Is It Serious? Why Your Lower Back Is Hurting & Medical Next Steps

Lower back pain is one of the most common health complaints in adults. Nearly everyone experiences it at some point. In many cases, it improves within a few days or weeks. But sometimes, lower back pain can signal something more serious.

So how do you know the difference?

Below, you'll learn the most common causes of lower back pain, warning signs to watch for, and what medical experts recommend as next steps.

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What Causes Lower Back Pain?

The lower back (lumbar spine) supports most of your body weight. It's involved in bending, lifting, walking, and sitting. Because it works so hard, it's especially vulnerable to strain and injury.

Most Common Causes (Usually Not Serious)

The majority of lower back pain is mechanical, meaning it comes from muscles, joints, or ligaments.

Common causes include:

• Muscle strain or ligament sprain

  • Lifting something heavy
  • Sudden twisting
  • Poor posture
  • Overuse during exercise

• Herniated or bulging disc

  • A spinal disc presses on a nerve
  • May cause pain that shoots down the leg (sciatica)

• Degenerative disc disease

  • Age-related wear and tear
  • Common after age 40

• Facet joint arthritis

  • Arthritis in spinal joints
  • Stiffness, especially in the morning

These conditions can be painful but are usually not dangerous. Most improve with time and conservative care.

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When Lower Back Pain Might Be Serious

Although uncommon, some causes of lower back pain require urgent medical attention.

Seek Immediate Medical Care If You Have:

• Loss of bladder or bowel control
• Numbness in the groin or inner thighs (saddle anesthesia)
• Severe weakness in one or both legs
• High fever with back pain
• Back pain after major trauma (car accident, fall)
• History of cancer with new back pain
• Unexplained weight loss
• Severe, constant pain that does not improve with rest

These symptoms could indicate serious conditions such as:

• Cauda equina syndrome
• Spinal infection
• Spinal fracture
• Cancer involving the spine
• Abdominal aortic aneurysm (rare but life-threatening)

These are not common—but they are important to rule out quickly.

If you experience any of the above, speak to a doctor immediately or seek emergency care.

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Acute vs. Chronic Lower Back Pain

Understanding the timeline helps determine seriousness.

• Acute lower back pain: lasts less than 4 weeks
• Subacute pain: 4–12 weeks
• Chronic lower back pain: more than 12 weeks

Most acute lower back pain improves within a few weeks.

If you're experiencing sudden or recent-onset symptoms and want to understand what might be causing them, try this free Acute Low Back Pain symptom checker to get personalized insights and recommended next steps based on your specific situation.

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What Lower Back Pain Feels Like (And What It May Mean)

Dull, Aching Pain

Often muscular. Worse with movement, better with rest.

Sharp Pain with Movement

May suggest muscle strain or joint irritation.

Burning or Shooting Pain Down the Leg

Possible nerve involvement, such as sciatica from a herniated disc.

Stiffness in the Morning

Common with arthritis.

Pain That Worsens at Night or Doesn't Change with Position

Needs medical evaluation to rule out more serious causes.

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What You Can Do at Home

If you don't have red-flag symptoms, conservative care is usually recommended first.

1. Stay Active (But Avoid Heavy Lifting)

Bed rest is no longer recommended for most cases. Gentle movement helps recovery.

• Short walks
• Light stretching
• Gradual return to normal activity

2. Use Heat or Ice

• Ice for the first 24–48 hours after injury
• Heat for muscle tightness and ongoing stiffness

3. Over-the-Counter Pain Relief

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help reduce inflammation and pain. Always follow dosing instructions and speak to a doctor if you have kidney, heart, or stomach conditions.

4. Improve Posture

• Sit with lower back supported
• Avoid slouching
• Adjust desk and computer height
• Use proper lifting techniques

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When to See a Doctor for Lower Back Pain

Make an appointment if:

• Pain lasts longer than 2–4 weeks
• Pain keeps returning
• Pain interferes with sleep
• You have weakness, tingling, or numbness
• Pain spreads down your leg
• You're over age 50 with new, severe pain
• You have osteoporosis

A doctor may perform:

• Physical exam
• Neurological testing
• Imaging (X-ray, MRI) if needed
  Note: Imaging is not usually required for uncomplicated lower back pain in the first 6 weeks.

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Medical Treatments for Persistent Lower Back Pain

If home care doesn't help, treatment options may include:

• Physical therapy

  • Core strengthening
  • Stretching programs
  • Posture training

• Prescription medications

  • Muscle relaxants
  • Nerve pain medications

• Steroid injections

  • For nerve-related inflammation

• Surgery (rare)

  • Reserved for severe nerve compression
  • Progressive weakness
  • Loss of bladder or bowel control

Surgery is typically considered only after conservative treatments fail or if urgent neurological symptoms are present.

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Risk Factors for Lower Back Pain

Certain factors increase your chances of developing lower back pain:

• Sedentary lifestyle
• Obesity
• Smoking
• Poor posture
• Repetitive lifting
• Weak core muscles
• Aging
• Stress and anxiety

Addressing these risk factors can reduce recurrence.

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Can Stress Cause Lower Back Pain?

Yes. Emotional stress can increase muscle tension, especially in the lower back and neck. Chronic stress may worsen existing pain and slow recovery.

If stress plays a role, consider:

• Gentle exercise
• Mindfulness or breathing techniques
• Adequate sleep
• Talking with a healthcare provider

Pain is physical—but it's also influenced by mental health.

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The Bottom Line: Is It Serious?

Most lower back pain is not dangerous and improves within a few weeks.

However, you should not ignore:

• Neurological symptoms
• Severe, unrelenting pain
• Systemic symptoms (fever, weight loss)
• Trauma-related pain

If you're uncertain about whether your symptoms warrant medical attention, use this free Acute Low Back Pain assessment tool to evaluate your symptoms and receive guidance on appropriate next steps.

Most importantly, speak to a doctor if your symptoms are severe, worsening, or include anything that could be life-threatening. Prompt evaluation can rule out serious conditions and give you peace of mind.

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Final Thoughts

Lower back pain is common, and in most cases, it's manageable and temporary. Staying active, practicing good posture, and seeking medical guidance when appropriate are key.

Don't panic—but don't ignore warning signs either.

If something feels different, severe, or concerning, trust your instincts and talk to a healthcare professional right away. Early evaluation can make all the difference.