Causes of Lower Back Pain: 3 Common Patterns and How to Tell Them Apart

Lower back pain does not always come from the same problem.

One person may develop pain after sitting at a desk all day. Another may feel a sharp pain when bending or lifting. Someone else may have back pain along with burning, tingling, or numbness traveling into the leg.

Although these symptoms may all be described as lower back pain, the underlying problem can be very different.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases , back pain can involve muscles, ligaments, spinal joints, discs, nerves, and other structures. In some cases, more than one factor may contribute at the same time.

That is why identifying which movements, positions, and activities reproduce your symptoms can be more useful than simply knowing where it hurts.

At Godo Chiropractic in Lakeview Chicago, I evaluate lower back pain by looking at how the spine, pelvis, hips, muscles, and nervous system are functioning together.

1. Joint Restriction and Mechanical Lower Back Pain

Your lower back contains multiple joints that must move together when you bend, twist, walk, exercise, or even change positions in a chair.

When movement becomes restricted in part of the lumbar spine, pelvis, or hips, other areas may compensate. As a result, normal activities may begin placing greater mechanical stress on certain joints and surrounding muscles.

What This Type of Back Pain May Feel Like

• Localized aching or stiffness in the lower back
• Pain that feels stronger on one side
• Stiffness after sitting for a long time
• Discomfort when standing after sitting
• Pain when twisting or extending the lower back
• Morning stiffness that improves once you begin moving
• Recurring episodes that improve temporarily but continue returning

The pain may feel very specific. You may even be able to point directly to the area that feels restricted or irritated.

However, the painful location does not necessarily identify the entire problem. For example, restricted hip motion or altered pelvic mechanics may cause the lower back to compensate during walking, lifting, or exercise.

This is one reason I evaluate more than just the area where you feel pain.

Learn more about my approach to chiropractic care for lower back pain in Chicago .

2. Muscle Strain, Overuse, and Movement Compensation

Muscles and connective tissues surrounding the lower back help stabilize your spine while you stand, lift, bend, exercise, and perform normal daily activities.

A sudden awkward movement can strain these tissues. However, lower back muscle pain can also develop gradually.

Repeated sitting, lifting, exercise, inadequate recovery, limited hip mobility, previous injuries, or repetitive work activities can change how the muscles around the spine are being used.

Consequently, some muscles may begin doing more work than they should.

Signs Muscle or Movement Dysfunction May Be Involved

• Tightness or soreness across the lower back
• Muscle spasms
• Pain after lifting or exercise
• Symptoms that become worse toward the end of the day
• Discomfort after prolonged sitting or standing
• Pain when bending or returning to an upright position
• One side of the back feeling tighter than the other
• Temporary improvement from stretching, massage, or changing positions

The Mayo Clinic lists muscle and ligament strain among conditions commonly associated with back pain.

Still, simply identifying a "tight muscle" may not explain why that muscle keeps becoming tight.

Muscle tension may instead be a response to limited joint movement, repetitive loading, altered movement coordination, or compensation from another area.

Why the Hips and Pelvis Matter

The hips and pelvis transfer forces between your lower body and your spine.

If hip movement is limited, the lower back may have to move more during activities such as:

• Squatting
• Running
• Weightlifting
• Getting out of a chair
• Bending forward
• Climbing stairs
• Rotating during sports

Over time, this compensation can contribute to recurring lower back discomfort.

For active patients, you can also read about my approach to sports injury rehabilitation in Lakeview Chicago .

3. Disc or Nerve-Related Lower Back Pain

Some lower back symptoms may involve irritation of a lumbar disc or one of the nerves traveling from the lower spine into the leg.

This pattern can feel quite different from localized muscular or joint-related discomfort.

Symptoms May Include

• Sharp or electric-like pain
• Burning pain
• Pain traveling into the buttock or leg
• Numbness or tingling
• Symptoms extending below the knee
• Leg or foot weakness
• Pain that changes significantly with sitting or bending
• Increased symptoms with coughing or sneezing

A disc problem does not automatically mean you will have sciatica. Likewise, a disc finding on an MRI does not necessarily prove that the disc is causing your pain.

Mayo Clinic notes that disc abnormalities can sometimes appear on imaging even when they are not producing symptoms.

Therefore, examination findings need to be compared with your symptoms rather than relying on an MRI finding alone.

Lower Back Pain vs. Sciatica: What Is the Difference?

Lower back pain and sciatica are related, but they are not the same condition.

Lower back pain may remain primarily around the lumbar spine, pelvis, or surrounding muscles.

