What are the common diagnoses for low back pain?

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After reviewing your medical history, asking questions about your low back pain, and examining your back, your doctor will likely be able to tell you what type of low back pain you have. It’s important to remember that even with advanced tests, it’s nearly impossible to know exactly where the low back pain comes from.

The most important step is for your doctor to make sure you have no Red flags that might be a sign of a serious problem. After that, the doctor will try to see if your low back pain might come from a few rare causes. Rare causes include inflammatory arthritis, spinal stenosis, or even something outside the low back. Since rare causes are responsible for only about 5% of cases, they probably won’t apply to you.

In 95% of cases, doctors say low back pain is “non-specific.” Some doctors use other terms, including lumbago, simple backache, lumbar sprain, or lumbar strain. All these terms mean the same thing. Some doctors use the term mechanical low back pain, which just means the pain gets worse with certain movements and gets better with rest. That helps distinguish it from other types of low back pain. Your doctor may also attribute your low back pain to spinal degeneration or spinal arthritis, which is called spondylosis. Nearly everyone gets some spinal degeneration as they age. As a result, it’s very difficult to determine if the spinal degeneration or spinal arthritis seen on diagnostic tests can really explain why you have low back pain.

If you have any Red flags or if your doctors think you may have a rare but specific cause of low back pain, they may order imaging or other tests to help choose the best care. You may be tempted to ask your doctor for X-rays or an MRI to try to “see” where the problem is, even if you don’t have Red flags. However, diagnostic imaging like that is rarely helpful in managing non-specific low back pain. X-ray and MRI images often reveal minor physical variations in the spine that have nothing to do with low back pain. Studies show such variations occur just as often in healthy people who don’t have low back pain.

Although it’s impossible to identify a precise source of pain in 95% of people with low back pain, it’s also not necessary to do so. Fortunately, the same basic treatment is called for, regardless of the exact origin of the pain. Most people with low back pain feel better in a few weeks.

 
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