What is low back pain?

Low back pain is one of the most common health problems in the world. Nearly 8 out of 10 adults will experience it at some point in their lives, and millions of Americans deal with back pain every year. Whether your pain started suddenly after lifting something heavy or has gradually worsened over months, understanding the cause is the first step toward lasting relief.

Fortunately, the vast majority of low back pain can be successfully treated without surgery when the underlying cause is correctly identified.

The low back is made up of the lumbar spine (the five vertebrae in the lower portion of your back), the sacrum, the sacroiliac (SI) joints, the intervertebral discs, and the surrounding muscles, ligaments, and nerves.

Low back pain can develop from many different conditions, ranging from simple muscle strains to herniated discs, arthritis, nerve irritation, joint dysfunction, or even less common medical conditions. You could have disk problems, torn or sprained muscles/ligaments, and even potential fractures.

One of the most common contributors to low back pain is poor biomechanics. This means the joints, muscles, and surrounding tissues are not moving together efficiently. Over time, this can increase stress on the spine and surrounding structures, making them more susceptible to pain and injury. Joint restrictions, imbalanced hips, and areas of decreased mobility can change the way your body moves, placing increased stress on the surrounding muscles, ligaments, joints, and nerves.

Although the pain is felt in the lower back, the underlying problem isn’t always located there. Because the body functions as an interconnected system, problems in the feet, hips, pelvis, or even the upper back and neck can alter movement patterns and place additional stress on the lumbar spine. This is why a thorough evaluation should include more than just the painful area. Identifying all of the contributing factors often leads to more effective and longer-lasting treatment.

For many people, the underlying weakness has been present for a long time. Research has shown that it can take years for symptoms to develop. Many of us have heard the stories about a friend who bent over to pick up a newspaper but couldn’t stand up again because they “threw their back out”. Most people don’t injure their back by picking up a newspaper. Instead, the newspaper was simply the final straw. The spine had often been under increasing stress for weeks, months, or even years before symptoms finally appeared.

The good news is that most cases of low back pain respond very well to conservative treatment. Identifying the true source of the problem early can help reduce pain, restore normal movement, and prevent future flare-ups, allowing you to return to work, exercise, and the activities you enjoy.

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Understanding the Anatomy of Your Lower Back

Understanding a few basic anatomy terms can make it easier to understand the cause of your low back pain and the treatment options available. Your lower back is made up of many structures that work together to provide strength, stability, and movement.

Lumbar Spine

The lumbar spine is the lower portion of your backbone and consists of five vertebrae (L1–L5). These bones support much of your body’s weight while allowing you to bend, twist, and move.

Vertebrae

Vertebrae are the individual bones that make up your spine. Together, they protect the spinal cord while providing a stable framework for movement.

Intervertebral Discs

Between each vertebra is an intervertebral disc that acts as a cushion and shock absorber. The discs help distribute forces placed on the spine during everyday activities such as walking, lifting, and running.

Each disc is made up of a tough outer ring of fibrous cartilage and a soft, gel-like center. If the outer layer develops a tear or weakness, the inner material can bulge or push through the tear, resulting in a herniated disc.

Facet Joints

Facet joints are the small joints located at the back of the spine that connect one vertebra to the next. They guide spinal movement while providing stability and can become irritated from injury or arthritis.

Sacrum

The sacrum is the triangular bone at the base of the spine that connects the lumbar spine to the pelvis. It helps transfer forces between the upper body and the legs.

Sacroiliac (SI) Joints

The sacroiliac joints connect the sacrum to the pelvic bones. These joints have very little movement but play an important role in absorbing forces during standing, walking, and lifting. Dysfunction of the SI joints is a common cause of low back pain.

Spinal Nerves

Spinal nerves exit the spine between each vertebra and carry signals between your brain and the rest of your body. If a nerve becomes irritated or compressed, it can cause pain, numbness, tingling, or weakness that may travel into the legs.

Muscles

The muscles of the low back, abdomen, hips, and pelvis work together to support the spine and control movement. Muscle strains and spasms are among the most common causes of low back pain.

Ligaments

Ligaments are strong bands of connective tissue that hold the bones of the spine together. They help stabilize the spine and may be stretched or injured during sudden movements or trauma.

Tendons

Tendons connect muscles to bones and allow muscles to move the spine and hips. Overuse or repetitive strain can lead to tendon irritation and pain.

Core Muscles

The core includes the abdominal muscles, back muscles, diaphragm, and pelvic floor. Together, these muscles provide stability for the spine and help protect it during everyday activities.

How does Low Back Pain Feel?

Low back pain is not the same for everyone. Some people experience a dull ache that comes and goes, while others develop sharp, stabbing pain that makes it difficult to move. The location, intensity, and type of symptoms often provide important clues about the underlying cause of the problem.

Pain may begin suddenly after an injury or develop gradually over weeks or months. Some people notice discomfort only during certain activities, while others experience constant pain throughout the day. Understanding your symptoms can help determine whether the problem is muscular, joint-related, nerve-related, or caused by another condition.

Common symptoms of low back pain include:

A dull, aching pain in the lower back
Sharp or stabbing pain with certain movements
Muscle tightness or spasms
Stiffness, especially after sitting or sleeping
Pain, numbness, tingling, or weakness that travels into the leg or foot (commonly called sciatica)
A feeling that your back locks, catches, or suddenly gives out during movement

You should seek a thorough evaluation if you experience any of the following.

How does Low Back Pain Feel?

Common symptoms of low back pain include:

A dull, aching pain in the lower back
Sharp or stabbing pain with certain movements
Muscle tightness or spasms
Stiffness, especially after sitting or sleeping
Pain, numbness, tingling, or weakness that travels into the leg or foot (commonly called sciatica)
A feeling that your back locks, catches, or suddenly gives out during movement

You should seek a thorough evaluation if you experience any of the following.

Why does my ache ache all the time?

