Low Back Pain Q&A: Washington University Orthopedics

“Why do I have low back pain that comes and goes?”

First, low back pain associated with lower extremity pain, numbness and tingling can be a sign of a neurological impairment and should be evaluated by your healthcare provider. Low back pain is very common with a lifetime incidence of over 90%. In other words, most of us experience it at one time or another.

Believe it or not, the cause of low back pain is multifactorial and therefore not well understood. Sometimes, structures of the spine are injured or sustain changes related to repetitive use such as a disc herniation. Other times low back pain is related to inefficient movement and load transfer across soft tissue structures. Imaging studies like a magnetic resonance image (MRI) can be helpful in showing alterations in structures of the spine but do not always confirm the source of pain. Studies show that 30% of spine MRIs in people without low back pain show a herniated disc. This tells us that though the MRI is helpful, it does not tell the entire story.

The best way to determine the cause of low back pain remains taking a history, performing a physical examination, and utilizing imaging studies that guide treatment. The treatment needs to match the diagnosis. Once this is determined, often there can be some simple things to add or subtract to your everyday life activities that can make a difference.

Make an Appointment