Understanding Low Back Pain: Why It Happens and What You Can Do About It
Low back pain is one of the most common reasons people see a doctor. While it can come from a strained muscle, it’s often a sign that something deeper like the joints, discs, or nerves is under stress. The good news: most people can find relief without surgery.
Staying Active and Preventing Recurrence
Strengthen your core and hip muscles
Avoid prolonged sitting; change positions often
Maintain a healthy weight and ergonomic workstation
Treat flare-ups early before they limit mobility
What Is Low Back Pain?
The lower back (lumbar spine) supports much of your body’s weight and movement. Pain can come from:
Muscles and ligaments strained by lifting or posture
Spinal joints (facet joints) that wear down over time
Discs that bulge, tear, or lose height
Nerves that become irritated or compressed
Understanding which structure is responsible is the key to long-term relief.
What Is Low Back Pain?
The lower back (lumbar spine) supports much of your body’s weight and movement. Pain can come from:
Muscles and ligaments strained by lifting or posture
Spinal joints (facet joints) that wear down over time
Discs that bulge, tear, or lose height
Nerves that become irritated or compressed
Understanding which structure is responsible is the key to long-term relief.
Common Causes
Muscle strain or overuse - sudden lifting, twisting, or repetitive bending.
Degenerative Disc Disease - age-related changes that dry and thin spinal discs.
Facet Joint Arthropathy - arthritis of the small stabilizing joints in the spine.
Spondylolisthesis - A vertebra slipping forward and pinching the nerve.
Sacroiliac Joint Pain - irritation where the spine connects to the pelvis.
Spinal Stenosis - narrowing of the spinal canal that pinches nerves.
When to See a Specialist
Back pain that lasts more than two to three weeks, spreads down the leg, or interferes with sleep or movement deserves evaluation. Seek immediate care if you experience:
New weakness or numbness in your leg
Loss of bladder or bowel control
Pain after a major fall or accident
Early, image-guided diagnosis can prevent chronic pain from becoming permanent.
How Specialists Diagnose the Source
At ePainHealth, physicians use fluoroscopy and ultrasound guidance to precisely identify the pain source. Your evaluation may include:
Review of your imaging (X-ray, MRI)
Focused physical exam to reproduce specific pain patterns
Diagnostic nerve or joint block to confirm the problem area
This step-by-step process ensures treatment targets the correct structure
When to See a Specialist
Back pain that lasts more than two to three weeks, spreads down the leg, or interferes with sleep or movement deserves evaluation. Seek immediate care if you experience:
New weakness or numbness in your leg
Loss of bladder or bowel control
Pain after a major fall or accident
Early, image-guided diagnosis can prevent chronic pain from becoming permanent.
How Specialists Diagnose the Source
At ePainHealth, physicians use fluoroscopy and ultrasound guidance to precisely identify the pain source. Your evaluation may include:
Review of your imaging (X-ray, MRI)
Focused physical exam to reproduce specific pain patterns
Diagnostic nerve or joint block to confirm the problem area
This step-by-step process ensures treatment targets the correct structure.
Non-Surgical Treatment Options
Modern interventional spine care focuses on restoring function and reducing pain before surgery is ever considered.
Medial Branch Nerve Blocks & Radiofrequency Ablation
Used to identify and calm painful spinal joints when pain worsens with extension or rotation.
Orthobiologic Treatments (PRP & BMAC)
Platelet-Rich Plasma (PRP) and Bone Marrow “Cell” Injections help heal damaged discs or joints naturally by using your body’s own repair cells.
Low Back Frequently Asked Questions
01. What is a facet ablation (RFA), and how is it different from diagnostic blocks?
Answer: Blocks test the pain source; ablation stops the nerve signal.
A medial branch block temporarily numbs a spinal joint to confirm the pain generator. If it works, radiofrequency ablation (RFA) uses heat to deactivate that small nerve for 6–12 months. The joint stays stable, and pain often lessens dramatically.
Lumbar | Interventional Spine | RFA
02. How long does a radiofrequency ablation (RFA) last, and can it be repeated?
Answer: Relief often lasts 6–12 months and the procedure can be repeated safely.
After an RFA, the tiny sensory nerves that send pain signals grow back slowly. Many patients enjoy meaningful relief for 6 months to a year. If the pain returns, a repeat ablation can usually be performed using the same approach. Regular stretching and strengthening help extend the benefit. Lumbar | Cervical | Interventional Spine | RFA
03. Why does my low back hurt after sitting or long drives?
Answer: It’s usually from facet-joint stress or weak postural muscles.
Sitting flexes the lumbar spine and compresses facet joints and discs, especially if the core is de-conditioned. Over time, this posture leads to inflammation and stiffness. Supportive cushions, regular breaks, and targeted therapy for core and glute muscles often relieve symptoms.
Lumbar | Ergonomics | Rehab
04. What is a diagnostic discogram, and why is it rarely done now?
Answer: It injects dye into spinal discs to find the pain source but carries risks.