Sciatica more commonly involves symptoms traveling along the course of a nerve into the buttock or leg.

These symptoms may include:

• Burning
• Tingling
• Numbness
• Electric-like pain
• Weakness

However, not every pain traveling into the leg is true sciatica. Hip problems, muscle irritation, joint dysfunction, and other conditions can sometimes produce similar symptoms.

If pain, numbness, or tingling is traveling into your leg, learn more about sciatica chiropractic care in Chicago .

What If More Than One Problem Is Causing Your Lower Back Pain?

This is common.

For example, you might have limited hip movement that changes how your pelvis moves. Your lower back then compensates, certain muscles become overworked, and eventually the irritated area becomes painful.

In another case, a sensitive lumbar disc may cause you to change how you move. Those changes can then create additional muscle tension or joint restriction.

This is why treating only the painful spot may provide temporary relief without addressing the mechanical pattern that continues to aggravate it.

The goal of an examination is to determine which findings actually relate to your symptoms.

How I Evaluate Lower Back Pain

At Godo Chiropractic, I do not assume that every patient with lower back pain needs the same treatment.

Your evaluation begins with your history.

I want to know:

• When the pain started
• What you were doing when it began
• Which movements aggravate it
• Which positions reduce it
• Whether the pain travels
• Whether numbness or weakness is present
• How the symptoms affect work, exercise, sleep, and daily activities
• Whether you have had previous injuries or similar episodes

Then I evaluate how your body is functioning.

Depending on your symptoms, the examination may include:

• Posture
• Lumbar spine movement
• Pelvic and hip mobility
• Muscle function
• Strength
• Movement patterns
• Joint function
• Orthopedic testing
• Neurological testing when appropriate

The purpose is not simply to find something that hurts.

It is to determine whether the findings from the examination help explain your symptoms and whether chiropractic care is appropriate.

If you have not been to our office before, read what to expect at your first chiropractic visit in Lakeview Chicago .

Do You Need an X-Ray or MRI for Lower Back Pain?

Not automatically.

Many people assume that an MRI is necessary to determine the cause of back pain. However, imaging findings and symptoms do not always match.

Your history and physical examination usually provide important information first.

Imaging may become appropriate when there has been significant trauma, progressive neurological change, unusual symptoms, or another finding that requires further investigation.

If your examination suggests that imaging or medical evaluation is more appropriate before treatment, I will explain why.

When Lower Back Pain Needs Medical Attention

Most mechanical lower back pain is not caused by a medical emergency. Nevertheless, certain symptoms deserve prompt medical evaluation.

The National Institutes of Health also recommends medical evaluation when back pain occurs with symptoms such as difficulty urinating, leg weakness or numbness, fever, or unexplained weight loss.

When symptoms are severe or rapidly progressing, emergency evaluation may be appropriate.

Can Chiropractic Care Help Lower Back Pain?

Chiropractic care may be appropriate when lower back pain is associated with factors such as:

• Restricted joint movement
• Mechanical irritation
• Muscle tension
• Reduced mobility
• Movement dysfunction
• Postural stress

However, treatment should be based on what your examination shows.

Depending on those findings, care may include chiropractic treatment, soft-tissue techniques, movement recommendations, exercise guidance, or modifications to activities that aggravate your symptoms.

If chiropractic care does not appear appropriate, further testing or referral may be recommended instead.

Why Does Lower Back Pain Keep Coming Back?

Recurring pain often means that an irritating factor has not completely changed.

For example, symptoms may improve temporarily while the underlying movement pattern, physical demand, workload, joint restriction, or aggravating activity remains the same.

That does not mean every recurring episode has one simple "root cause."

Instead, several factors may interact.

Identifying those factors provides a better starting point for deciding what should change.

Frequently Asked Questions About the Causes of Lower Back Pain

Looking for a Lower Back Pain Chiropractor in Lakeview Chicago?

If your lower back pain keeps returning, the first question should not simply be:

"Where does it hurt?"

A better question is:

"Why is this area repeatedly becoming irritated?"

At Godo Chiropractic, I evaluate your symptoms, posture, movement, joint function, muscle function, and relevant neurological findings to determine what may be contributing to your problem.

I am a chiropractic physician and registered nurse with more than 23 years of clinical experience, and my approach is individualized rather than giving every patient the same treatment.

Godo Chiropractic is located in Lakeview Chicago and serves patients from Lakeview, Lincoln Park, Wrigleyville, Northalsted, Roscoe Village, Uptown, River North, and surrounding Chicago neighborhoods.