Dull ache low back pain

A dull, aching pain is one of the most common types of low back pain. Rather than feeling sharp, stabbing or burning, it is often described as a constant soreness, tightness, or deep ache across the lower back. Some people notice it on only one side, while others feel it across the entire low back or into the hips.

This type of pain frequently develops gradually rather than after a single injury. It may become more noticeable after long periods of sitting, standing, driving, or performing repetitive activities such as lifting, bending, or yard work. Many people also report increased stiffness first thing in the morning or after getting up from a chair. For many people, the discomfort gradually increases throughout the day as the muscles and joints become fatigued. Others notice the opposite pattern, waking up stiff and sore in the morning before gradually loosening up as they begin moving.

A dull ache is often associated with degenerative disc disease, muscle strain, ligament irritation, joint dysfunction, poor posture, or age-related wear and tear in the spine. In many cases, the pain develops because the muscles and joints have been under increased stress for weeks or months before symptoms become noticeable. While these conditions are usually not serious, persistent pain should not be ignored, especially if it continues to interfere with your daily activities.

Although a dull ache is often mechanical in nature, it is important to remember that the sensation alone cannot determine the exact cause. A comprehensive evaluation that includes your health history, physical examination, and, when appropriate, diagnostic imaging can help identify the source of the pain and guide the most effective treatment plan.

Depending on your symptoms and examination findings, diagnostic imaging such as X-rays or MRI may be recommended to better understand the underlying cause of your pain. X-rays can help identify structural changes such as arthritis, spinal alignment, fractures, or degenerative changes, while MRI is often used when a disc injury or nerve involvement is suspected. Imaging is not necessary for every patient, but it can be an important tool when the history or examination suggests a more complex condition or when symptoms fail to improve as expected.

A dull ache is not always a sign of a serious spinal condition. In fact, many cases improve with conservative treatment and appropriate activity. However, pain that persists for several weeks or repeatedly returns should be evaluated to determine the underlying cause.

Why Do I Have a Sharp Pain in My Lower Back?

Sharp Stabbing Pain

Sharp or stabbing pain in the lower back often develops suddenly and is commonly associated with an acute injury or irritation of the muscles, joints, ligaments, or discs. Many people can identify the movement that triggered the pain, such as lifting something heavy, twisting awkwardly, slipping, falling, or participating in strenuous physical activity. However, sharp pain can also occur during seemingly simple movements if the tissues have been under stress for an extended period of time.

Common causes of sharp low back pain include muscle strains, ligament sprains, muscle spasms, facet joint irritation, sacroiliac (SI) joint dysfunction, and acute disc injuries such as a herniated disc. Because several different conditions can produce similar symptoms, a thorough examination is often necessary to determine the exact source of the pain.

Sharp pain may remain localized to the lower back, or it may radiate into the buttock, hip, or leg if a nerve becomes irritated or compressed. Pain that travels below the knee, is accompanied by numbness or tingling, or causes weakness in the leg should be evaluated promptly, as these symptoms may indicate nerve involvement.

Many episodes of sharp low back pain improve over the course of several days to a few weeks with appropriate conservative treatment and activity modification. People often find temporary relief by avoiding painful movements, changing positions, or resting for short periods. While symptoms frequently improve on their own, early evaluation can help identify the underlying cause, guide treatment, and reduce the risk of developing chronic pain.

Seek immediate medical attention if sharp back pain occurs after a major fall or accident, is accompanied by loss of bowel or bladder control, numbness in the groin area, significant leg weakness, fever, or unexplained weight loss.

Why Does My Back Keep Going Into Spasm?

Muscle tightness or spasms

Muscle spasms are one of the most common symptoms associated with low back pain. Some people describe them as a constant tightness or cramping sensation, while others experience sudden, intense contractions that can make it difficult to stand up straight, walk, or change positions. In severe cases, even simple movements such as getting out of bed or rolling over can become painful.

Muscle tightness and spasms can occur as the primary source of pain, such as after overexertion or a muscle strain. However, they are often a secondary response to another injury within the spine. Conditions such as a herniated disc, facet joint irritation, ligament injury, or SI joint dysfunction frequently cause the surrounding muscles to tighten in an attempt to protect the injured area.

This protective muscle guarding is the body’s natural way of limiting movement while injured tissues begin to heal. In many ways, the muscles act like a natural brace or splint, helping prevent movements that could place additional stress on the injured structures. Although this response is designed to protect you, the muscle spasms themselves can become painful and sometimes contribute more to your discomfort than the original injury.

Muscle spasms often improve as the underlying condition heals. While short periods of rest may be helpful during the first day or two after an injury, prolonged inactivity can actually make muscles tighter. Many people find that gentle movement, such as walking, swimming, or light stretching, helps reduce muscle tension and improve mobility. Applying heat may also help relax tight muscles, while ice can be beneficial during the early stages of an acute injury to reduce inflammation.

Depending on the underlying cause, conservative treatments such as chiropractic care, soft tissue therapy, massage therapy, therapeutic exercises, and stretching programs may help reduce muscle spasms, improve joint mobility, and restore normal movement patterns. Because muscle spasms are often a symptom rather than the primary problem, identifying and treating the underlying cause is an important part of achieving long-term relief.

Why Is My Back So Stiff in the Morning?

Stiffness

Many people describe low back stiffness as feeling like their back is “locked up” or difficult to move, especially when getting out of bed in the morning or standing after sitting for a long time. Unlike sharp pain, stiffness is often characterized by a loss of flexibility and a feeling that the back needs time to “loosen up” before moving normally.

Stiffness is one of the most common symptoms of low back pain and can occur with both acute injuries and long-standing spinal conditions. It often develops after muscle strains, joint irritation, ligament injuries, or episodes of muscle spasm. Chronic conditions such as degenerative disc disease, arthritis, and age-related changes within the spine can also contribute to persistent stiffness.

Many people notice that their stiffness is worse after remaining in one position for an extended period. Sitting at a desk, driving long distances, standing in one place, or sleeping through the night can all allow the joints and surrounding muscles to become less mobile.

