What causes lower back pain, and why does it sometimes seem to radiate to other parts of the back and hip area?

We turned to Peter Whang, M.D., spine expert at the Yale School of Medicine Department of Orthopaedics. He writes:

“Low back pain is, unfortunately, a ubiquitous problem in our society. Approximately 80% of individuals will have an episode of low back pain at some point in their lives and it is one of the most common reasons for doctor visits.

“Low back pain can be caused by numerous conditions such as arthritis affecting the discs or joints of the spine, or muscle strains.  On rare occasions, more serious disorders can also result in back pain, including fractures, tumors, infections, or even pathology in the abdomen or pelvis. Depending upon which anatomic structures are involved, this pain can radiate to other parts of the body like the buttocks or hips. Specifically, if there is any irritation of the nerves of the spine, a patient can even experience symptoms radiating into one or both legs.

“Because there are so many potential causes, low back pain can be very challenging to treat. Nevertheless, the majority of individuals may be managed effectively with conservative measures consisting of activity modification, physical therapy, and anti-inflammatories or other medications.

“In some instances, it may be beneficial to consider spinal injections, which are intended to decrease inflammation and hopefully provide symptomatic relief. Surgery may be a reasonable option for patients with chronic low back pain that has proven to be resistant to these other types of treatments, or for cases in which there is significant nerve compression (i.e. pain, numbness, or weakness in the legs).

“In the past we often performed fusions for this problem, but in recent years, newer operative strategies have been developed, including minimally invasive and motion-preserving techniques. Unfortunately, recurrent low back pain is not uncommon so if these symptoms do not resolve over time, it may be worthwhile to see your physician for further evaluation.”

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