Conditions & Treatments

Low Back Pain

Low back pain can range from mild, dull, annoying pain, to persistent, severe, disabling pain in the lower back. Pain in the lower back can restrict mobility and interfere with normal functioning.

Low Back Pain

What is low back pain?

Illustration of lumbar spine and pelvis
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Low back pain can range from mild, dull, annoying pain, to persistent, severe, disabling pain in the lower back. Pain in the lower back can restrict mobility and interfere with normal functioning.

Low back pain is 1 of the most significant health problems facing society today. Consider these statistics from the National Institutes of Health:

  • Eight out of 10 people have back pain at some time in their life.

  • Back pain is a common cause of activity limitation in children and adults of all ages.

What causes low back pain?

Even with today's technology, the exact cause of low back pain can be difficult to determine. In most cases, back pain may be a symptom of many different causes, including any or several of the following:

  • Overuse, strenuous activity, or improper use (for example, repetitive or heavy lifting, or exposure to vibration for prolonged periods of time)

  • Trauma, injury, or fracture

  • Degeneration of vertebrae (often caused by stresses on the muscles and ligaments that support the spine, or the effects of aging)

  • Infection

  • Abnormal growth (tumor)

  • Obesity (often caused by increased weight on the spine and pressure on the discs)

  • Poor muscle tone in the back

  • Muscle tension or spasm

  • Sprain or strain

  • Ligament or muscle tears

  • Joint problems (such as, spinal stenosis)

  • Smoking

  • Protruding or herniated (slipped) disk

  • Disease (for example, osteoarthritis, spondylitis, or compression fractures)

Can low back pain be prevented?

The following may help to prevent low back pain:

  • Practicing correct lifting techniques

  • Maintaining correct posture while sitting, standing, and sleeping

  • Exercising regularly (with proper stretching before participation)

  • Avoiding smoking

  • Maintaining a healthy weight

  • Reducing emotional stress which may cause muscle tension

How is low back pain diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for low back pain may include the following. However, during many initial assessments and examinations, specialized tests are not necessary:

  • X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of bones onto film.

  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body.

  • Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient's bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

  • Electromyogram (EMG). A test to evaluate nerve and muscle function.

Treatment for low back pain

Specific treatment for low back pain will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Diagnosis

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include:

  • Activity modification

  • Medication

  • Physical rehabilitation and/or therapy

  • Occupational therapy

  • Weight loss (if overweight)

  • No smoking

  • Following a prevention program (as directed by your doctor)

  • Surgery

  • Assistive devices (for example, mechanical back supports)

Low back pain rehabilitation

Generally, there are 3 phases to low back pain rehabilitation. These include the following:

  • Phase I: Acute Phase. During this initial phase, the physiatrist and treatment team focus on making a diagnosis, developing an appropriate treatment plan, and implementing the treatment regimen to reduce the initial low back pain and source of inflammation. This may include any or all of the items listed above and/or the utilization of ultrasound, electrical stimulation, or specialized injections.

  • Phase II: Recovery Phase. Once the initial pain and inflammation are better managed, the rehabilitation team then focuses on helping the patient to restore working function of the body. This includes returning the patient to normal daily activities while implementing a specialized exercise program that is designed to help the individual regain flexibility and strength.

  • Phase III: Maintenance Phase. The goal of this phase of low back pain rehabilitation is 2-fold educating the individual on ways to prevent further injury and strain to the back, and helping the individual to maintain an appropriate level of physical fitness to help further increase strength and endurance.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



Imaging

  • Pediatric Imaging
    The Pediatric Imaging Program at Massachusetts General Hospital Imaging specializes in ensuring the safety and comfort of child patients while providing the latest technology and the expertise of specialized pediatric radiologists.
  • Neuroendovascular Program
    Working as part of the Vascular Center, the interventional specialists of the Neuroendovascular Program perform minimally invasive, image-guided treatments for conditions including stroke and cerebral aneurysm. These same interventionalists also use minimally invasive techniques to treat non-vascular conditions including herniated disc and vertebral fractures. In addition, our specialty-trained radiologists use the latest imaging technologies to provide diagnostic exams for a full range of neurological conditions.
  • Bone and Joint Imaging and Intervention
    The Bone and Joint Imaging and Intervention Program at Massachusetts General Hospital Imaging offers state-of-the-art diagnostic exams including MRI and CT, interpretation by specialty-trained radiologists, and image-guided procedures for the bones, joints, and spine.
MassGeneral Hospital for Children

  • Pediatric Rheumatology Program
    Pediatric rheumatologists at MassGeneral Hospital for Children specialize in the diagnosis and treatment of all rheumatic and inflammatory conditions of infants, children and adolescents.
  • Pediatric Orthopaedics
    The MassGeneral Hospital for Children Orthopaedics Service provides clinical care to infants, children and adolescents, from birth to college age, for the entire spectrum of musculoskeletal problems.
Department of Orthopaedics

  • Spine Service
    Our Harvard Spine doctors use non-operative therapies as well as advanced surgical techniques to treat scoliosis, spinal disorders, and spinal deformities and injuries helping their patients can get back to doing the things they love.
Obstetrics and Gynecology

  • Midlife Women's Health Center
    The Massachusetts General Hospital Midlife Women’s Health Center brings together experts from more than 15 specialties to improve, promote and advance health care for women at menopause and beyond through research, collaboration and education.
Benson Henry Institute for Mind Body Medicine

Center for Pain Medicine

  • Acute Pain Services
    The Acute Pain Services at the Center for Pain Medicine at Massachusetts General Hospital deliver comprehensive, multidisciplinary care for individuals with postoperative or post-traumatic pain, and treat conditions such as arthritis, back pain and joint pain.

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