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Chronic Low Back Pain

Chronic low back pain is back pain lasting 12 weeks or longer, most often from muscle strain, disc degeneration, or arthritis; most cases improve with exercise, physical therapy, and medication.

Musculoskeletal
Chronic low back pain is back pain that lasts 12 weeks or longer, even after an initial injury or strain has healed. Low back pain is one of the most common reasons adults see a doctor and a leading cause of missed work in the United States. The reassuring news is that most chronic low back pain is not caused by a dangerous underlying disease, and most people improve meaningfully with the right combination of activity, therapy, and medication. Causes: In many cases no single structure can be blamed, but several conditions commonly contribute:
  • Muscle or ligament strain: Repeated heavy lifting, awkward movements, and deconditioned core muscles leave the back vulnerable to ongoing strain.
  • Degenerative disc disease: The cushioning discs between vertebrae naturally dry out and flatten with age, which can cause aching stiffness.
  • Arthritis of the spine: Osteoarthritis of the small facet joints of the spine is a frequent source of chronic ache in older adults.
  • Nerve-root compression: A herniated disc or bony overgrowth can pinch a spinal nerve, producing lumbosacral radiculopathy — pain, numbness, or weakness radiating down the leg.
  • Compression fractures: In people with osteoporosis, weakened vertebrae can fracture with little or no trauma.
  • Centralized pain conditions: Disorders such as fibromyalgia can amplify back pain even when imaging looks unremarkable.
Symptoms and Warning Signs: Chronic low back pain may be a dull ache, stiffness, or sharp pain that flares with activity. For most people, symptoms wax and wane over time, with flares triggered by unusual exertion or prolonged sitting. Certain "red flag" symptoms warrant prompt medical attention:
  • Numbness in the groin or inner thighs, or loss of bladder or bowel control: These can signal serious nerve compression and are an emergency.
  • Progressive leg weakness: Worsening strength in the legs suggests significant nerve involvement.
  • Fever, unexplained weight loss, or a history of cancer: These raise concern for infection or tumor.
  • Pain after significant trauma: A fall or accident can cause a fracture that needs imaging.
Diagnosis: Your physician will review your history and perform a physical and neurologic examination. Imaging is not needed for most chronic back pain because incidental findings are extremely common; X-rays or MRI are reserved for red-flag symptoms, suspected nerve compression, or pain that fails to improve with appropriate treatment. Your physician will also ask about sleep, mood, and activity levels, because these strongly influence chronic pain and how quickly it improves. Treatment: The most effective plans combine several approaches rather than relying on any single one:
  • Exercise and physical therapy: Core strengthening, stretching, and graded aerobic activity such as walking or swimming are the cornerstone of treatment. Staying active outperforms bed rest.
  • Medications: NSAIDs such as naproxen ease pain and inflammation. Muscle relaxants such as cyclobenzaprine or methocarbamol may help short-term during flares, and duloxetine is an option for persistent chronic pain.
  • Weight management and smoking cessation: Both reduce strain on the spine and improve healing.
  • Heat, massage, and manual therapies: These provide meaningful short-term relief for many people.
  • Injections and surgery: Epidural steroid injections or surgery are considered only for specific problems, such as confirmed nerve compression that has not responded to conservative care.
Because chronic back pain often travels with sleep problems, stress, and inactivity, treating the whole person matters. The primary-care team at Zimmer Medical Group can build a personalized plan and coordinate physical therapy or specialist care when needed — schedule an evaluation if back pain is limiting your work, sleep, or activity.

Related Medications

Commonly prescribed medications for this condition

CyclobenzaprineMethocarbamolNaproxenDuloxetine

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