Morning stiffness often occurs because the spine remains relatively still for several hours during sleep. Muscles and connective tissues can tighten overnight, and arthritic joints may become less mobile after prolonged inactivity. For most people, this stiffness improves within 15 to 30 minutes of gentle movement. However, stiffness that lasts for several hours every morning or is accompanied by swelling in other joints may warrant further medical evaluation.

Fortunately, movement is often one of the most effective ways to reduce stiffness. As the joints begin moving and blood flow increases to the surrounding muscles, many people notice that their back gradually loosens up and becomes more comfortable. While it may seem counterintuitive, prolonged rest often allows stiffness to worsen, whereas gentle, controlled movement usually helps improve mobility.

One of the simplest ways to reduce stiffness throughout the day is to avoid staying in any one position for too long. If your job requires sitting at a desk, try changing positions every 30 to 60 minutes. Alternate between sitting, standing, walking, or using a sit-to-stand workstation if one is available. Even taking a short walk or performing gentle stretches for a few minutes every hour can help keep your joints moving and reduce stiffness. The goal isn’t to find the “perfect” position—it’s to keep your body moving throughout the day.

If stiffness persists for several weeks, continues to worsen, or significantly limits your ability to perform everyday activities, a comprehensive evaluation can help determine the underlying cause and identify the most appropriate treatment options.

Why does my back pain shoot down my leg?

Pain, numbness, tingling, or weakness that travels into the leg or foot (commonly called sciatica)

Pain that starts in the lower back and travels into the buttock, thigh, calf, or foot is commonly referred to as sciatica. Unlike pain that stays localized in the lower back, radiating pain often suggests that one of the nerves exiting the lumbar spine has become irritated or compressed. The farther the pain travels down the leg, the more likely it is that a spinal nerve is involved.

People describe sciatica in many different ways. Some experience a sharp, shooting pain, while others report a burning sensation, tingling, numbness, or a deep ache that feels like it is “deep in the leg” or “near the bone.” Unlike muscle soreness, sciatic pain is often difficult to relieve by simply changing positions and may become worse with prolonged sitting, coughing, sneezing, or certain movements.

Sciatica is a symptom rather than a diagnosis. Several different conditions can irritate the nerves in the lower back and produce similar symptoms. Common causes include herniated or bulging discs, degenerative disc disease, spinal stenosis, arthritis, and inflammation around the spinal nerves. In some cases, particularly during pregnancy, changes in posture and increased muscle tension around the pelvis can place additional stress on the sciatic nerve. The piriformis muscle, which lies close to the sciatic nerve, can also become tight or irritated and contribute to symptoms, a condition commonly referred to as piriformis syndrome.

Pain that travels below the knee, extends into the foot, or is accompanied by numbness, tingling, or weakness is more suggestive of nerve involvement and should not be ignored. While many cases of sciatica improve with conservative treatment, persistent or worsening symptoms should be evaluated to determine the underlying cause and reduce the risk of long-term nerve irritation.

Why did my back lock up?

A feeling that your back locks, catches, or suddenly gives out during movement

One of the most common ways people describe an episode of acute low back pain is by saying, “My back went out.” This phrase isn’t a medical diagnosis, but it is an accurate description of what many people experience when sudden pain causes the back to “lock up” or become difficult to move.

These episodes often occur during a simple movement such as bending over to pick something up, twisting while lifting, getting out of bed, or shoveling snow. Although the movement itself may seem minor, it is often the final event that places stress on tissues that have already been overloaded over time.

When the back “goes out,” people commonly report:

A sudden sharp or intense pain in the lower back
Difficulty standing up straight
Feeling like the back has locked or seized up
Greatly reduced range of motion
Pain that “takes your breath away”
Leaning to one side to avoid painful movements (known as an antalgic lean)

In many cases, this locked feeling occurs because the muscles surrounding the injured area tighten rapidly to protect the spine. This protective muscle guarding acts much like a natural brace, limiting movement while the injured tissues begin to heal.

Several different conditions can create the sensation that your back has “gone out.” Common causes include muscle strains, ligament sprains, muscle spasms, facet joint syndrome, sacroiliac (SI) joint dysfunction, and herniated or bulging discs. Because these conditions can produce very similar symptoms, a thorough examination is often needed to determine the exact cause.

Fortunately, many episodes of acute low back pain begin to improve over several days with appropriate conservative care and gradual return to normal movement. Gentle walking, avoiding prolonged bed rest, and following an appropriate treatment plan often help speed recovery. However, if the pain continues to worsen, prevents you from standing or walking, or is accompanied by pain traveling down the leg, numbness, tingling, weakness, or loss of bowel or bladder control, you should seek prompt medical evaluation.

Red Flag Symptoms

Although most episodes of low back pain are not caused by serious medical conditions, certain symptoms require immediate medical evaluation.

Seek prompt medical attention if your back pain is accompanied by:

Loss of bowel or bladder control
Numbness around the groin or inner thighs (saddle anesthesia)
Progressive weakness in one or both legs
Significant trauma, such as a fall or motor vehicle accident
Fever, chills, or unexplained weight loss
A history of cancer with new or worsening back pain
Severe pain that consistently wakes you at night or is not relieved by rest

These symptoms may indicate a more serious condition that requires urgent medical evaluation.

If you experience symptoms of low back pain you may also ask

Pain During Daily Activities

Why does my back hurt when I bend over?
Why does my back hurt when I lift something?
Why does my back hurt when I sit?
Why does my back hurt when I stand?
Why does my back hurt when I walk?
Why does my back hurt after sleeping?

Nerve-Related Symptoms

Why does my back pain shoot down my leg?
Why is my foot numb?
Why does my leg tingle?
Why does my leg feel weak?

Pain Patterns

Why is my back so stiff in the morning?
Why is my pain only on one side?
Why does my back keep going into spasm?

What is causing my low back pain?

