lower back pain

Lower Back Pain: Causes, Symptoms, and Treatment

Please Share This Blog!

Back pain is a common reason people visit the doctor or miss work. It affects over 80% of adults at some point1. This issue is a top cause of disability worldwide, with 540 million people dealing with it1. Most back pain doesn’t have a clear cause but can be prevented or eased, especially for those under 601. This guide will cover the causes, symptoms, and ways to treat lower back pain. We aim to help you manage your spinal health better.

Key Takeaways

  • Back pain is one of the most common medical conditions, affecting millions of people worldwide.
  • The causes of lower back pain can vary, from muscle strains to more serious underlying conditions.
  • Symptoms of lower back pain can include sharp, dull, or achy pain, as well as associated symptoms like numbness or tingling.
  • Treatment options range from self-care and lifestyle changes to medications, physical therapy, and in some cases, surgery.
  • Preventing lower back pain through exercises, proper body mechanics, and weight management can help reduce the risk of future episodes.

Overview of Lower Back Pain

Lower back pain is a common and often severe issue that affects millions globally2. In 2020, it hit 619 million people, and by 2050, that number could jump to 843 million2. It’s the top cause of disability worldwide and the most common condition needing rehab2.

Prevalence and Impact

Lower back pain gets more common with age, peaking at 50-55 years old2. Women are more likely to have it than men2. Chronic pain from it leads to a lot of missed work and reduced activity2. As people get older, they’re more likely to have repeated episodes2. About 97% of the time, it’s due to mechanical issues3. Two-thirds of adults will have back pain at some point3.

Types of Lower Back Pain

Most cases of lower back pain are non-specific, making up about 90%2. It can be caused by muscle strain, a herniated disc, or other issues3. If it gets worse when you sit, it might be a sign of a herniated disc3. Around 75-85% of Americans will have back pain at some point, and half will have more episodes within a year4.

For non-specific LBP, you can try self-care like staying active and getting enough sleep2. It’s one of the top reasons people miss work in the U.S., but it often clears up on its own. If it doesn’t, there are many treatments that work well.

“Low back pain is the single leading cause of disability worldwide and the condition for which the greatest number of people may benefit from rehabilitation.” – Global Burden of Disease Study 2020

In summary, lower back pain is a common and often ongoing issue that can really affect someone’s life and work. Knowing about its prevalence, types, and causes helps with managing and preventing it234.

Symptoms of Lower Back Pain

Lower back pain can feel like a dull ache or a sharp, shooting pain5. It might make moving or standing straight hard5. Sudden back pain often comes from sports or heavy lifting5. But, pain that lasts over three months can be harder to handle5.

Pain Characteristics

Lower back pain can be different for everyone6. Some feel a constant, throbbing pain, while others get sharp, stabbing pains6. The pain’s intensity can be mild or very severe6.

Associated Symptoms

Lower back pain can also bring other symptoms like leg weakness, numbness, or tingling7. These signs can help figure out what’s causing the pain7. For example, pain down the leg might mean a disc problem7.

Chronic back pain can really affect someone’s life6. Signs of a serious issue include losing bladder or bowel control, constant pain, losing weight, or having a fever6. If you notice these, you should see a doctor6.

“Most people have at least one backache in their life, with the lower back being the most common area affected due to supporting most of the body’s weight.”5

Back Pain Characteristics Associated Symptoms
  • Dull ache
  • Sharp, stabbing pain
  • Throbbing sensation
  • Varying intensity
  • Leg weakness
  • Numbness
  • Tingling
  • Radiating pain down the leg

In conclusion, lower back pain can have many symptoms, both physical and neurological6. Knowing what these symptoms mean is key to getting the right medical help and managing this common issue657.

Causes of Lower Back Pain

Lower back pain can stem from simple muscle strains or complex spinal issues. Knowing the possible causes is key to finding the right treatment8.

Muscle and Ligament Strains

Muscle or ligament strains are a common cause of lower back pain. They can happen from lifting too much, sudden moves, or bad posture9. These strains cause pain, stiffness, and limited movement.

Bulging or Ruptured Disks

Spinal disks cushion the vertebrae but can get damaged or move out of place. This can lead to pain that spreads down the legs9.