Discography involves pressurizing discs with contrast dye while monitoring pain response. It was once common before spine surgery but is now less used because it can worsen disc damage and cause infection. Modern MRI and targeted nerve blocks provide safer diagnostic insight.
05. Why do some people have chronic back pain even after “successful” fusion surgery?
Answer: Adjacent levels often wear out faster.
Spinal fusion stabilizes one level but transfers stress to the discs and joints above and below, leading to adjacent segment disease. Scar tissue, muscle atrophy, and nerve irritation can also persist. Nonsurgical options like PRP or radiofrequency treatment can help preserve the surrounding spine.
Lumbar | Post-Surgery | Interventional Spine
06. What are “adjacent segment disease” and “hardware failure” after spine surgery?
Answer: They mean nearby levels or implants break down over time.
After fusion, joints next to the fused area compensate by moving more, sometimes developing arthritis or stress fractures. Hardware fatigue or loosening can also occur years later. Regular imaging helps detect changes early; pain-management injections or strengthening programs can often delay revision surgery.
Lumbar | Cervical | Post-Surgery | Spine Degeneration
07. How do you tell if leg pain is from the back or from a knee or hip problem?
Answer: Back-related pain travels below the knee; joint pain usually stays local.
Nerve compression in the spine typically causes sharp, shooting pain that radiates past the knee or into the foot. Hip or knee arthritis usually creates aching localized pain or stiffness without tingling. Imaging and physical-exam maneuvers help determine whether the source is spinal, joint, or both.
Diagnostics | Lumbar | Hip | Knee
08. What is an epidural steroid injection and what does it do?
Answer: It delivers anti-inflammatory medicine around pinched nerves.
Guided by X-ray, a thin needle places medication into the epidural space of the spine. The steroid reduces swelling around irritated nerves from a herniated disc or arthritis. Relief may last weeks to months and can allow better participation in physical therapy.
Interventional Spine | Epidural | Lumbar | Cervical
09. What are red-flag symptoms that spine pain is not just mechanical?
Answer: Fever, unexplained weight loss, numbness, or bladder issues.
Warning signs include constant pain at rest, night sweats, progressive weakness, loss of control of urine or stool, or recent infection. These could signal infection, tumor, or severe nerve compression and need emergency evaluation.
Safety | Lumbar | Cervical | Emergency
10. How long should I wait before considering spine surgery?
Answer: Only after conservative care has clearly failed and red flags are excluded.
Most mechanical back or neck pain improves with guided injections, therapy, or biologic repair within 3–6 months. Surgery is reserved for progressive weakness, structural instability, or nerve compression causing loss of function. A second opinion is always appropriate before proceeding.
Lumbar | Cervical | Surgery Decision
11. What is a “facet joint,” and why can it cause back or neck pain?
Answer: It’s a small stabilizing joint behind each vertebra that can become arthritic.
Facet joints allow bending and twisting. With aging or injury, they may develop arthritis and inflammation that causes sharp localized pain, often worse when leaning backward or standing long periods. Facet injections or RFA can calm these joints for months at a time.
Lumbar | Cervical | Anatomy | Interventional Spine
12. When should I seek emergency care after a neck or back injury?
Answer: Sudden weakness, numbness, fever, or bladder/bowel changes.
Go to the ER immediately for severe pain with loss of strength, incontinence, high fever, or trauma with head injury. These could indicate nerve or spinal-cord compression, infection, or fracture. Early treatment prevents permanent damage.
Cervical | Lumbar | Emergency | Safety
13. What is a “nerve root block,” and how is it different from an epidural?
Answer: A nerve-root block targets one specific nerve, while an epidural bathes several.
A selective nerve-root block (SNRB) uses live X-ray to deliver medication directly around one irritated spinal nerve. It helps confirm which nerve causes the pain and can calm inflammation at that precise level. Epidural injections are broader, covering multiple nerves at once.
14. How can I tell if my hip pain is coming from the joint or my back?
Answer: Hip arthritis hurts in the groin; back problems radiate to the leg.
Hip joint disease often causes deep aching in the groin or front thigh, worse with walking or stairs. Lumbar nerve compression tends to cause burning or tingling down the leg. Diagnostic injections into the hip or spine can confirm the true source.
Hip | Lumbar | Diagnostics | Joint Pain
15. Can regenerative medicine help spine patients who already have hardware or fusions?
Answer: Yes, but injections are placed around not into the fused levels.
PRP and bone-marrow concentrate can reduce inflammation in joints and ligaments next to a fusion where new pain develops. These procedures don’t interact with the hardware itself. Most patients benefit from improved flexibility and less reliance on pain medication.
Spine | Post-Surgery | Orthobiologics | Interventional Spine
Take the Next Step Toward Relief
You don’t have to live with constant back pain. Our board-certified specialists offer minimally invasive, image-guided solutions tailored to your needs.
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