Low back pain is one of the most common reasons people seek medical care, but there is no single cause. In fact, low back pain is a symptom rather than a diagnosis, meaning many different conditions can produce similar pain and discomfort.

Some people develop back pain after a sudden injury, while others notice it gradually worsening over months or even years. The exact cause often depends on several factors, including age, activity level, occupation, previous injuries, posture, overall health, and the way the spine moves during everyday activities.

Understanding why your back hurts is an important part of choosing the most effective treatment. Although many conditions produce similar symptoms, each has its own underlying cause, expected recovery, and treatment approach. Identifying the correct diagnosis helps ensure that treatment is focused on the source of the problem rather than simply masking the pain.

Common Conditions That Cause Low Back Pain

The following conditions are among the most common diagnoses associated with low back pain. Each condition affects the spine differently and may require a unique treatment approach.

Herniated Disc
- A herniated disc occurs when the soft, gel-like center of a spinal disc pushes through a tear in the outer layer. If the disc irritates a nearby nerve, it can cause low back pain, numbness, tingling, or pain that travels down the leg.
Sciatica
- Sciatica is a symptom, not a diagnosis. It describes pain, numbness, tingling, or weakness that travels along the sciatic nerve, usually from the low back into the buttock and leg. Several different conditions can cause sciatica, including a herniated disc or spinal stenosis.
SI Joint Pain/SI Joint dysfunction
- The sacroiliac (SI) joints connect the spine to the pelvis. When these joints become irritated or move improperly, they can cause pain in the low back, buttock, or hip and may sometimes mimic sciatica.
Degenerative Disc Disease
- Degenerative disc disease refers to the gradual wear and aging of the spinal discs over time. As discs lose water content and height, they may become less effective at absorbing shock, leading to stiffness, pain, or other spinal conditions.
Lumbar Arthritis
- Lumbar arthritis is the breakdown of the joints in the lower back due to normal wear and tear. It commonly causes stiffness, aching, and pain that may worsen after periods of inactivity or prolonged standing.
Spinal Stenosis
- Spinal stenosis is a narrowing of the spaces within the spine that can place pressure on the spinal nerves. It most commonly affects older adults and may cause low back pain, leg pain, numbness, or difficulty walking.
Low back muscle strain
- A muscle strain occurs when the muscles or tendons of the lower back are overstretched or torn. It is one of the most common causes of acute low back pain and often results from lifting, twisting, sports, or overuse.
Bulging disc
- A bulging disc occurs when the outer layer of a spinal disc extends beyond its normal boundaries without tearing. While many bulging discs cause no symptoms, some can irritate nearby nerves and contribute to low back or leg pain.
Facet Joint syndrome
- Facet joint syndrome occurs when the small joints at the back of the spine become irritated or inflamed. This condition often causes localized low back pain and stiffness, especially with bending backward or twisting.
Spondylolisthesis
- Spondylolisthesis occurs when one vertebra slips forward over the one below it. Depending on the severity, it may cause low back pain, stiffness, nerve irritation, or no symptoms at all.

What did I do to make my back hurt?

Low back pain risk factors

Although the diagnoses above are different, many of them share similar contributing factors. Everyday habits, repetitive movements, poor body mechanics, previous injuries, prolonged sitting, heavy lifting, reduced physical activity, and the natural aging process can all place additional stress on the spine over time.

Understanding these risk factors not only helps explain why back pain develops but also provides valuable insight into how future episodes may be prevented.

Risk Factors for Low Back Pain include

Improper lifting technique
Prolonged sitting
Repetitive bending and twisting
Poor posture
Weak core muscles
Lack of regular exercise (deconditioning)
Previous back injuries
Excess body weight
Aging and degenerative changes
Genetics (hereditary risk)
Pregnancy

How do you figure out what is causing my low back pain?

One of the most important things to understand about low back pain is that it is a symptom rather than a diagnosis. Many different conditions can cause pain in the lower back, including muscle strains, ligament injuries, herniated discs, bulging discs, arthritis, sacroiliac (SI) joint dysfunction, spinal stenosis, and many other conditions. While these problems often produce similar symptoms, they each have different causes and may require different treatment approaches.

The goal of a thorough evaluation is to determine why your back hurts—not simply where it hurts. An accurate diagnosis helps identify the tissues involved, rule out more serious conditions, and create a treatment plan that addresses the underlying cause of your pain rather than simply masking your symptoms.

1. Your Health History

The diagnostic process begins long before any physical examination. One of the most valuable tools in determining the cause of low back pain is a detailed discussion about your symptoms, medical history, and lifestyle. A thorough health history helps your doctor identify potential causes of your pain while also ruling out conditions that may require additional evaluation or medical referral.

The more information you can provide and the better the communication between you and your doctor, the more accurate the diagnosis is likely to be. Sometimes details that seem unrelated to your back pain can provide important clues that help determine the true source of your symptoms.

Questions your doctor may ask include:

Where is your pain located?
When did your pain begin?
Did it start after a specific injury or activity?
Does the pain travel into your buttock, leg, or foot?
What activities make your pain better or worse?
Have you experienced this problem before?
Are you experiencing numbness, tingling, or weakness?
Have you noticed any changes in bowel or bladder function?
Do you have a history of cancer, osteoporosis, or other medical conditions?
Have you experienced fever, unexplained weight loss, or other concerning symptoms?

The answers to these questions help guide the physical examination and narrow the list of possible causes before any hands-on testing even begins.

2. Physical Examination

After discussing your health history, your doctor will perform a comprehensive physical examination. The purpose of this examination is to evaluate how your spine moves, identify the tissues involved, and determine which structures are most likely responsible for your pain.

Posture Evaluation

A posture evaluation provides valuable information about how your body is responding to your injury. Some people naturally lean away from the painful side, a finding known as an antalgic lean, while others may stand with altered posture because of muscle spasms or joint restrictions. Your doctor will also evaluate for underlying structural conditions such as scoliosis or other postural abnormalities that may contribute to your symptoms.