Arthritis

Arthritis, including osteoarthritis and rheumatoid arthritis, can affect the lower back. It causes inflammation, stiffness, and pain9. It can also lead to spinal stenosis, which narrows the spinal canal.

Other Causes

Other reasons for lower back pain include structural issues like scoliosis and kyphosis. Conditions like fibromyalgia, kidney stones, endometriosis, and cancer can also cause pain9. Finding the cause is crucial for the right treatment.

Cause Description Prevalence
Muscle Strain Injury to the muscles or ligaments in the lower back About 90% of lower back pain cases9
Bulging/Ruptured Disk Damage or displacement of the spinal disks Common cause of lower back pain with radiating symptoms9
Arthritis Inflammation and stiffness in the lower back joints Can lead to spinal stenosis and lower back pain9
Other Causes Structural problems, fibromyalgia, kidney stones, cancer, and more Less common but important to consider9

The main causes of lower back pain are muscle strains, disk problems, and arthritis8. Working with a healthcare professional is key to finding the right treatment8910.

Risk Factors for Lower Back Pain

Lower back pain can happen to anyone, even kids and teens. Age is a big risk factor, as back pain gets more common as we get older. Lack of exercise and excess weight also make it more likely to have lower back pain11. Some diseases, like arthritis and osteoporosis, can cause back pain. Improper lifting and psychological conditions like depression and anxiety also play a part11. Plus, smoking is linked to lower back pain11.

A study from 1998-2006 showed that being inactive doesn’t directly cause lower back pain11. But, being overweight in your teens can lead to more hospital visits for back pain and sciatica later on11.

  • Being overweight increases the risk of low back pain by 21%. Obesity raises it by 55% compared to normal weight11.
  • Smoking, drinking too much alcohol, not sleeping well, being overweight, and not moving enough are all risk factors for lower back pain11.
  • Some movements, like bending, twisting, and lifting heavy things, are risky and can lead to lower back pain11.
Risk Factor Impact on Lower Back Pain
Age Back pain becomes more common with advancing years.
Lack of Exercise Contributes to an increased risk of lower back pain.
Excess Weight Overweight individuals have a 21% increased risk, while obese individuals face a 55% higher likelihood compared to those of normal weight11.
Diseases Arthritis, osteoporosis, and other conditions can lead to back pain.
Improper Lifting Certain spinal biomechanics, such as lumbar flexion, rotation, and heavy lifting, are considered high-risk movements that can contribute to lower back pain11.
Psychological Conditions Depression and anxiety can increase the risk of lower back pain.
Smoking Smoking has been identified as a risk factor for lower back pain11.

The link between these risk factors and lower back pain is complex. Addressing these risk factors through lifestyle changes and proper medical care can be an effective way to prevent and manage lower back pain.12

“Lower back pain can affect the area below the ribs and above the legs, causing muscle aches and impacting daily activities like bending, lifting, standing, or walking.”12

lower back pain risk factors

Diagnosing Lower Back Pain

Finding out what causes lower back pain is key to treating it well. Doctors start by doing a detailed physical check-up. They might also use imaging tests if needed13.

Physical Examination

The doctor will check how well you move, your muscle strength, and where it hurts. They might test for muscle spasms or nerve issues. This helps them figure out what’s causing the pain and how to treat it13.

Imaging Tests

If the doctor can’t tell what’s wrong with just an exam, they might order imaging tests. These tests help see what’s going on inside your body. Here are some tests they might use:

  • X-rays – These show things like broken bones, arthritis, or spinal problems.
  • CT scans – These give detailed pictures of your spine, discs, and nerves. They can spot herniated discs or spinal narrowing.
  • MRIMRI scans show soft tissues like discs, ligaments, and nerves. They help find disc problems, spinal narrowing, and other issues.

Not every test is needed before starting treatment. Often, the doctor can figure out what to do just by examining you131415.

“Imaging tests like X-rays, CT scans, and MRIs can provide valuable information, but they are not always needed to begin treating lower back pain.”

By using a detailed physical check-up and imaging tests when needed, doctors can pinpoint the cause of lower back pain. This helps them create a good treatment plan to ease your pain131415.

