How to Diagnose Lower Back Pain


Lower back pain is a common affliction, with millions each year visiting doctors for relief. Not only will they seek relief, they will want a diagnosis.

It is not always easy to diagnose lower back pain. Many body structures can cause it. There are muscles, ligaments, and tendons; spinal column bones; joints, discs and nerves. In addition to these structures, there may be under medical conditions your physician needs to evaluate.

Whether you initially diagnose lower back pain yourself, or leave that to your physician, the diagnosis will need to consider both the location and symptoms of your pain.

Step 1 – Location

The first step is to decide the location. "Where does it hurt?"

1. Axial lower back pain: This lower back pain hurts only in the low back. Pain does not travel into any other area.

2. Radicular lower back pain: This lower back pain hurts in the low back, and also radiates down the backs of the thighs into one or both legs.

3. Lower back pain with reported pain: Diagnose lower back pain with reported pain if it hurts in the low back area, and tends to radiate into the groin, buttocks, and upper thighs. The pain will rarely radiate below the knee, but may seem to move around.

Step 2 – Symptoms

Once you diagnose lower back pain as to location, you will consider symptoms. "How does it feel?"

1. Worsens with certain activities: If you play football, for example, the pain is worse.

2. Worsens in certain positions: Perhaps it gets worse if you stand for too long. Or it is more painful after you sit in a car.

3. Feels better after rest: Resting from the activity or position usually reduces the lower back pain.

4. Deep and steady: Not a sharp muscle catch, this pain is constant and deep within the affected areas.

5. Severe: The pain is excruciating, possibly more so in the calf than the lower back.

6. Numbness and tingling: There may be "pins and needles" within the area.

7. Fleeting pain: Pain may seem to come and go, leaving you unsure at times just how it feels.

8. Achy and dull: Like the flu, this pain is sore and dull, though sometimes intensifying.

9. Migratory: It hurts in one spot, then another.


AXIAL: If location is best described by number 1 above, and symptoms are a combination of 1, 2, and 3, you can probably diagnose lower back pain as being axial – the most common type. This is also called "mechanical" lower back pain. A variety of back structures can cause axial lower back pain, and it is difficult to identify which is the cause. Axial pain gets better on its own, and about 90% of patients recover within six weeks.

RADICULAR: If location is best described by number 2 above, and symptoms are a combination of 4, 5, and 6, you can probably lower lower back pain as being radicular – commonly called sciatica. This lower back pain is caused by compression of a lower spinal nerve, usually the sciatica nerve that runs from the spinal column, down the back of the thighs to the feet. Doctors usually recommend conservative treatment such as physical therapy exercises, medications, and possibly spinal injections, for six to eight weeks.

REFERRED: If location is best described by number 3 above, and symptoms are a combination of 7, 8, and 9, you can probably diagnose your pain as being lower back pain with referred pain – the least common type. This lower back pain is treated the same as axial back pain and frequently goes away as the problem resolves on its own.

How do you diagnose lower back pain?

Diagnose lower back pain with care. You need an accurate diagnosis, which your physician can best make, to be sure no underlying causes need attention. It is not enough to know you have sciatica. You need to know the undering cause of the sciatica to determine treatment options.

If you do diagnose lower back pain, check the diagnosis with your physician.