Lower Back Pain — Causes, Red Flags and Treatment
Also described as lumbar pain, backache, slip disc pain.
Most lower back pain settles within a few weeks with movement, physiotherapy and simple pain relief, and does not need a scan. Pain radiating below the knee, numbness, or any loss of bladder or bowel control needs urgent assessment. Iswarya Hospital's spine team, OMR Chennai, treats most cases without surgery.
🚨 Get emergency care if you have
- •Loss of bladder or bowel control, or numbness around the groin — go to an emergency department immediately
- •Progressive weakness in a leg or foot drop
- •Back pain with fever, or with unexplained weight loss
- •Pain after a significant fall or accident
- •Severe night pain that is not eased by any position
What causes lower back pain?
Disc herniation (slip disc)
The disc's soft centre presses a nerve, causing sciatica — pain running from the back down one leg.
Muscular strain
The commonest cause. Follows lifting, a sudden twist or prolonged poor posture, and settles with movement.
Spinal stenosis
Narrowing of the spinal canal, typically in older adults, causing leg pain on walking that eases on sitting.
Arthritis of the spine
Age-related wear of the facet joints, causing stiffness that is worst in the morning.
Kidney stones
Pain in the flank rather than the midline, coming in waves, sometimes with blood in the urine.
How it is investigated
- ✓Clinical and neurological examination of the legs
- ✓X-ray for suspected fracture or instability
- ✓MRI when nerve symptoms persist beyond six weeks, or immediately if red flags are present
- ✓Urine and blood tests where infection or a kidney cause is suspected
Not every patient needs every test. The consultation decides which of these apply to you.
Frequently asked questions
Do I need an MRI for back pain?▼
Usually not at first. Most back pain improves within four to six weeks, and scans of people with no pain frequently show disc bulges that mean nothing. An MRI is indicated when there are red flags, when nerve symptoms persist, or when surgery is being considered.
Should I rest or keep moving with back pain?▼
Keep moving. Prolonged bed rest weakens the supporting muscles and slows recovery. Stay as active as the pain allows, avoid heavy lifting for a few weeks, and start physiotherapy early.
Will I need spine surgery?▼
Most patients do not. Surgery is considered when there is a significant neurological deficit, when a nerve is compressed and symptoms persist despite conservative treatment, or in an emergency such as cauda equina syndrome. Iswarya Hospital offers endoscopic and minimally invasive options where surgery is needed.
This page is general health information, not a diagnosis or a substitute for a consultation. Symptoms overlap between harmless and serious conditions, and only an examination can tell them apart. If you are worried, see a doctor.
Plan your first visit
Not sure which specialist to see? Tell our care team the reason for your visit and we will help you choose.
- Bring previous prescriptions, relevant test reports or scan images, a medication list and photo ID.
- If you plan to use insurance, bring your policy details. OPD, tests and admission benefits depend on your individual plan and approval.
- Your first consultation determines which tests or treatments are needed; not everyone needs every test listed on this page.
Appointments are requests until confirmed. In a medical emergency, call 044 2025 2025 or go to the nearest emergency department.