Low Back Pain (Dorsalgia)

Condition Definition

Low back pain, or dorsalgia, refers to pain arising from the lumbar spine, the five vertebrae of the lower back, and the surrounding structures, including intervertebral discs, facet joints, muscles, ligaments, and nerve roots. It is one of the most common reasons adults seek medical care. Low back pain may be acute (resolving within six weeks), subacute (six to twelve weeks), or chronic (persisting beyond twelve weeks). Its causes range from muscle strain to structural disc and nerve conditions, and accurate diagnosis is essential to selecting the right treatment approach.

Common Causes

The lumbar spine bears the majority of the body's weight and is subject to significant mechanical stress throughout daily activity. Common causes include muscle and ligament strain from sudden movements, heavy lifting, or poor posture. Degenerative changes, disc dehydration, facet joint arthritis, and ligament thickening accumulate with age and can narrow the spinal canal or compress nerve roots. Disc herniation, where inner disc material pushes through the outer ring, is a frequent structural cause of both localized and radiating pain.

Typical Symptoms

Low back pain can present as a dull, aching sensation localized to the lumbar region, or as sharp pain triggered by specific movements such as bending, twisting, or lifting. When a nerve root is compressed, pain shoots from the lower back through the buttock and down the leg, a pattern known as sciatica. Lumbar stenosis often produces neurogenic claudication: leg cramping or fatigue with walking that improves with rest or sitting.

Related Diagnoses

Lumbar Radiculopathy / Sciatica

Compression of a lumbar nerve root produces sharp, shooting pain from the lower back through the buttock and down the leg, often with associated numbness, tingling, or weakness.

Lumbar Spinal Stenosis

Narrowing of the lumbar spinal canal that compresses nerve roots and causes neurogenic claudication, leg pain, cramping, and fatigue with walking that resolves with rest.

Vertebrogenic Pain Syndrome

Pain originating from damaged or degenerated vertebral endplates, producing deep axial low back pain that is often unresponsive to conventional injection-based treatments.

Multifidus Muscle Dysfunction

Impaired function of the deep multifidus muscles that stabilize the spine, resulting in chronic low back pain and instability when no clear structural cause is identified.

SCOPES Clinical Approach

Low back pain is evaluated at SCOPES Health through a structured diagnostic process that begins with a detailed clinical history, physical examination, and review of available imaging. The goal is to identify the precise pain generator before any intervention is considered. Depending on diagnosis, treatment may include epidural steroid injections for radiculopathy, medial branch blocks and radiofrequency ablation for confirmed facet pain, sacroiliac joint injections, intradiscal procedures for discogenic pain, basivertebral nerve ablation for vertebrogenic pain, MILD procedure for stenosis, vertebral augmentation for compression fractures, restorative neurostimulation for multifidus dysfunction, or spinal cord stimulation for complex and refractory cases.

Recommended Treatments

Frequently Asked Questions

What is the difference between low back pain and sciatica?

Low back pain refers broadly to pain in the lumbar region. Sciatica specifically describes pain that radiates from the lower back through the buttock and down the leg, caused by compression or irritation of the sciatic nerve or its contributing nerve roots.

Is imaging always necessary to diagnose low back pain?

Not always. Many acute cases are diagnosed clinically without imaging. Imaging such as MRI or CT is typically ordered when neurological symptoms are present, when conservative treatment has not produced improvement, or when a fracture or serious structural cause is suspected.