Back pain is one of the most common physical complaints.  If the condition does not improve within two days, see a health care practitioner experienced in back conditions.

Most people experience at least one backache in their lives.  And most backaches occur in the lumbar region, or lower back – which supports most of the body's weight.  Low back pain can emanate from the spine, nearby bones, muscles, nerves – just about any related structure.  It can appear immediately or develop over a period of time.  The cause might be obvious – such as a strain or injury – or a total mystery.  The pain itself might be sharp, dull, throbbing, burning, tingling, localized, widespread, radiating, a mere nuisance or breath-takingly severe.  It can pass in days or weeks, or linger for months or years.  All of this falls under the clinical heading of back pain.

The most common causes of back pain are a strain (such as from lifting), an injury and sitting in one position for a long period.  The condition might be incubating for a long period before the pain strikes.  The specific change in the back might never be identified, but people are at particular risk from the following:

• Work involving heavy lifting, bending, twisting or vibration
• Bad posture
• Pregnancy
• Advancing age  (30 and above)
• Smoking
• Lack of exercise or physical activity
• Obesity
• Arthritis
• Osteoporosis
• Ongoing stress
• Clinical depression

If pain persists to the point where a doctor's visit is required, the diagnostic process will attempt to rule out more serious underlying causes – nerve disorder, fracture, infection, tumor, etc.  The doctor will check for:

• Long-term chronic pain
• Numbness or tingling in the legs
• Muscle weaknessPoor blood circulation
• Redness or swelling on the back
• Loss of bowel or bladder control
• Recent accident or injury
• Fever
• Unusual age for a first-time episode  (under 30 and over 65)
• Cancer or a family history of cancer
• Steroid or intravenous drug use
• Unintended weight loss

Interestingly, a physical exam often will determine a person with back pain to be normal – except for the pain.  X-rays are almost always unhelpful in finding an explanation for back pain, so they are often not taken at the first visit.  Even if the x-ray does pick up an abnormality, plenty of people have abnormalities in their backs and don't experience pain.  MRI (magnetic resonance imaging) or CT (computed tomography) scans provide "3-D" x-rays and reveal the soft structures of the spine – discs, tendons, etc. – as well as bone structures, and therefore are sometimes useful diagnostic tools.

Doctors commonly ask a host of questions to get at the patient's recent activities, living habits and current symptoms.  Because most episodes of back pain clear up in a few weeks or less, medical tests probably will not be ordered for the first visit.  However, the patient will be asked to stand, sit and walk, bend in various directions, perform leg lifts while lying down and similar exercises to pinpoint the source and severity of the pain.