Range of Motion

Evaluating how your spine moves helps identify painful movement patterns, stiffness, and functional limitations. Your doctor may assess both active range of motion (movements you perform yourself) and passive range of motion (movements assisted by your doctor). Comparing these two types of movement can provide valuable information about whether muscles, joints, ligaments, or other tissues are contributing to your pain.

Palpation

Palpation is a hands-on examination in which your doctor carefully evaluates your spine, joints, and surrounding muscles. This allows the doctor to identify areas of tenderness, muscle tension, joint restriction, swelling, or inflammation. Palpation is an essential part of a chiropractic examination because it helps determine which structures may be involved and guides treatment decisions.

Orthopedic Testing

Orthopedic tests are designed to place controlled stress on specific tissues to help narrow the list of possible diagnoses. Rather than relying on a single test, doctors use several orthopedic tests together to build an accurate clinical picture.

For example, a Straight Leg Raise Test may reproduce symptoms caused by irritation of the sciatic nerve or a lumbar nerve root. Other orthopedic tests help determine whether your pain is coming from the muscles, ligaments, joints, discs, or other structures within the lower back.

3. Neurological Examination

When symptoms suggest nerve involvement, your doctor may perform a neurological examination to determine whether the nerves exiting the spine are functioning normally. These tests help identify the location and severity of nerve irritation or compression.

Reflex Testing

Reflexes help evaluate how well signals are traveling through the nervous system. Changes in reflexes can provide important clues about whether a spinal nerve root has been affected and may also help identify conditions involving the central nervous system.

Muscle Strength Testing

Muscle testing evaluates the strength of specific muscle groups supplied by individual spinal nerves. Weakness in certain muscles may indicate nerve compression or irritation and can help identify the spinal level involved.

Sensation Testing

Your doctor may also evaluate sensation by testing specific areas of the skin known as dermatomes. Changes in feeling, such as numbness or decreased sensation, can help determine which spinal nerve may be affected.

4. Diagnostic Imaging

Not every patient with low back pain requires imaging. In many cases, a thorough history and physical examination provide enough information to begin appropriate treatment. However, when clinically indicated, imaging can provide valuable additional information.

X-rays

X-rays are often the first imaging study performed because they are quick, readily available, and cost-effective. They provide excellent visualization of the bones and joints of the spine and can identify conditions such as fractures, arthritis, scoliosis, spinal alignment changes, and spondylolisthesis. Because X-rays are performed while standing, they also provide valuable information about how the spine functions under normal weight-bearing conditions.

While X-rays are an important diagnostic tool, they do have limitations. They do not clearly show soft tissues such as discs, muscles, ligaments, nerves, or the spinal cord.

MRI

When the suspected injury involves the soft tissues of the spine, an MRI is often the preferred imaging study. MRI provides detailed images of the intervertebral discs, spinal nerves, ligaments, muscles, and other soft tissues. It is particularly useful when evaluating conditions such as herniated discs, spinal stenosis, nerve compression, or injuries that have not improved with conservative care.

Your doctor will recommend the most appropriate imaging based on your symptoms, examination findings, and overall clinical picture.

The Importance of an Accurate Diagnosis

The goal of diagnosing low back pain is not simply to determine that your back hurts—it is to identify the specific tissues and structures responsible for your symptoms. Once the underlying cause has been identified, an individualized treatment plan can be developed to reduce pain, restore normal movement, improve function, and help prevent future episodes of low back pain.

A thorough evaluation allows treatment to focus on correcting the cause of the problem whenever possible, rather than simply managing the symptoms.

How can I get rid of my low back pain?

Treatment for Low Back Pain

The most effective treatment for low back pain depends on the underlying cause of your symptoms. A muscle strain requires a different treatment approach than a herniated disc, spinal stenosis, or SI joint dysfunction. Evidence-based care begins with determining the stage of the condition and selecting treatment based on the patient’s presentation rather than applying the same approach to everyone.

From a chiropractic perspective, the goal is not simply to reduce pain but to restore normal movement, improve function, and help your body heal as efficiently as possible. Treatment is tailored to your individual condition, symptoms, activity level, and overall health.

For many causes of low back pain, conservative care is recommended before considering more invasive treatments. Clinical practice guidelines for many common spinal conditions recommend beginning with conservative approaches whenever appropriate, as many patients experience meaningful improvement without surgery or other invasive procedures.

Chiropractic Adjustments

The chiropractic adjustment is one of the primary treatments used to restore normal movement to the joints of the spine. When joints become restricted or lose their normal motion, they can contribute to pain, stiffness, muscle guarding, and altered movement patterns.

The goal of an adjustment is to improve joint mobility, restore normal biomechanics, and reduce stress on the surrounding muscles, ligaments, and nerves. Improving the way the spine moves often allows patients to move more comfortably and return to their normal daily activities.

At Cadence Chiropractic, we primarily use the Activator Method, a gentle instrument-assisted adjusting technique that does not require twisting, popping, or cracking. This approach allows adjustments to be highly specific while remaining comfortable for patients of all ages.

Soft Tissue Therapy

Muscles and connective tissues often play a significant role in low back pain. Injury, repetitive strain, and prolonged poor posture can lead to muscle tightness, trigger points, scar tissue, and restricted movement.

Soft tissue therapies—including massage therapy, myofascial release, and other manual techniques—are designed to reduce muscle tension, improve circulation, increase tissue mobility, and decrease pain. These therapies are often combined with chiropractic adjustments to address both the joints and the surrounding muscles.

Logan Basic Technique

The Logan Basic Technique is a specialized chiropractic method that focuses on improving the biomechanics of the pelvis and sacrum. Because the pelvis forms the foundation of the spine, restricted motion or abnormal mechanics in this area can contribute to stress throughout the lower back.

This gentle technique uses sustained pressure and specific positioning to encourage improved movement within the pelvis and sacroiliac joints. It also incorporates gentle lumbar distraction, which may help reduce pressure on irritated spinal structures in appropriate patients.

