Back Pain

Back pain is one of the most common reasons people see a doctor, and it can come from the muscles, discs, joints, or nerves of the spine. Most cases improve with conservative care, but pain that lingers, returns, or travels into a leg usually has a specific source that can be found and treated.

Person holding the lower back with both hands
Man holding his lower back in pain, viewed from behind

What Is Back Pain?

The spine is a column of vertebrae cushioned by discs and held together by joints, ligaments, and muscles. Because the lower back carries most of the body’s weight and acts as the hinge between the upper and lower body, it is the most common place to feel pain. Pain can stay in the back or spread into the buttocks and legs when a nerve is involved.
 
Acute back pain starts suddenly, often after lifting or twisting, and usually settles within a few weeks. Chronic back pain lasts longer than about three months and is more likely to have a structural source, such as a disc, arthritic joint, or narrowed canal, that benefits from a specialist evaluation.

What Can Cause Back Pain?

Because the spine is made up of many structures, back pain has many possible sources. Common causes include:

Muscle or ligament strain

Lifting, twisting, or overuse can strain the soft tissues that support the spine.

Herniated or bulging discs

Disc material can press on a nearby nerve root and cause back or leg pain.

Spinal arthritis

Wear of the facet joints and bone spurs can cause stiffness and aching pain.

Spinal stenosis

A narrowing of the spinal canal that crowds the nerves, often with leg pain when walking.

SI joint dysfunction

The joints linking the spine and pelvis can cause pain low in the back or buttock.

Spondylolisthesis

One vertebra slips forward over the one below, which can strain joints and nerves.

Symptoms Of Back Pain

Back pain can feel different depending on its source. Common signs include:

  • A dull ache or stiffness across the lower or middle back.
  • Sharp or shooting pain with bending, lifting, or twisting.
  • Radiating symptoms, such as pain, numbness, or tingling into the buttock or leg.
  • Muscle spasm or difficulty standing up straight.
  • Pain that changes with position, such as worse after sitting or better when lying down.

Most back pain is felt in the lower back; pain in the middle and upper back is less common and often muscular.

Lumbar (lower back)

  • Aching or sharp pain that can spread into the buttock and hip.
  • Pain down the leg, commonly known as sciatica, often from a disc at L4-L5 or L5-S1.
  • Frequently linked to discs, facet joints, or the SI joint.

Thoracic (mid and upper back)

  • Aching between the shoulder blades, often from posture or muscle strain.
  • Pain that wraps around the ribs can point to an irritated thoracic nerve.
  • Pain with neck or arm symptoms may start in the cervical spine; see neck pain.
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Man holding his lower back in pain at a desk

Acute Or Chronic Back Pain?

How long your pain has lasted, and how it started, shapes what it is likely to be and what will help.

Acute back pain

Sudden and short-lived

Usually improves within a few weeks

  • Often starts after lifting, twisting, or a fall.
  • Most commonly a muscle or ligament strain.
  • Gentle movement, heat or ice, and anti-inflammatory medication help most people.

Chronic back pain

Lasting or recurring

More than about three months

  • More likely to have a structural source, such as a disc, arthritic joint, or narrowed canal.
  • Imaging and a specialist evaluation help pinpoint the source.
  • Often treated with physical therapy, targeted injections, or a minimally invasive procedure.

When to see a spine specialist: book an evaluation if back pain lasts more than a few weeks, keeps coming back, limits your daily activities, or travels into a leg with numbness or tingling.

Seek immediate care for back pain with progressive leg weakness, foot drop, numbness in the groin or inner thighs, or any loss of bladder or bowel control.

How Back Pain Is Diagnosed

Evaluation begins with a clinical history and a physical examination that assesses movement, reflexes, strength, and sensation. When pain persists or comes with leg symptoms, imaging helps find the source. MRI is the preferred study because it shows the discs, joints, and nerves in detail. Radiographs (X-rays) and CT can add detail about alignment and the bony anatomy.
 
If you already have MRI imaging, you can sign up for our free MRI review. Our team of highly trained staff will examine your imaging, answer all of your questions, and help point you towards the path of effective, minimally invasive treatments.
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Clinician examining a patient's lower back

How Back Pain Is Treated

Most back pain improves without surgery, so care begins with the least invasive options and advances only as needed.

