Lower Back Pain
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Reviewed By:

Tomohiro Hamahata

Tomohiro Hamahata, MD (Orthopedic surgery)

Dr. Hamahata graduated from the Jikei University of Medical Science. After working at Asanokawa General Hospital and Kosei Chuo Hospital, he joined the Department of Orthopedics at Asakusa Hospital in April 2021, specializing in general orthopedics and joint replacement surgery.

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People with these symptoms also use Ubie's symptom checker to find possible causes

  • Pinched nerve in lower back

  • Low back pain worsens when getting up from a sitting or lying position

  • Severe back pain that prevents me from bending down when standing

  • Back pain that prevents me from standing still for a long time

  • Low back pain aggravated by coughing, sneezing, or straining

  • Low back pain when leaning forward and lifting something

  • Lower back pain is worse when pressed on a painful area

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Content updated on Jan 4, 2023

About the symptom

Low back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist.

When to see a doctor

Seek professional care if you experience any of the following symptoms

  • Fever

  • Intermenstrual bleeding

  • Numbness of lower limbs

  • Abnormal sensation (tingling, prickling)

  • Abdominal pain

  • Lower abdominal pain

Possible causes

  • Low back pain

    Low back pain is very common, affecting more than 80% of people at least once in their lifetime. It is usually not serious and often resolves on its own but can be frustrating when it interferes with daily life. Risk factors include smoking, obesity, older age, female sex, physically strenuous or sedentary work, stress, and mental health issues. Serious causes can be menstrual problems, injury, slipped disc, nerve disease, spine disease, or joint deformities.

  • osteoporosis

    Osteoporosis is a disease that makes your bones weak and brittle, resulting in the bone to fracture easily even with minor trauma or stress (for instance, after a simple fall). It may be caused due to long-term low calcium intake, estrogen deficiencies in women, and an inactive lifestyle.

  • Diabetes mellitus (DM)

    A disease where blood sugar levels are abnormally high due to issues with insulin production or resistance. Often, there are no symptoms until the condition worsens, so regular screening is important.

  • Lumbar spondylosis
  • Chronic pain
  • Neuropathic pain
  • Fibromyalgia
  • Acute low back pain
  • Ovulation bleeding
  • Osteoarthritis (OA)

Questions your doctor may ask about this symptom

Your doctor may ask these questions to check for this symptom

  • Do you have pain in the lumbar back?

  • Did your symptoms appear when you move your body?

  • Did your symptoms appear when you lifted something or leaned forward?

  • Do your symptoms improve with exercise?

  • Do you feel the low back pain improves when you lie on your back?



What diseases could cause lower back pain?


Lower back pain might be caused by an issue in the spine itself, or it may come from elsewhere, including from diseases or psychological factors like stress.


Lower back pain can be divided into two categories: pain caused by the lower back (spine) itself, and pain arising from causes outside of the lower back. Diseases where the cause is directly related to the lower back (spine) itself ・Aging or overuse of the back: lumbar disc herniation, lumbar spinal stenosis, degenerative lumbar spine disease ・Falls or accidents: lumbar compression fracture, muscle injury ・Growth: scoliosis, lumbar spondylolisthesis ・Bacterial infection: purulent spinal inflammation, spinal caries ・Tumors: spine-originating cancer, cancer that has spread from other locations Diseases where the cause is outside the lower back ・Vascular diseases: dissecting aortic aneurysm ・Urinary tract diseases: ureteral stone ・Gynecological diseases: uterine fibroids or endometriosis ・Digestive system diseases: cholecystitis or duodenal ulcer ・Orthopedic diseases outside the lower back: degenerative joint disease ・Psychological stress-related diseases: somatoform disorder, schizophrenia


Japanese Orthopaedic Association, Japanese Society for Spine Surgery and Related Research. Clinical Guidelines for Low Back Pain, 2nd Revised Edition. Nan'endo, 2019.



Can lower back pain be caused by a herniated disc in the lumbar spine?


If you feel pain or tingling not only in your lower back but also in your buttocks, the back of your thighs, or your shins, it might be a sign of a herniated disc in the lumbar spine.


If you have the following symptoms, there's a strong chance it might be a herniated disc, and you should see an orthopedic doctor near you: ・Sudden onset of lower back pain and intense pain or tingling in the legs ・Pain or tingling in the buttocks, back of the thighs, or shins ・Symptoms get worse with coughing, sneezing, or straining ・Pain increases when bending forward ・Unconsciously leaning to one side Please note that people in their 20s to 40s and those with smoking habits are particularly more prone to herniated discs in the lumbar spine.


Clinical Practice Guideline Committee for Lumbar Disc Herniation & Lumbar Disc Herniation Treatment Guideline Development Committee. Lumbar Disc Herniation Treatment Guidelines, 3rd Edition, Revised 2021. Nankodo; 2021. Referenced August 5, 2023.



Can I get back pain before or during my period?


Yes, back pain before or during your period is part of menstrual symptoms and cramps, and many women experience it.


Often, the pain can spread from the lower belly to the back. This is believed to be because of changes in hormones. Specifically, changes in the balance of some female hormones can cause the uterus to contract strongly, leading to back pain. If the back pain is very strong, you should see an orthopedic doctor. If you also have pain in the lower belly, you should see a gynecologist.


Smith, Derek R et al. Menstrual disorders and their influence on low back pain among Japanese nurses. Industrial health. 2009, 47, p.301-12.


Huei-Mein Chen. Randomized Trial of Modified Stretching Exercise Program for Menstrual Low Back Pain. West J Nurs Res. 2019, 41, p.238-257.


Other Related Symptoms

Similar symptoms or complaints


  • Will JS, Bury DC, Miller JA. Mechanical Low Back Pain. Am Fam Physician. 2018 Oct 1;98(7):421-428. PMID: 30252425.


  • Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021 Jul 3;398(10294):78-92. doi: 10.1016/S0140-6736(21)00733-9. Epub 2021 Jun 8. PMID: 34115979.


  • Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, Viswanath O, Jones MR, Sidransky MA, Spektor B, Kaye AD. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep. 2019 Mar 11;23(3):23. doi: 10.1007/s11916-019-0757-1. PMID: 30854609.


  • Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):A1-57. doi: 10.2519/jospt.2012.42.4.A1. Epub 2012 Mar 30. PMID: 22466247; PMCID: PMC4893951.


  • Patrick N, Emanski E, Knaub MA. Acute and chronic low back pain. Med Clin North Am. 2014 Jul;98(4):777-89, xii. doi: 10.1016/j.mcna.2014.03.005. PMID: 24994051.


Reviewed By:

Tomohiro Hamahata

Tomohiro Hamahata, MD (Orthopedic surgery)

Dr. Hamahata graduated from the Jikei University of Medical Science. After working at Asanokawa General Hospital and Kosei Chuo Hospital, he joined the Department of Orthopedics at Asakusa Hospital in April 2021, specializing in general orthopedics and joint replacement surgery.

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