Lumbar Traction

Lumbar traction is used to gently decompress the lower spine by creating controlled separation between the vertebrae. Depending on the condition being treated, this may help reduce pressure on irritated spinal joints, discs, or nerve roots.

Traction may also promote the normal movement of fluids within the intervertebral discs through a process known as imbibition. Because spinal discs receive very little direct blood supply, they rely on the movement of fluids to exchange nutrients and remove waste products. While traction is not appropriate for every patient, it can be a valuable part of treatment for certain disc-related conditions.

Stretching

Appropriate stretching can improve flexibility, reduce muscle tension, restore range of motion, and improve overall movement. Because every cause of low back pain is different, no single stretch is appropriate for every patient. Your doctor will recommend stretches based on your diagnosis and stage of recovery.

Some of the stretches we commonly recommend include:

Piriformis Stretch
Glute Stretch
Child’s Pose
McKenzie Back Extensions
Nerve Flossing
Psoas Stretch
Hamstring Stretch
Quadriceps Stretch
Knee-to-Chest Stretch
SI Joint Stretch

(Each stretch will link to an instructional video demonstrating proper technique.)

Therapeutic Exercise

While pain relief is important, long-term recovery depends on improving the strength, stability, and coordination of the muscles that support your spine.

Therapeutic exercises help restore normal movement patterns, improve spinal stability, reduce the risk of future injury, and support long-term spinal health. Exercises are progressed based on your condition, goals, and recovery.

Some of the exercises we commonly prescribe include:

Abdominal Bracing
Diaphragmatic Breathing
Glute Bridge
Front Plank
Side Plank
Bird Dog
Cat-Camel

(Each exercise will link to an instructional video with proper form and progression.)

Education and Prevention

One of the most important parts of treating low back pain is helping you understand why your pain developed and how to reduce the likelihood of it returning.

Depending on your condition, your doctor may provide recommendations on:

Proper lifting mechanics
Workplace ergonomics
Sitting posture
Sleeping positions
Activity modification
Home stretching and exercise programs
Returning safely to work, sports, and recreation

Our goal is not only to help relieve your current symptoms but also to give you the knowledge and tools to keep your spine healthy for years to come.

No two patients experience low back pain in exactly the same way, which is why every treatment plan at Cadence Chiropractic is individualized. Your care may include chiropractic adjustments, soft tissue therapy, rehabilitation exercises, stretching, traction, ergonomic recommendations, or a combination of these treatments based on your diagnosis, symptoms, goals, and response to care. Our objective is not simply to help you feel better today, but to restore normal function and help prevent future episodes of low back pain.

How long does recovery from low back pain take?

Recovery and Prognosis

The outlook for low back pain depends on the underlying cause of your symptoms, the severity of the condition, your overall health, and how quickly appropriate treatment begins. Because every case is different, it is difficult to predict an exact recovery timeline during the early stages of care.

Many episodes of acute low back pain improve significantly within several days to a few weeks with conservative treatment and a gradual return to normal activity. More complex conditions, such as herniated discs or nerve-related injuries, often require a longer recovery period and may take several weeks or months to reach their maximum improvement.

Conditions involving age-related changes, such as arthritis or degenerative disc disease, cannot typically be reversed. In these cases, the goal of treatment is to reduce pain, improve mobility, restore function, and help slow the progression of symptoms whenever possible. Many people with these conditions are able to remain active and enjoy an excellent quality of life with the right combination of treatment, exercise, and lifestyle modifications.

While every patient’s recovery is unique, an accurate diagnosis, individualized treatment plan, and active participation in your rehabilitation are some of the most important factors in achieving the best possible outcome.

Why choose Cadence Chiropractic

Low back pain can have a significant impact on nearly every aspect of your life. It is one of the leading causes of disability worldwide and can affect your ability to work, exercise, sleep, spend time with your family, and enjoy the activities you love.

When it comes to your health, you deserve to understand what is causing your pain, what treatment options are available, and what you can realistically expect during your recovery. Choosing a healthcare provider is an important decision, and we believe that an informed patient is better equipped to make the right decision for their health.

At Cadence Chiropractic, our approach to treating low back pain is built on four core principles.

1. Diagnosis Before Treatment

Successful treatment begins with an accurate diagnosis.

Rather than assuming every episode of low back pain is the same, we perform a thorough evaluation to determine the most likely source of your symptoms. Your initial visit typically lasts up to 60 minutes and includes a detailed health history, orthopedic and neurological examination, movement assessment, and imaging when clinically appropriate.

Our goal is to understand why your back hurts before recommending any treatment. This allows us to create an individualized care plan that is based on your diagnosis, your goals, and your overall health—not a one-size-fits-all approach.

2. Gentle, Instrument-Assisted Chiropractic Care

Many people hesitate to seek chiropractic care because they are concerned that twisting, popping, or cracking their back may be uncomfortable or make their symptoms worse.

At Cadence Chiropractic, we primarily use the Activator Method, a gentle instrument-assisted adjusting technique that does not require twisting, popping, or cracking. The Activator allows us to deliver precise adjustments while keeping patient comfort our top priority.

This gentle approach is appropriate for many patients, including those experiencing acute low back pain, older adults, pregnant patients, and individuals who simply prefer a lower-force treatment option.

3. Comprehensive Conservative Care

Every patient is different, and successful treatment often requires more than a chiropractic adjustment alone.

Based on your diagnosis, your treatment plan may include a combination of chiropractic adjustments, Logan Basic Technique, Sacro Occipital Technique (SOT), sacral unlocking techniques, soft tissue therapy, lumbar traction, therapeutic exercises, stretching, and home care recommendations.

Our goal is to reduce pain, restore normal movement, improve function, and provide you with the tools to help prevent future episodes of low back pain.

Rather than treating only your symptoms, we strive to address the underlying factors contributing to your condition and help you return to the activities that matter most to you.

Proper education

We believe one of the most valuable things a doctor can provide is education. The more you understand your condition, the better equipped you are to make informed decisions about your health—and better decisions often lead to better outcomes.

