Overview

how the lower back works

Your lower back carries more load than any other part of the spine, which is why it is the most common source of spine-related pain. Most of it comes from the muscles, discs, and small joints, which is real pain but rarely dangerous. The key question in every visit is whether the pain is mechanical, or whether a nerve is being pinched and sending pain, tingling, or weakness down the leg.

What Usually Causes Low Back Pain

the usual suspects

Mechanical low back pain

The most common back problem there is. Muscles, discs, and small joints get irritated; the pain is real, and it almost always settles.

Herniated disc

The cushion between two spine bones bulges and presses on a nerve. Back pain plus pain shooting down the leg.

Sciatica

Pain running from the buttock down the back of the leg, from a pinched nerve in the lower back.

Spinal stenosis

The nerve canal narrows with age. Legs that ache and tire with walking and feel better leaning on a grocery cart.

Spondylolisthesis

One vertebra slips forward on the one below it, which can pinch nerves and ache with standing and walking.

SI joint pain

Pain low and to one side, where the spine meets the pelvis. Often mistaken for the hip or the back.

When to Come In

timing and warning signs

Most low back pain settles over days to a few weeks with staying active, over-the-counter pain relievers, and time. Come in sooner if the pain runs down the leg with numbness or weakness, follows a real injury, or comes with fever or unexplained weight loss. New trouble controlling your bladder or bowels, numbness in the groin, or rapidly spreading weakness needs same-day emergency care.

What Your Visit Looks Like

exam first, imaging second

Your visit starts with a conversation and a hands-on exam, including a careful check of your nerves: strength, feeling, and reflexes. Most low back pain does not need an MRI; we order one when the answer would change the plan. Nearly all of it gets better without surgery: staying active, physical therapy, and time. When an injection is the right next step, OSI refers you to a pain management specialist for that treatment. When an operation is needed, OSI refers you to a spine surgeon and stays involved in your non-operative care.

How We Treat Low Back Pain

non-operative first, surgery when it counts

Nearly all low back pain gets better without an operation. The usual path is staying active (bed rest makes it worse), a structured course of physical therapy, simple pain relievers, and time. OSI provides this first-line conservative care. When a pinched nerve calls for an injection to calm the pain, OSI refers you to a pain management specialist for that treatment.

Surgery is uncommon, and most people improve without it. It is reserved for specific problems: a nerve being compressed with worsening weakness, narrowing of the spinal canal that has shrunk your walking distance, or instability between spine bones. When an operation is needed, OSI refers you to a spine surgeon and stays involved in your non-operative care. Browse non-operative care, or see how we handle neck pain.