Lower Back Pain
Causes, conditions, and how physical therapy helps
What causes lower back pain?
Your lower back (the lumbar spine) stacks five vertebrae, cushioned by discs and supported by muscles, ligaments, and joints. Pain usually appears when the demand placed on these tissues outpaces what they can comfortably handle. Causes generally sort into a few groups.
Mechanical and muscle-related causes
The most common type is non-specific mechanical back pain — a strain of the muscles or ligaments after lifting, twisting, a sudden movement, or simply too much sitting. It can be intense but is rarely dangerous, and it typically settles with time and gentle activity.
Disc, joint, and nerve causes
Sometimes a disc bulges or herniates and irritates a nearby nerve, producing pain that travels into the buttock or leg (sciatica). The small facet joints at the back of the spine or the SI joint in the pelvis can also become painful, as can age-related changes like degenerative disc disease or narrowing of the spinal canal (spinal stenosis).
Posture and load-related causes
Long hours sitting, repetitive bending, deconditioning, and a sudden spike in activity all raise the odds of a flare. Importantly, "wear and tear" seen on scans is common in pain-free people too — so imaging findings don't always explain symptoms.
Common lower back conditions
Lumbar strain, herniated disc, sciatica, spinal stenosis, degenerative disc disease, facet joint syndrome, SI joint dysfunction, and spondylolisthesis are the conditions we see most. Each has its own detailed guide.
Common lower back symptoms
Pain when standing up, pain that radiates down the leg, morning stiffness, being unable to straighten up after lifting, and one-sided pain are some of the most common patterns. How your back behaves often hints at the cause — which is why a focused exam usually beats rushing to an MRI.
How physical therapy treats lower back pain
A physical therapist looks at how your spine, hips, and core move together, identifies which positions and tissues drive your pain, and builds a graded plan. Treatment commonly blends targeted exercise, movement and posture retraining, hands-on techniques, and education to reduce fear of movement. For most back pain, active exercise-based PT is a first-line, guideline-recommended treatment.
Red flags — when to seek urgent care
Get emergency care for loss of bladder or bowel control, numbness around the groin or inner thighs, or sudden severe weakness in both legs (possible cauda equina syndrome). Also seek prompt evaluation for back pain with unexplained weight loss, fever, a history of cancer, significant trauma, or a throbbing sensation in the abdomen.
Guides
Back Spasms That Come and Go? Here's What It Means and What to Do
Recurring lower back spasms are usually your muscles tightening to protect an irritated or under-strengthened area. Each episode is uncomfortable but rarely dangerous, and the come-and-go pattern often points to deconditioning, repeated overload, or stress rather than serious disease. Gentle movement during a spasm and consistent core strengthening between episodes reduce how often they happen. Spasms with leg weakness or numbness need evaluation.
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Can't Straighten Up After Lifting? Here's What It Means and What to Do
Getting "stuck" bent over after lifting usually means you've strained your lower back and the muscles have gripped into a protective spasm. It's painful and alarming but rarely dangerous — most people loosen up over a few days. Gentle movement, avoiding bed rest, and easing back to activity help. Seek urgent care if you have leg weakness, groin numbness, or loss of bladder/bowel control.
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Degenerative Disc Disease: Symptoms, Causes & PT Treatment
Degenerative disc disease (DDD) is the natural drying and thinning of spinal discs as we age — it's so common that most pain-free adults have it on scans. When it does cause symptoms, you may feel achy, stiff low back pain that flares with certain activities. It is not a progressive "disease," and physical therapy helps you stay strong and active. Surgery is rarely needed.
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Do I Need Physical Therapy for Lower Back Pain?
Consider physical therapy if your lower back pain has lasted more than 1–2 weeks, limits daily activities, keeps coming back, or sends pain down your leg. See a doctor first if you have red flags like loss of bladder/bowel control, numbness in the groin, fever, or pain after major trauma. In most U.S. states you can see a PT directly without a referral.
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Facet Joint Pain (Facet Syndrome): Symptoms, Causes & PT Treatment
Facet joints are small joints at the back of your spine that guide movement. When they're irritated or arthritic, you feel localized lower back pain that's typically worse when you lean backward or twist, and better when you bend forward. It's a common, manageable cause of back pain, and physical therapy that restores movement and core control usually helps.
1 min read
Lower Back Pain From Sitting Too Long? Here's What It Means and What to Do
Lower back pain that builds the longer you sit usually comes from sustained load on the discs and joints plus tightening hips and a relaxed core — not from a serious problem. The fix is rarely a "perfect" chair; it's movement. Standing and walking briefly every 30–45 minutes, varying your posture, and strengthening your core and hips typically resolve it. Persistent or leg-radiating pain deserves a PT assessment.
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Lower Back Pain in the Morning? Here's What It Means and What to Do
Morning lower back pain that eases within 30 minutes of moving is usually from stiffness — your spine and muscles settle overnight and need to "warm up." Common contributors are mattress and sleep position, disc aging, and general deconditioning. Gentle morning movement and strengthening typically help. Stiffness lasting well over 30–60 minutes, or that wakes you at night, deserves a medical check.
1 min read
Lower Back Pain on One Side Only? Here's What It Means and What to Do
One-sided lower back pain is usually mechanical — a muscle strain, an irritated facet joint, or SI joint dysfunction loading one side more than the other. It's typically not serious. Gentle movement, avoiding the positions that flare it, and targeted strengthening usually help. See a clinician if pain travels down the leg, comes with fever, or sits more in the flank than the back.