Throughout your care, we’ll take the time to explain your diagnosis, discuss your treatment options, answer your questions, and help you understand what you can do at home to support your recovery. Our goal is not simply to help you feel better today, but to give you the knowledge and confidence to care for your spine and maintain your health for years to come.

Ready to Find the Cause of Your Back Pain?

Whether your symptoms started yesterday or have been affecting you for years, the first step toward recovery is understanding why your back hurts.

Every patient at Cadence Chiropractic begins with a comprehensive evaluation designed to identify the source of their symptoms and develop a personalized treatment plan based on their specific diagnosis and goals.

If you’re looking for a thoughtful, conservative approach to low back pain that emphasizes accurate diagnosis, gentle treatment, and individualized care, we’d be honored to help.

Schedule Your Appointment Today

FAQ

When should I see a chiropractor for low back pain?
- It’s generally best to address low back pain sooner rather than later. While some mild episodes improve with rest and stretching, early evaluation can help identify the cause of your pain and prevent symptoms from becoming more severe or long-lasting.

If your pain persists, worsens, begins to interfere with your daily activities, or is accompanied by numbness, tingling, weakness, or pain traveling down your leg, you should be evaluated by a healthcare provider. At Cadence Chiropractic, we believe that early diagnosis and appropriate conservative care often lead to better outcomes.

Should I rest or stay active with low back pain?
- It depends on the cause of your back pain. For many cases, gentle movement can help reduce stiffness, muscle spasms, and improve recovery. However, some conditions may worsen with certain activities, making an accurate diagnosis important.

As a general rule, avoid activities that cause a sudden increase in pain, especially sharp or radiating pain. If your symptoms are severe, continue to worsen, or limit your ability to perform normal daily activities, you should be evaluated by a healthcare provider.

Is walking good for low back pain?
- In many cases, yes. Walking is a low-impact activity that can help reduce stiffness, improve circulation, and gently activate the muscles that support your lower back and core.

However, not every cause of low back pain responds well to walking. If your pain significantly increases, begins to travel down your leg, or you develop numbness or weakness, stop the activity and seek evaluation from a healthcare provider.

Should I use heat or ice?
- Both heat and ice can help relieve low back pain, but they are often used for different purposes. Ice is generally most helpful during the early stages of an acute injury to help reduce pain and inflammation, while heat is often beneficial for muscle tightness, stiffness, and chronic pain.

Everyone responds differently, however. Some people find greater relief with ice, while others respond better to heat, regardless of how long they’ve had symptoms. If one method doesn’t help, it’s reasonable to try the other and use whichever provides the most relief.

Can chiropractic help a herniated disc?
- In many cases, yes. Conservative care is often recommended as the first treatment for a herniated disc, and chiropractic care may be an effective part of that approach. Treatment focuses on improving spinal movement, reducing pressure on irritated tissues, relieving pain, and restoring function.

The most appropriate treatment depends on the size and severity of the disc injury and your symptoms. A thorough evaluation is important to determine whether chiropractic care is appropriate for your specific condition.

Is chiropractic safe for low back pain?
- For most people, yes. Chiropractic care is generally considered a safe and effective conservative treatment for many common causes of low back pain when performed after an appropriate evaluation.

At Cadence Chiropractic, we primarily use the Activator Method, a gentle instrument-assisted technique that does not require twisting, popping, or cracking. This approach allows us to deliver precise adjustments while maximizing patient comfort. Before beginning treatment, we perform a thorough examination to ensure chiropractic care is appropriate for your specific condition.

Will my back pain come back?
- It depends on the underlying cause of your back pain. While some people recover completely, others may experience future episodes, especially if the factors that contributed to the injury are not addressed.

A comprehensive treatment plan should include more than pain relief. Home exercises, stretching, proper lifting techniques, ergonomic recommendations, and patient education can all help reduce the risk of your back pain returning and keep your spine functioning at its best.

Can sitting all day cause low back pain?
- Yes. Prolonged sitting is one of the most common contributors to low back pain, but the problem is not sitting alone—it’s staying in any one position for too long. Your spine is designed to move, and prolonged static positions can increase stiffness, muscle tension, and joint stress.

If you have a desk job, make it a habit to change positions regularly. Standing, walking for a few minutes, stretching, or alternating between different seating options can help reduce stress on your lower back and keep your body moving throughout the day.

What sleeping position is best for low back pain?
- The best sleeping position is usually the one that allows you to maintain a comfortable, neutral spine. Most people do well sleeping on their back or side, and neither position has been shown to be consistently better for low back pain.

If you sleep on your side, placing a pillow between your knees can help keep your pelvis and spine aligned. If you sleep on your back, placing a pillow under your knees may reduce tension in your lower back. Stomach sleeping is generally the least recommended position because it can place additional stress on the spine and neck.

What mattress is best for low back pain?
- There is no single mattress that is best for everyone. The ideal mattress is the one that allows you to sleep comfortably while keeping your spine in a neutral position. Some people find better relief with a firmer mattress, while others are more comfortable on a softer surface.

Before investing in a new mattress, consider making small changes to your current one. Adding a memory foam topper can make a mattress feel softer, while placing a firm camping pad or similar support under your body can help you determine if a firmer sleeping surface provides better relief. Once you know what feels best for your body, you can make a more informed decision when purchasing a new mattress.

Should I wear a back brace?
- In general, a back brace is not recommended for long-term use. Our goal is to improve the strength and stability of your core so your body provides its own support rather than relying on an external brace.

There are situations where a back brace may be helpful, such as during heavy lifting, certain work activities, or while recovering from specific injuries. Your doctor can help determine whether a brace is appropriate for your condition and how to use it safely.

Is it okay to exercise with low back pain?
- In many cases, yes. Appropriate exercise and movement can be an important part of recovering from low back pain. The key is to choose activities that do not significantly increase your symptoms and to avoid movements that cause new or worsening pain.