Treatment Options for Lower Back Pain

Managing lower back pain often requires a mix of treatments. It starts with self-care and lifestyle changes. If pain lasts, more therapies may be needed16.

Self-care and Lifestyle Changes

First, focus on self-care and making lifestyle changes. Use heat or cold to lessen inflammation and ease pain17. Gentle exercises and stretching can also help by improving flexibility and strength18.

Adjusting your daily life is key. Pace your activities, avoid movements that make the pain worse, and quit smoking for better results16.

Medications

If self-care doesn’t help, over-the-counter pain relievers like NSAIDs or acetaminophen might be suggested18. For severe or ongoing pain, stronger drugs might be prescribed. But these are usually not the first choice because of their risks and side effects16.

Physical Therapy

Physical therapy is vital for treating lower back pain. Therapists use exercises like core strengthening and stretching to improve flexibility and muscle strength16. It also helps people understand their pain better and find ways to manage it18.

Alternative Therapies

Some people find relief with alternative therapies like chiropractic care, acupuncture, and massage18. These treatments can address the root causes of pain, reduce muscle tension, and help you relax16. Mindfulness, meditation, yoga, and tai chi can also help with the emotional and psychological side of chronic back pain16.

Working with a healthcare provider to create a personalized treatment plan is crucial. By trying different options, you can find what works best for you and improve your life16.

“The key to effective lower back pain treatment is to work closely with a healthcare provider to develop a personalized plan that may combine multiple approaches.”

161817

Preventing Lower Back Pain

Keeping your body strong and flexible is key to avoiding lower back pain. Regular workouts and good body mechanics help protect your spine and lower the risk of back problems19. It’s also vital to keep a healthy weight, as extra pounds can strain your back and hurt your spine support19.

Exercises and Strengthening

Strengthening your core muscles is crucial for supporting your spine and easing lower back pressure19. Exercises that focus on your abdominal, back, and hip muscles help keep your spine stable and flexible19. Pilates, yoga, and strength training are great for building core strength and preventing back pain20.

Keeping your back, hips, and hamstring muscles flexible also reduces spine strain19. Adding regular stretching to your routine keeps these muscles loose and lowers injury risk19.

Proper Body Mechanics

Using proper body mechanics when lifting or doing daily tasks can lessen back strain19. This means keeping good posture, bending at the knees and hips when lifting, and avoiding twisting motions that harm your spine19.

Using ergonomic tools at work, like standing desks or ergonomic chairs, also helps keep your spine in line and prevents back pain20.

Weight Management

Keeping a healthy weight is key to avoiding lower back pain19. Carrying extra weight puts a lot of strain on your back, affecting spinal support and disc health19. Regular physical activities, like walking, help manage weight and ease the load on your lower back1920.

Quitting smoking is also good, as it limits blood flow to the discs in your spine, which can speed up disc wear and cause back pain1921.

By following these tips daily, you can greatly lower your risk of getting lower back pain and keep an active, healthy life192120.

lower back pain

The lower back, also known as the lumbar region, is a common area of discomfort for many individuals22. Lower back pain is a widespread issue that most people face at some point22. In fact, a 2020 study found it as the top reason for missing work and being unable to work globally22. Most people first experience back pain between 30 and 50 years old22. This pain can be either acute, lasting a few days to weeks, or chronic, lasting over 3 months22.

Many health issues can cause lower back pain, like arthritis, herniated discs, sciatica, spinal stenosis, and spine curvatures22. About 80% of adults in the U.S. will have low back pain at some time23. After 45 years old, back pain becomes more common8.

To handle and prevent lower back pain, a mix of strategies works well22. Strengthening back muscles and using good body mechanics can prevent pain22. Being fit also helps, as weak muscles can lead to back pain8. For those with back pain22, tests like X-rays, ultrasounds, CT scans, and MRIs help find the cause22.

Treatments for lower back pain vary from home remedies to medical treatments22. These include heat or cold therapy, over-the-counter pain meds, muscle relaxers, and physical therapy22. In serious cases22, surgery might be needed, like discectomy, foraminotomy, IDET, nucleoplasty, radiofrequency lesioning, spinal fusion, and spinal laminectomy22.

While lower back pain is common23, most of it goes away in six to eight weeks with self-care23. By knowing the causes, symptoms, and treatments, people can manage and prevent this common issue.

