Back pain happens when your spine gets hurt or overworked. This can be from an accident, aging, or poor alignment. Acute low back pain starts suddenly but goes away in a few days or weeks. Rest, stretching, physical therapy, and self-care can help it heal. Staying active and using good posture can help prevent and recover from back pain. Chronic low back pain lasts more than 3 months.
The lumbar spine supports the weight of your body and is prone to injury (Fig. 1). Pain ranges from mild to severe depending on the amount of injury. It can be acute or chronic.
Acute low back pain starts suddenly and heals in a few days to weeks. The source is usually from the muscles, ligaments, joints, or discs. Mechanical back pain is caused by tight muscles, worn-out discs, and swollen facet joints.
Chronic low back pain persists for more than 3 months. It may be felt all the time or worsen with certain activities. The source may be nerve damage, scar tissue, arthritis, or stress. People with chronic symptoms may be referred to a pain specialist (see Pain Management).
Acute low back pain may feel like:
- Stiffness or tightness
- Aching or burning
- Sharp, stabbing or shooting pains
- Pressure or tingling
- Muscle spasms
The pain may spread to the butt, thighs, or knees. It may get worse when you bend or arch the back, lift heavy objects, or sit or stand for a long time.
Get medical help right away if you suddenly feel extreme leg weakness or can't control your bladder or bowels. This could be a serious problem called cauda equina syndrome.
Being overweight, lack of exercise, poor posture, and improper lifting can make back injuries more likely. Often the cause is unknown.
Some conditions that cause back pain include:
- Muscle strain: A sports injury, fall, or strenuous activity can strain muscles and ligaments. Lack of exercise increases the risk.
- Bulging or herniated disc: The soft center of a disc can push or rupture through the disc wall and pinch a nerve.
- Facet joint arthritis: The facets are paired joints on each vertebra. Arthritis damages the joint capsule causing them to become enlarged and painful. A synovial cyst may form.
- Degenerative disc (osteoarthritis): As you get older, the discs can dry out and shrink. Small tears in the disc wall can be painful. Bone spurs can form and ligaments thicken.
- Stenosis: Narrowing of the bony canals in the spine can compress the spinal cord and nerves.
- Compression fracture: A break in the vertebra bone can cause it to collapse like a wedge. Often due to osteoporosis.
A medical provider will ask about your health history and how your back problem started. Diagnosis begins with a physical exam to check your muscle strength and nerve reflexes. Sometimes X-rays, CT, or MRI scans are ordered.
Healing begins with self-care and nonsurgical treatments (Fig. 2). The goal is to fix the problem, help you move better, and prevent re-injury.
Self care: Back pain often resolves with rest, ice or heat, massage, pain relievers, and gentle stretches. Use an ice pack for 20 minutes a few times a day during the first 2 to 3 days. After that, try a warm shower or heating pad on low setting to relax your muscles. Don't stay in bed too long—more than a couple of days can make things worse. Get up and walk short distances. If you're not starting to improve after a few days, see your doctor.
Medication: You can take nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen. These help reduce swelling and pain. If you have muscle spasms, the doctor may give you a muscle relaxant. If pain is severe, a stronger analgesic may be prescribed. Steroids can also reduce swelling and inflammation of the nerves. A Medrol dose pack are pills taken by mouth and tapered over five days. They start working within 24-hours. Your doctor may suggest an epidural steroid injection near the painful nerve.
Physical therapy/exercise: We advise you to keep moving as normally as possible. A physical therapist can help you return to regular activity and prevent re-injury. They'll teach you proper lifting and walking techniques. You'll also learn home exercises to strengthen and stretch your back, leg, and stomach muscles. Massage, ultrasound, cupping, dry needling, heat, and traction may be helpful. People also benefit from yoga or chiropractic care.
Surgery: Surgery is seldom offered for nonspecific low back pain. Surgery may help those who have muscle weakness, a serious disc herniation, or a pinched nerve that doesn't get better after a reasonable time of nonsurgical treatment.
Most people with acute low back pain respond to treatment. 90% are symptom-free within 1 to 2 weeks and 10% recover within 3 months. A positive attitude, staying active, and going back to work are key elements of recovery. If your regular job duties are too hard at first, modified (light or restricted) duty may be prescribed for a time.
Prevention is key to avoiding recurrence:
- Proper body mechanics and lifting techniques
- Good posture during sitting, standing, sleeping
- Regular exercise with stretching and strengthening
- An ergonomic work area
- Good nutrition, healthy weight, lean body mass
- Stress management and relaxation techniques
- No smoking
If you have more questions, please contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.
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acute: a condition of quick onset lasting a short time, opposite of chronic.
arthritis: joint inflammation caused by infection, immune deficiency (rheumatoid arthritis), or degeneration of the cartilage that causes pain, swelling, redness, warmth, and restricted movement.
chronic: a condition of slow progression and continuing over a long period of time, opposite of acute.
disc (intervertebral disc): a fibrous cushion that separates spinal vertebrae. Has two parts, a soft gel-like center called the nucleus and a tough fibrous outer wall called the annulus.
osteoporosis: loss of bone or atrophy of skeletal tissue that causes bones to weaken and become brittle, and prone to fracture. Preventive measures include adequate calcium and regular exercise to stimulate bone metabolism.
radiculopathy: refers to any disease affecting the spinal nerve roots. Also used to describe pain along the sciatic nerve that radiates down the leg.
sciatica: pain that courses along the sciatic nerve in the buttocks and down the legs. Usually caused by compression of the 5th lumbar spinal nerve.
updated > 7.2025
reviewed by > Banita Bailey, RN, Mayfield Clinic, Cincinnati, Ohio
Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. We comply with the HONcode standard for trustworthy health information. This information is not intended to replace the medical advice of your health care provider.
Nearly 80 percent of our spine patients are able to recover with nonsurgical treatment. Our interventional pain and physical medicine experts help patients find relief from neck, back, and leg pain. But when physical therapy, medications, and spinal injections fail to relieve pain, we help patients with surgery.
We treat about 7,000 patients with low back pain each year.
To make an appointment call 513-221-1100.
Many Mayfield patients have the option of same-day, outpatient surgery at our spine surgery center.
VIDEO: Back pain Q&A with Mayfield neurosurgeon Dr. Bryan Krueger
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