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. Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowly—possibly coming and going—and gradually get worse over time. Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example:. In addition, symptoms of lower back pain are usually described by type of onset and duration:.
Low back pain caused by degenerative disc disease can be felt off and on, but pain flare-ups get progressively more severe over a long period of time. Sudden or jarring movements can damage the spine and its supportive muscles, causing immediate, acute pain. Sometimes symptoms develop or get worse a few hours or days after an accident or injury.
Delayed pain is generally thought of as a side effect of natural healing processes of muscles. These vertebrae are highly susceptible to degeneration and injury, and an injury at one spinal level can cause a specific set of symptoms:. The L3-L4 nerve root is likely to cause shooting pain in the front of the thigh, possibly including numbness or tingling. Pain or neurological symptoms may radiate to the front of the knee, shin, and foot as well, though it is less common.
Pain from the L4-L5 segment typically manifests as sciatic pain in the back of the thigh, and possibly pain that reaches the calves, combined with axial low back pain. Where the base of the spine connects to the sacrum there are a couple of joints that provide support and flexibility.
One is the lumbosacral joint, which allows the hips to swing side to side, and the other is the sacroiliac joint, which has limited mobility and mainly absorbs shock from the upper body to the low body. Pain from the L5-S1 segment is generally caused by problems with these joints or from a compressed nerve root. Issues with the L5-S1 segment commonly cause sciatica. Different nerve roots are irritated depending on the structures in the back that are injured, and being able to point to the specific areas of radicular pain can help more precisely diagnose the source of low back pain.
Sometimes low back pain can signal a serious underlying medical condition. People who experience any of the following symptoms are advised to seek immediate care. Additionally, people who experience pain symptoms after a major trauma such as a car accident are advised to see a doctor. Alternatively, you may want to consider contacting a physiotherapist directly. Some NHS physiotherapists accept appointments without a doctor's referral, or you could choose to pay for private treatment.
Read more about how to get access to physiotherapy. A GP, specialist or physiotherapist may recommend extra treatments if they do not think your pain will improve with self-help measures alone.
Some people choose to see a therapist for manual therapy without seeing a GP first. If you want to do this, you'll usually need to pay for private treatment. Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition. It's often not possible to identify the cause of back pain.
Doctors call this non-specific back pain. Sometimes the pain may be from an injury such as a sprain or strain , but often it happens for no apparent reason. It's very rarely caused by anything serious.
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