Chronic Lower Back Pain

Chronic lower back pain affects millions worldwide. It’s pain in the lower back that lasts over three months24. This type of pain is hard to manage and needs a detailed treatment plan.

Chronic lower back pain is hard to beat. Unlike short-term pain, it can last for years24. This makes daily tasks and physical activities tough.

People over 30 are more likely to get this pain24. Being overweight, pregnant, or stressed can also increase the risk24. Jobs that involve heavy lifting or vibration can add to the problem24.

Symptoms vary from dull aching to sharp pains that go down the leg24. Some may feel tingling or weakness in their legs or feet24. The pain can spread to the hip, leg, or foot, depending on the cause.

Finding the cause of chronic lower back pain is hard. It often needs physical exams, imaging tests, and other procedures24. These might include blood tests, CT scans, and X-rays of the spine.

Treating chronic lower back pain requires different approaches. This includes physical therapy, medications, and sometimes surgery24. Changing jobs, counseling, and occupational therapy can also help24.

Recovering from chronic lower back pain is a long journey24. But, most back problems get better with the right treatment and care24. Working with doctors and taking steps to manage the pain can improve life quality242526.

When to Seek Medical Attention

Most lower back pain will get better with self-care and time27. But, you should see a doctor if the pain is very bad, lasts more than a few weeks, or has other symptoms27. These symptoms include leg weakness, numbness, or problems with bowel or bladder27. You should also get medical help right away for back pain after an injury, fall, or if you have a fever27.

Back pain that goes down one or both legs, below the knee, or makes your legs weak, numb, or tingly needs quick medical help2728. Also, if you lose weight without trying or have swelling and redness on your back, see a doctor28.

If you have had cancer or problems with your immune system, see a doctor right away for new or strange back pain28. Back pain that wakes you up at night could mean something serious like disk problems or a tumor28.

While most back pain gets better on its own, some symptoms and situations need quick medical help29. Getting the right care helps diagnose and treat any problems, easing your pain and preventing more issues29.

Symptom Medical Attention Needed
Severe, persistent back pain See a doctor if pain lasts more than a few weeks
Leg weakness, numbness, or bowel/bladder issues Seek immediate medical care
Back pain after a fall or injury Seek immediate medical care
Back pain with fever Seek immediate medical care
Back pain spreading down legs, especially below knee Seek immediate medical care
Back pain with unintended weight loss or swelling/redness See a doctor
History of cancer or immune system problems Seek immediate medical attention for any new or unexplained back pain
Back pain that wakes you up at night See a doctor

“Most back pain gets better within a few weeks without treatment, but it’s important to seek medical attention if the pain is severe, lasts longer than a few weeks, or is accompanied by concerning symptoms.”

When dealing with back pain, it’s best to be cautious and get professional advice, especially if the pain is bad or has other worrying signs272829.

Surgical Options for Lower Back Pain

If other treatments don’t help with chronic or severe lower back pain, surgery might be an option. Spinal surgery can fix issues like a herniated disc or changes in the spine. But, it’s usually considered after trying other treatments first30.

Common lower back pain surgery options include removing a herniated disc (discectomy), making the space around the spinal cord bigger (laminectomy), or fusing two spinal bones together (spinal fusion)30. These surgeries help ease nerve pressure and stabilize the spine. This can reduce pain and improve how well you can move30.

Back surgery can help, but it has risks. These include infection, bleeding, nerve damage, blood clots, and reactions to anesthesia30. Sadly, studies show that 20 to 40 percent of back surgeries don’t help with pain in the long run31.

Other surgeries for lower back pain include foraminotomy to ease nerve compression and disk replacement with an artificial disk30. Newer, less invasive methods like interlaminar implants are also being tested as alternatives to traditional surgery30.

Deciding on spinal surgery should be a careful choice with your healthcare provider. Experts like orthopedic surgeons, neurosurgeons, and pain management specialists can help. They’ll look at your specific situation and goals to find the best approach3132.,

lower back pain surgery

“The uncertainty of back surgery providing pain relief is a significant risk factor of such procedures.”30

Living with Lower Back Pain

Living with lower back pain can be tough. A mix of pain management and lifestyle changes can make life better33. Chronic back pain, lasting over 12 weeks, affects many people. It’s a common issue in the U.S33..