  1. 1
    Conservative care
    Treatments

    Activity modification, physical therapy, heat or ice, and anti-inflammatory medication.

    When it is considered

    The first step for nearly every patient; most improve at this stage.

  2. 2
    Image-guided injections
    Treatments

    Epidural, facet, or SI joint injections, and medial branch blocks.

    When it is considered

    When pain persists after several weeks of conservative care, or to confirm where the pain is coming from.

  3. 3
    Radiofrequency ablation
    Treatments

    Radiofrequency ablation to quiet the small nerves that carry joint pain.

    When it is considered

    For arthritic facet or SI joint pain confirmed by diagnostic blocks, when longer relief is needed.

  4. 4
    Minimally invasive procedures
    Treatments

    Endoscopic spine surgery, decompression, or, for selected patients, disc repair or SI joint fusion.

    When it is considered

    When imaging shows a clear source and symptoms have not responded to other care; usually same-day.

Treatment is individualized. Your specialist will recommend the least invasive option appropriate for your condition.

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Frequently Asked Questions

How long should back pain last before I see a doctor?

Most acute back pain improves within a few weeks. If pain lasts longer than that, keeps coming back, or is accompanied by leg pain, numbness, or weakness, an evaluation is recommended so the source can be identified.

Does back pain usually require surgery?

No. The large majority of back pain improves with conservative care such as activity modification, physical therapy, and medication. Surgery is considered only when imaging shows a clear source and symptoms have not responded to other treatment.

What is the most common cause of lower back pain?

Muscle and ligament strain is the most common cause of sudden lower back pain. Pain that lasts or travels into a leg is more often linked to a herniated disc, spinal arthritis, or spinal stenosis.

What is the difference between acute and chronic back pain?

Acute back pain starts suddenly and usually settles within several weeks. Chronic back pain lasts longer than about three months and is more likely to have a structural source that benefits from imaging and a specialist assessment.

When is back pain an emergency?

Seek immediate care for back pain with progressive leg weakness, foot drop, numbness in the groin or inner thighs, or any loss of bladder or bowel control. These can signal cauda equina syndrome, which requires urgent treatment.

Can an MRI find the cause of my back pain?

MRI shows the discs, joints, and nerves in detail and often reveals the source of persistent or nerve-related back pain. Total Spine and Orthopedics offers a complimentary MRI review to explain your findings and options.

Are back pain procedures done on a same-day basis?

In most cases, yes. The majority of minimally invasive and endoscopic procedures at Total Spine and Orthopedics are performed on a same-day, outpatient basis, with patients returning home within hours.

What can I do at home for back pain?

Gentle movement, short walks, heat or ice, and over-the-counter anti-inflammatory medication help many patients. Avoid prolonged bed rest. If pain does not improve or gets worse, see a specialist. To schedule an evaluation in Melbourne, Orlando (Lake Nona), or Titusville, call (321) 499-4646.

Conditions That Can Cause Back Pain

Herniated Discs

Chances are you’ve heard of a herniated disc. If you have been diagnosed with a herniated disc, you are likely also familiar with the pain and symptoms often caused by this condition. As you begin to research the treatment options available to help you find pain relief, it’s important to understand what causes a herniated disc to develop in the first place.

Bulging Discs

Bulging discs, also known as disc protrusions, are a very common occurrence in people of all ages. The spine is made up of small, round bones (vertebrae) that are cushioned by shock-absorbing discs. These discs feature a tough, fibrous shell and a soft, gel-like core. The outer fibrous portion of our discs can weaken due to factors such as daily wear and tear, sudden injury, and the body’s natural aging process. Pressure from the inner core of the disc can then stretch to the outer rim, causing the disc to “bulge” outward in one direction.

Sciatica

The sciatic nerve is the longest and widest nerve in our body. It controls numerous muscles in the lower extremities and supplies sensation as well.

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal that can crowd the nerves and cause back pain and leg pain when standing or walking.