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Lower Back Pain Radiating Down the Leg? Here's What It Means and What to Do
Pain that starts in your lower back and travels down your leg usually means a spinal nerve is irritated — most often from a herniated disc, a pattern known as sciatica. It can feel sharp, burning, or electric, sometimes with numbness or tingling. Most cases improve within weeks to a few months with movement and physical therapy. Groin numbness or loss of bladder/bowel control is an emergency — seek care immediately.
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Lower Back Pain That Won't Go Away? Here's What It Means and What to Do
Lower back pain lasting more than about 6–12 weeks is called persistent (chronic) back pain. It usually doesn't mean ongoing damage — instead, the pain system has become sensitized, and muscles have weakened from guarding and inactivity. The most effective approach is active: graded exercise, building strength and confidence, and a structured PT plan. New red-flag symptoms (leg weakness, groin numbness, fever, weight loss) should always be checked.
1 min read
Lower Back Pain When Standing Up? Here's What It Means and What to Do
Pain in your lower back when you stand up — especially after sitting — usually means stiff, irritated joints or muscles that don't like the quick shift from a bent to an upright position. It's most often mechanical and not serious. Moving gently for a few steps, avoiding long sitting, and gradual strengthening typically help. If it lasts beyond 2–3 weeks or pain travels down your leg, see a physical therapist.
1 min read
Lower Back Stiffness After Sleeping? Here's What It Means and What to Do
Lower back stiffness right after sleeping that loosens within about 30 minutes is usually normal overnight stiffening, often nudged along by your mattress, sleep position, or general fitness. It's rarely a sign of damage. A short morning mobility routine and reviewing your sleep setup typically help. Stiffness that lasts well over an hour, or that wakes you at night, is worth a medical check.
1 min read
Lumbar Spinal Stenosis: Symptoms, Causes & PT Treatment
Spinal stenosis is a narrowing of the spaces in your lower spine that can crowd the nerves, causing leg pain, heaviness, or tingling — usually when standing or walking, and relieved by sitting or leaning forward (like on a shopping cart). It's an age-related change, and physical therapy can help you walk farther and stay active. Surgery is considered only when symptoms are severe and don't respond to conservative care.
1 min read
Numbness and Tingling Down the Leg? Here's What It Means and What to Do
Numbness or tingling that runs down your leg usually means a nerve in your lower back is irritated — commonly from a herniated disc (sciatica) or, in older adults, spinal stenosis. It often comes with back or leg pain. Most cases improve with movement and physical therapy over weeks to months. But numbness in the groin, loss of bladder/bowel control, or quickly worsening leg weakness is an emergency — get care right away.
1 min read
Pulled Lower Back Muscle (Lumbar Strain): Symptoms, Causes & PT Treatment
A lumbar strain is an overstretch or small tear of the muscles or ligaments in your lower back, usually from lifting, twisting, or an awkward movement. It causes sudden, achy, sometimes spasming pain that's worse with movement. It's rarely serious and most people recover within a few weeks by staying gently active. Physical therapy helps you heal faster and lowers the chance it returns.
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Sciatica: Symptoms, Causes & Physical Therapy Treatment
Sciatica is pain that travels along the sciatic nerve — from the lower back through the buttock and down the leg — usually because a nerve root is irritated, often by a herniated disc. It can feel sharp, burning, or electric, sometimes with numbness or tingling. Most sciatica improves within a few weeks to a few months with physical therapy and staying active. Groin numbness or loss of bladder/bowel control is an emergency.
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Sharp Lower Back Pain When Bending Over? Here's What It Means and What to Do
A sharp catch in your lower back when you bend forward usually means the discs or muscles don't like the forward-flexed, loaded position — often a strain or disc irritation. It's commonly mechanical and improves with time and the right movement. Bend at your hips rather than rounding your back, stay gently active, and strengthen your core. Pain that shoots down your leg or comes with weakness needs a closer look.
1 min read
SI Joint Pain (Sacroiliac Dysfunction): Symptoms, Causes & PT Treatment
The sacroiliac (SI) joints connect your spine to your pelvis. When one becomes irritated, you feel pain low and to one side — often near the dimple above the buttock — that can flare with standing, climbing stairs, or rolling in bed. It's common during and after pregnancy and very treatable with physical therapy focused on pelvic control and strength.
1 min read
Slipped (Herniated) Disc in the Lower Back: Symptoms, Causes & PT Treatment
A "slipped" disc is a herniated disc — the soft center of a spinal disc pushes through its outer wall and can press on a nearby nerve. This often causes back pain plus pain, numbness, or tingling down the leg. The good news: most herniated discs improve within weeks to a few months with physical therapy and time, and surgery is rarely needed. Seek emergency care for groin numbness or loss of bladder/bowel control.
1 min read
Spondylolisthesis: Symptoms, Causes & Physical Therapy Treatment
Spondylolisthesis is when one vertebra slips slightly forward over the one below it. Many people have it without symptoms; when it does cause pain, you may feel lower back ache, stiffness, and sometimes leg symptoms, often worse with standing or leaning back. Physical therapy focused on core stability and flexion-friendly movement helps most people manage it well without surgery.
1 min read
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