Back Pain: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Back Pain?
A primary care doctor usually evaluates back pain first. For pain that does not improve, a physiatrist (a doctor of physical medicine and rehabilitation), an orthopaedic surgeon, or a neurosurgeon may take over. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is back pain?
Back pain is one of the most common medical problems in the United States. It can range from a dull, constant ache to a sudden, sharp pain that may shoot down the leg. It can start suddenly after an accident, a fall, or lifting something heavy, or develop slowly from age-related changes in the spine.
Doctors describe it by how long it lasts. Acute back pain happens suddenly and usually lasts a few days to a few weeks. Subacute back pain lasts 4 to 12 weeks. Chronic back pain lasts longer than 12 weeks and occurs daily.
Symptoms
Back pain varies from person to person. Depending on the cause, you may have:
- Pain that increases with lifting and bending.
- Pain that worsens when resting, sitting, or standing.
- Stiffness in the morning that eases with activity.
- Pain that radiates from the back into the buttocks, leg, or hip.
- Numbness or weakness in the legs or feet.
With a herniated disk, pain, numbness, tingling, or weakness can extend from the buttock down the leg to the foot. This is called sciatica.
Causes and who gets it
Almost everyone has back pain at some time. Often the exact cause cannot be found. Common causes include:
- Overactivity, such as muscle soreness from activity your body is not used to.
- Sprains and strains, meaning injuries to the ligaments, muscles, or tendons of the back.
- Disk problems, including disk tears and herniated disks, where the disk's soft center pushes out and presses on nearby nerves.
- Disk degeneration and arthritis, as the spine ages and the disks wear away.
- Spinal stenosis, a narrowing of the space around the spinal cord that puts pressure on the cord and nerves.
- Fractured vertebrae, sometimes from osteoporosis, a condition that weakens bones.
- Inflammatory arthritis of the spine, such as ankylosing spondylitis.
Back pain becomes more common with age, especially after 45. Being unfit or overweight, heavy or stressful work, poor sleep, and depression or anxiety raise the risk. Smoking also plays a role.
How doctors diagnose it
Your doctor will discuss your symptoms and medical history, then examine your back. The exam checks which movements hurt and tests the nerves in your legs by checking reflexes, strength, and feeling. If needed, tests include X-rays, which show bones but not disks or nerves, an MRI scan, which shows soft tissues such as disks and nerves, CT scans, and blood tests.
Treatment
Most back problems get better on their own within a few weeks. Treatment falls into three groups: medicines, physical medicine, and surgery.
- Medicines: acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, steroids, and muscle relaxers. Muscle relaxers can make you drowsy, so do not drive while taking them.
- Physical medicine: physical therapy with stretching and strengthening exercises, heat, ice, massage, braces, and, for some patients, chiropractic or manipulation therapy or yoga.
- Surgery: considered only when nonsurgical treatment has been tried and failed, usually for 6 months to a year, and only when the doctor can pinpoint the source of the pain.
Counseling can help you understand and manage ongoing pain. An epidural injection may be offered if pain does not improve with other treatments.
When to see a doctor
Call your doctor if your back pain does not get better within a few weeks, or if it comes with fever, chills, or unexpected weight loss. Call 911 or go to the emergency room right away if you have weakness in your legs or loss of bladder and bowel control. Also contact your provider right away if you have numbness or loss of movement.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can examine your back, start safe treatment, and refer you to physical therapy or a spine specialist. They can also follow your recovery and help you prevent future episodes.
Common questions
Should I rest in bed?
No. Most back problems get better on their own, and staying active helps. Your doctor can guide you on which activities are safe while you recover.
Do I need an X-ray or MRI?
It depends. Your doctor will examine your back. Other tests you have depend on your medical history and symptoms.
Can back pain be prevented?
It may not be possible to prevent it completely, but you can lower your risk. Exercise regularly to keep your back and stomach muscles strong, lift with your legs and not your back, keep a healthy weight, and avoid smoking.
Does smoking really affect back pain?
Yes. Both smoke and nicotine cause the spine to age faster than normal, and smoking speeds up disk degeneration. Quitting helps protect your spine.
Sources
- NIAMS - Back Pain Symptoms, Types, & Causes
- AAOS OrthoInfo - Low Back Pain
- MedlinePlus - Low back pain, chronic
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
