What is causing my low back pain?
A question I see all the time in clinic. Low back (Lumbar) pain may be several things:
Muscular pain / spasms
Bone pain
Spondylolisthesis - the bones may be slipped in relation to one another
Facet pain - the joints in the back are worn out and degenerated causing pain
Spondylosis = arthritis in the bones
Due to the vertebral bodies degenerating themselves - this sometimes shows up as swelling or “Modic changes” on MRI
Scoliosis - abnormal curve to the spine. Can happen as a teenager or with aging as an older adult.
Compression fracture - if the bone is cracked or broken
Disc pain
Degenerative disc disease - the discs are potentially dried out, worn out, and smaller than normal
Disc herniation / bulge - the disc pushes out to compressing a nerve, but this usually causes radiculopathy or shooting pain into the leg (sometimes called sciatica depending on the nerves involved).
SI (sacroiliac) joint pain
This is the joint that connects the hip to the spine. This is often overlooked.
Can cause pain on either side of the low back, into the leg, buttock, and groin
SI joint quiz: https://si-bone.com/si-joint-pain-quiz
Hip pain
Bertolotti Syndrome
Often overlooked but very rare
When a part of the bone in the lumbar spine has an abnormal connection to the hip/sacrum