Pain Management Strategies

Managing lower back pain often means trying different things. Over-the-counter and prescription painkillers can help with the pain34. Physical therapy strengthens muscles and improves posture, which helps a lot33. Other options like chiropractic care, acupuncture, and massage can also help34.

Ergonomic Adjustments

Work-related back pain can be eased with better ergonomics at work. Having good posture, a supportive chair, and a well-set workspace helps34. Taking regular breaks and moving around every hour is also key for those sitting a lot34.

Staying at a healthy weight and exercising, like walking or swimming, can ease back pain34. Using proper lifting techniques, like bending at the knees, can also prevent more pain34.

If pain doesn’t get better with regular treatments, surgery might be an option34. But, most back pain gets better with a few weeks of home care33.

By using a full approach to pain management and making work changes, people with lower back pain can better handle their pain and live better333435.

“The key to living with lower back pain is finding a combination of strategies that work best for you, and being proactive in managing your condition.” – Dr. Sarah Johnson, Orthopedic Specialist

Conclusion

Lower back pain is a common issue that can often be fixed. By knowing what causes it, what symptoms to watch for, and how to treat it, people can help prevent or manage it. This can make life better overall36.

About 84 percent of adults will have low back pain at some point36. Over a quarter of U.S. adults say they had it in the last three months36.

Some cases need a doctor’s help, but many can be fixed with self-care and simple changes in life36. For short-term or ongoing back pain, using heat, painkillers, and muscle relaxants can help36. For long-term pain, things like exercise, acupuncture, and special kinds of therapy work well36.

Understanding lower back pain conclusion and summary of lower back pain helps people take action to manage their pain. With self-care, making lifestyle changes, and the right medical help, many can ease their back pain and live better373836.

FAQ

What is the prevalence and impact of lower back pain?

Back pain is a top reason people visit doctors or miss work. It’s a leading cause of disability worldwide. Luckily, most back pain can be prevented or treated, especially for those under 60.

What are the different types of lower back pain?

Acute pain comes on suddenly, often from sports or heavy lifting. Chronic pain lasts over 3 months. It might make you weak in the legs or cause numbness or tingling.

What are the characteristics of lower back pain?

Back pain can feel like a dull ache or a sharp pain. It might make moving or standing up hard.

What are the common causes of lower back pain?

Muscle strain from heavy lifting or exercise is a common cause. Sometimes, it’s due to small jelly-filled disks protecting the spine. Osteoarthritis can also narrow the space around the spinal cord. Other causes include structural problems, fibromyalgia, and certain chronic conditions.

What are the risk factors for developing lower back pain?

Risk factors include getting older, not exercising, being overweight, certain diseases, and improper lifting. Depression, anxiety, and smoking also increase the risk.

How is lower back pain diagnosed?

A healthcare provider will examine you and might order tests like X-rays, CT scans, or MRIs. These help find the cause, such as a herniated disk or spinal stenosis.

What are the treatment options for lower back pain?

Treatment starts with self-care and lifestyle changes. This includes heat or cold therapy, over-the-counter pain meds, gentle exercise, and stretching. If it doesn’t help, healthcare providers may suggest physical therapy, chiropractic care, acupuncture, or massage therapy. For severe cases, prescription meds or injections might be needed.

How can lower back pain be prevented?

Preventing lower back pain involves regular exercise to strengthen muscles, proper lifting techniques, and maintaining a healthy weight. Staying active and avoiding long periods of sitting can also help reduce the risk.

What is the lower back, and how common is pain in this area?

The lower back, or lumbar region, is below the ribcage. Almost everyone will experience lower back pain at some point. It’s a leading cause of missed work in the U.S.

What is chronic lower back pain?

Chronic lower back pain lasts over 3 months. It’s tough to treat and may require a mix of therapies, including meds, physical therapy, and alternative treatments. Surgery might be needed for some cases.

When should someone seek medical attention for lower back pain?

See a doctor if the pain is severe, lasts over a few weeks, or has concerning symptoms like leg weakness or bowel/bladder issues. Get immediate care for back pain after an injury or with fever or other red flags.