Arthritis Of The Spine

Arthritis is one of the most common types of disorders experienced by older people, with some estimates stating that as many as 67 million people may suffer from some form of arthritis by the year 2025. Arthritis can affect many different parts of the body and the spine is unfortunately not immune. This type of arthritis is typically known as arthritis of the spine and its onset can cause or worsen a variety of other issues that can cause neck and back pain as well as a variety of other issues.

Sacroiliac (SI) Joint Pain

If you’ve heard of SI Joint Pain, you may know that it is one of the most common causes of chronic back pain. According to some estimates, as much as 24% of back pain originates from the SI Joint and related issues. The actual causes of this SI-Joint originating pain can vary greatly from age related issues to injury, or spinal abnormalities.

Pinched Nerves

Pinched nerves are one of the most common causes of chronic neck and back pain. A nerve becomes “pinched” when it is placed under pressure from an external source, such as an out of place bone or soft tissue from a herniated disc.

Degenerative Disc Disease

Degenerative disc disease describes age-related wear of the spinal discs that can cause chronic back or neck pain.

Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward over the one below it, which can strain joints and compress nerves.

Foraminal Stenosis

Foraminal stenosis, or narrowing, occurs when the open passageways between the spinal vertebrae (foramina) are encroached upon by displaced bone or soft tissue, often due to degenerative changes in parts of the spine.

Annular Tear

Annular tears are a common, degenerative condition that can develop in the spine naturally as you age or through external factors such as an injury or abnormal stress on the spine. An annular tear is formed when the normally thick outer layer of a disc is ripped or torn as a result of stress. After an annular tear is formed, additional stress on the disc can cause the soft inner “jelly” (nucleus pulposus) to leak out from the interior of the disc forming what is known as a Herniated Disc. If this leakage happens on the rear side of the disc, the nucleus pulposus can press against the nearby nerve roots resulting in what is commonly referred to as a “pinched nerve”.

Radiculopathy

Radiculopathy is a pinched spinal nerve root causing pain, numbness, or weakness that radiates into an arm or leg. Learn the causes and minimally invasive treatments.

Nerve Pain

Nerve pain, also known as neuralgia, can occur when a nerve in the body is pinched or compressed. Nerve pain is something that nearly everyone experiences at some point in their lives. While this pain can occur anywhere, it commonly occurs in the neck or back. Because the nerves in the spinal column are so tightly packed, they can very easily become compressed by displaced or strained anatomy.

Failed Back Surgery Syndrome

If you’ve undergone spine surgery but still experience persistent or worsening pain, you might be dealing with Failed Back Surgery Syndrome (FBSS). At Total Spine and Orthopedics, our experienced specialists understand how frustrating ongoing pain after surgery can be. We're dedicated to providing personalized care to help you regain comfort and quality of life.

Scoliosis

Scoliosis is the presence of an abnormal curvature of the spine. Scoliosis may affect the cervical (upper), thoracic (middle) and lumbar (lower) regions of the spine. The curves, which veer to the left or right, often present in an S- or C-shape. These curvatures may be categorized as non-structural — meaning the curve is temporary and the spine is structurally normal — or structural, meaning that the spine has a fixed curve.

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Why Choose Total Spine and Orthopedics

Expert, ultra-minimally invasive spine and orthopedic care, close to home.

  • Ultra-minimally invasive and endoscopic techniques

    We specialize in procedures performed through incisions smaller than a dime, sparing muscle and supporting a faster recovery.

  • Same-day, outpatient procedures

    Most patients walk in and return home within hours, rather than facing an overnight hospital stay.

  • Board-certified, fellowship-trained surgeons

    Our team includes early leaders in endoscopic spine surgery.

  • A complimentary MRI review

    Understand your diagnosis and options from a board-certified specialist before committing to any treatment.

  • Trusted by our community

    More than 1,100 patient reviews at a 4.6-star average, and over 50,000 patients treated.

  • Finding the true source of your pain

    We focus on identifying what is causing your back pain, then begin with the least invasive treatment that will work.

  • Comprehensive spine and orthopedic care

    From injections to advanced procedures, your full continuum of care is handled in one place.

  • Convenient locations across the Space Coast and Orlando

    Care close to home in Melbourne, Orlando (Lake Nona), and Titusville.

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