If you lift weights or participate in other strenuous activities, listen to your body and be willing to temporarily reduce the amount of weight, intensity, or volume while you recover. It’s normal to need to modify your routine for a period of time. Most people can gradually return to their previous level of activity, but progressing too quickly may delay recovery or worsen the injury.

If you’re unsure which exercises are safe, consult your healthcare provider for recommendations based on your specific diagnosis.

When should I go to the emergency room?
- Most cases of low back pain are not medical emergencies and can be evaluated by your primary care provider or chiropractor. However, you should seek immediate medical attention if you experience any of the following:

Loss of bowel or bladder control.
Numbness in the groin or inner thighs (saddle anesthesia).
Progressive weakness in one or both legs.
Severe pain following a major fall, car accident, or other significant trauma.
Fever, chills, or unexplained weight loss accompanied by back pain.
A history of cancer with new, persistent back pain.
Severe, constant pain that is not relieved by rest or becomes significantly worse.

These symptoms may indicate a serious underlying condition that requires urgent medical evaluation. If you are unsure whether your symptoms are an emergency, it is always safest to seek immediate medical care.

How many chiropractic visits will I need?
- The answer is different for every patient. The number of visits recommended depends on several factors, including your diagnosis, the severity and duration of your symptoms, your age, overall health, activity level, and any previous injuries or other complicating factors.

Some people experience significant improvement after only a few visits, while others require a longer course of care to allow the injured tissues to heal and normal function to return. A thorough evaluation is the best way to determine the cause of your pain and develop a treatment plan that is appropriate for your individual needs.

Does insurance cover chiropractic care?
- Many health insurance plans include chiropractic benefits. At Cadence Chiropractic, we currently accept Blue Cross Blue Shield, UnitedHealthcare, UMR, Select Health, and Medicare.

Before beginning care, our team will verify your insurance benefits and explain what your plan covers, any out-of-pocket costs, and any limitations that may apply. Our goal is to give you all the information you need so you can make an informed decision about your care with no surprises.

Can children get low back pain?
- Yes. Although low back pain is less common in children than adults, it can still occur. The good news is that children generally recover very well because their bodies are still growing and healing. In many cases, low back pain is related to sports, falls, overuse, or muscle strain.

Young children may not always be able to describe what they are feeling. Instead, they may limp, avoid certain activities, complain of leg or back discomfort, or seem reluctant to run, jump, or play. If your child has persistent back pain, pain that interferes with daily activities, or symptoms that concern you, a thorough evaluation can help determine the cause and whether treatment is needed.

Can pregnancy cause low back pain?
- Yes. In fact, most women will experience low back pain at some point during or after pregnancy. As your baby grows, changes in posture, weight distribution, hormones, and the pelvis can place additional stress on the muscles and joints of the lower back.

Because many treatment options are limited during pregnancy, chiropractic care can be a safe, conservative option to help manage pregnancy-related low back pain. A thorough evaluation can determine whether your symptoms are related to normal pregnancy changes or another condition that may require a different approach.

Evidence & References

The information on this page is based on current peer-reviewed research, clinical practice guidelines, and evidence-based recommendations. Our goal is to provide accurate, up-to-date information that helps patients better understand low back pain and the available treatment options.

Research Articles

Spinal High-Velocity Low-Amplitude Manipulation in Acute Nonspecific Low Back Pain: A Double-Blinded Randomized Controlled Trial in Comparison With Diclofenac and Placebo
Wolfgang J. von Heymann, Patrick Schloemer, Juergen Timm, Bernd Muehlbauer
Journal: Spine (2013)

This randomized controlled trial compared spinal manipulation with diclofenac (Voltaren®) and placebo in patients with acute nonspecific low back pain. The study found that spinal manipulation produced better outcomes than diclofenac in this selected patient group, with no adverse events reported.

Read the study:
PubMed

Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey
Haiou Yang, Scott Haldeman, Ming-Lun Lu, Dean Baker
Journal: Journal of Manipulative and Physiological Therapeutics (2016)

This study examined how workplace factors such as job insecurity, work-family conflict, hostile work environments, and long work hours are associated with low back pain in U.S. workers.

Read the study:
PubMed

Innominate Movement Patterns, Rotation Trends and Range of Motion in Individuals With Low Back Pain of Sacroiliac Joint Origin
Divya B. Adhia, Stephan Milosavljevic, Steve Tumilty, Melanie D. Bussey
Journal: Manual Therapy (2015)

This study demonstrated that patients with clinically diagnosed sacroiliac joint pain exhibited different pelvic movement patterns than patients whose low back pain originated elsewhere, supporting the importance of an accurate diagnosis.

(I couldn’t locate a reliable PubMed record during my search. This article is indexed by Elsevier/Manual Therapy, and you can later replace this with the PubMed link if available.)

The Effect of Spinal Manipulation on Deep Experimental Muscle Pain in Healthy Volunteers
Søren O’Neill, Øystein Ødegaard-Olsen, Beate Søvde
Journal: Chiropractic & Manual Therapies (2015)

This study found that spinal manipulation did not produce a generalized pain-blocking effect in healthy volunteers, suggesting that clinical pain relief is more likely related to improving an existing mechanical problem rather than simply masking pain.

Read the study:
PubMed

Individualized Chiropractic and Integrative Care for Low Back Pain: The Design of a Randomized Clinical Trial Using a Mixed-Methods Approach
Kristine K. Westrom, Michele J. Maiers, Roni L. Evans, Gert Bronfort
Journal: Trials (2010)

This paper describes an evidence-based clinical trial evaluating individualized chiropractic care compared with multidisciplinary integrative care for chronic low back pain, emphasizing that no single treatment is appropriate for every patient.

Read the study:
PubMed article (PMCID/PMID)

Clinical Resources

The recommendations throughout this page are also informed by evidence-based clinical practice guidelines and current standards of care for the evaluation and conservative management of low back pain.

Written and reviewed by Dr. Marc Nelson, DC

Last update Aug 2026