer, drug or alcohol use, steroid use and autoimmune diseases (RA, lupus).  

Your physician will then do a thorough exam assessing flexibility, mobility, standard functions (sitting, standing, bending, ability to raise legs), sensation in the legs and muscle strength.


  1. Osteoarthritis/Degenerative arthritis
  2. Muscle or ligament strain/sprain from repetitive movements or sudden trauma
  3. Bulging or herniated disks- The substance composing the disks that cushions the space between the vertebrae can go out of the space and/or press on a nerve
  4. Spondyloarthropathy (Ankylosing Spondylitis, Psoriatic arthritis)

NOTE: Inflammatory spinal condition affecting young individuals less than 40 years old. Back pain is improved with activity.

  1. Sacroiliitis- Inflammation of joint connecting the bottom of spine to pelvis
  2. Fractures from Osteoporosis
  3. Scoliosis- Curvature of spine to the side. See below on more information
  4. Spinal stenosis- When the spinal canal is narrowed and there is compression of nerve roots
  5. Infection (especially in drug and alcohol users)
  6. Cancer (metastatic disease, multiple myeloma)
  7. Sometimes abdominal and pelvic diseases  (kidney stones, inflammatory bowel disease) can have referred pain to the back



  • Xray
  • MRI or CT scan
  • Nerve tests to assess nerve compression from disc herniation or spinal stenosis
  • Blood tests looking for inflammation markers, abnormalities in calcium


Most acute back pain can be treated with over the counter anti- inflammatory agents, acetaminophen (Tylenol) and use of heat.  Prolonged rest may not be the best course of action.

You can continue to do ligh activity like walking but stay away from motions or activities that exacerbate the pain.  Always speak with your physician first to confirm what activities are allowed.


  • Physical therapy and exercise
  • Prescription Non Steroidal Anti-inflammatory Drugs like Naproxen
  • Muscle relaxants
  • Topical ointments or creams
  • Some antidepressants have been used to treat chronic pain
  • Epidural injections

NOTE: In special cases, a physician or pain management specialist may prescribe a limited course of narcotics BUT always be aware of the addictive properties of these medications and it should never be used long term. I am not a fan of these pain medications.

NOTE: Surgery may be recommended for herniated disc or spinal Injections which is not responsive to other therapies.


There are individuals who have reported improvement with acupuncture, yoga, and massage therapy.


  1. ENGAGE in low impact aerobic exercise that can increase back muscle strength. Try swimming!  STAY ACTIVE!!
  2. MAINTAIN a healthy weight! Excess pounds places stress on your back.
  3. INCREASE ABDOMINAL AND CORE STRENGTH!! Conquer that plank position!
  4. STOP SMOKING!! Smoking decreases blood flow and nutrients necessary for the health of your lower spine.
  5. LEARN how to lift heavy objects properly
  6. AVOID  excessive twisting or bending!
  7. PAY ATTENTION to your posture to reduce stress on your back.
  8. CHANGE sitting and standing positions frequently to relieve your backload.
  9. TRY a different chair with better back support at work or use a pillow for assistance.

NOTE: Get that FIT BIT and increase your daily steps!

Reference: CURRENT Diagnosis and Treatment in Rheumatology. Second edition.

Disclaimer:  This blog contains my personal opinion based on personal and clinical experience, tips from trainers, health coaches and lastly research.  This blog does not endorse specific treatments, procedures, products.  You should always consult with a doctor, nutritionist, or other healthcare professional to discuss your own health and lifestyle goals and regimen based on your medical history.  Thank you for reading!