Low back pain

Low back pain is a common medical condition that affects millions of people worldwide. It is estimated that 80% of people will experience low back pain at some point in their lives. The diagnosis, phenotypes, and treatment of low back pain vary depending on the underlying cause of the pain.


The diagnosis of low back pain is made through a combination of physical examination, medical history, and imaging studies. During the physical exam, the doctor will evaluate range of motion, strength, and sensation in the lower back and legs. They may also perform specific tests, such as the straight leg raise test, to assess the presence of low back pain. Imaging studies, such as X-rays, magnetic resonance imaging (MRI), or computed tomography (CT), may be used to visualize the extent of any damage or abnormalities in the lower back.


There are several phenotypes or patterns of low back pain. The most common ones are mechanical low back pain, radicular pain, and axial pain.

Mechanical low back pain: This phenotype is characterized by pain in paraspinal muscles that is worsened by movement and activity. It is often caused by muscle strain, ligament sprain, or joint dysfunction in the lower back.

Radicular pain: This phenotype is characterized by pain that radiates down the leg due to compression or irritation of a spinal nerve root. This is often caused by a herniated disc or spinal stenosis.

Axial pain: This phenotype is characterized by pain that is localized to the lower back and is not associated with any radiation of pain to the legs. It is often caused by degenerative disc or facet joint disease or spondiloarthritis.


The medical treatment of lumbago, or lower back pain, depends on the underlying cause and the severity of the symptoms. Some of the common treatment options are:

Rest and modified activity:

In mild cases of low back pain, relative rest and avoiding activities that worsen pain may be helpful.

The gradual incorporation of light physical activities and muscle strengthening exercises is recommended under the supervision of a health professional.

Analgesic and non-steroidal anti-inflammatory drugs (NSAIDs):

Medications, such as ibuprofen and naproxen, can relieve pain and inflammation. However, these must be prescribed by a doctor, since they may have contraindications in some patients.

Muscle relaxants:

In some cases, muscle relaxants can help relieve pain associated with low back pain, especially if there are significant muscle spasms.


Physiotherapy plays an important role in the treatment of low back pain. Physical therapists can provide manual therapy techniques, specific strengthening and stretching exercises, as well as education on posture and ergonomics.

Heat therapy:

Applying heat to the affected area can relieve pain. Hot compresses can be used.

Epidural injections:

In cases of chronic or persistent low back pain, depending on the etiology of the low back pain, epidural corticosteroid injections into the epidural space around the spinal nerves may be helpful to reduce inflammation and pain.