Low back pain is the most common pain complaint in medicine and the one most often managed by guesswork.
What it is
Most low back pain comes from one of four structures: the discs, the facet joints, the sacroiliac joints, or the muscles and fascia. Each has a recognizable pattern.
A small proportion has a serious cause — infection, fracture, tumour, or cauda equina compression. Screening for those is the first job, and it is mostly done by history rather than by scanning everyone.
How it usually presents
- Pain across the lower back, sometimes into the buttock.
- Worse with sitting suggests a disc; worse with standing and extension suggests the facet joints.
- Pain below the knee suggests nerve root involvement — see sciatica.
- Pain focused to one side just below the belt line is often the sacroiliac joint.
How we treat it
- Identify the pain generator rather than treating ‘back pain’ as one thing.
- Physical therapy aimed at what is actually failing, not generic core work.
- Epidural injection, facet injection or sacroiliac injection depending on the source.
- Attention to sleep, blood sugar and deconditioning, which is what turns an episode into a chronic problem.
To be assessed, call (314) 310-5577 or request an appointment. If this began with a crash or a fall, see accident and injury care.
Common questions
When is back pain an emergency?
Loss of bladder or bowel control, numbness in the saddle area, or progressive leg weakness. Those need an emergency department the same day, not an appointment.
Should I rest?
Brief relative rest, then movement. Bed rest beyond a day or two makes outcomes worse.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.