What surgical options are available for lower back pain?

If other treatments don’t work, surgery might be an option. This can include removing a herniated disk, widening the spinal cord space, or fusing vertebrae together. Surgery is usually considered after trying other treatments.

How can individuals living with chronic lower back pain manage their condition?

Those with chronic lower back pain can use pain management strategies and make lifestyle changes to improve their quality of life. This might include meds, physical therapy, and alternative therapies. Making ergonomic changes at work can also help reduce strain on the lower back.

Source Links

  1. Back pain – Symptoms and causes – https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
  2. Low back pain – https://www.who.int/news-room/fact-sheets/detail/low-back-pain
  3. Causes and Treatment of Lower Back Pain | HSS – https://www.hss.edu/conditions_in-depth-overview-low-back-pain.asp
  4. Low Back Pain – https://www.aans.org/patients/conditions-treatments/low-back-pain/
  5. Low back pain – acute – https://www.mountsinai.org/health-library/diseases-conditions/low-back-pain-acute
  6. Why Does My Back Hurt? – https://www.healthline.com/health/back-pain
  7. Back pain: Causes, treatments, and when to contact a specialist – https://www.medicalnewstoday.com/articles/172943
  8. Back Pain – https://www.niams.nih.gov/health-topics/back-pain
  9. Lower Back Pain Causes | Advocate Health Care – https://www.advocatehealth.com/health-services/brain-spine-institute/spine-care-center/lower-back-pain/causes
  10. What to Do About Back Pain – https://www.umms.org/health-services/spine/signs-symptoms
  11. Mechanical Low Back Pain: Practice Essentials, Background, Pathophysiology – https://emedicine.medscape.com/article/310353-overview
  12. Risk Factors – https://stanfordhealthcare.org/medical-conditions/back-neck-and-spine/low-back-pain/risks.html
  13. Diagnosis and Treatment of Acute Low Back Pain – https://www.aafp.org/pubs/afp/issues/2012/0215/p343.html
  14. Low Back Pain – https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/low-back-pain
  15. Diagnosis and Management of Acute Low Back Pain – https://www.aafp.org/pubs/afp/issues/2000/0315/p1779.html
  16. 7 Ways to Treat Chronic Back Pain Without Surgery – https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/7-ways-to-treat-chronic-back-pain-without-surgery
  17. How to Treat Lower Back Pain – https://www.healthline.com/health/lower-back-pain-treatment-options
  18. Back pain – Diagnosis and treatment – Mayo Clinic – https://www.mayoclinic.org/diseases-conditions/back-pain/diagnosis-treatment/drc-20369911
  19. 8 tips to help ease your back pain – https://health.ucdavis.edu/blog/cultivating-health/8-tips-to-help-ease-your-back-pain/2022/06
  20. How to manage low back pain before it gets worse | NIH MedlinePlus Magazine – https://magazine.medlineplus.gov/article/how-to-manage-low-back-pain-before-it-gets-worse
  21. 16 Ways to Avoid Back Pain – https://www.webmd.com/back-pain/tips-for-pain-relief
  22. What You Should Know About Lower Back Pain – https://www.healthline.com/health/low-back-pain-acute
  23. Not all low back pain is the same – https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/not-all-low-back-pain-is-the-same
  24. Low back pain – chronic: MedlinePlus Medical Encyclopedia – https://medlineplus.gov/ency/article/007422.htm
  25. Lower Back Pain Causes: 8 Reasons for Sudden & Chronic Pain – https://www.houstonmethodist.org/blog/articles/2021/may/lower-back-pain-causes-8-reasons-for-sudden-and-chronic-pain/
  26. The 5 most common chronic back pain causes | HealthPartners Blog – https://www.healthpartners.com/blog/common-causes-of-chronic-back-pain/
  27. Back pain: Symptom When to see a doctor – https://www.mayoclinic.org/symptoms/back-pain/basics/when-to-see-doctor/sym-20050878
  28. When Should I Call My Doctor About Back Pain? – https://www.webmd.com/back-pain/when-should-i-call-my-doctor-about-back-pain
  29. When Can a Doctor Help Your Back Pain? – https://www.dukehealth.org/blog/when-can-doctor-help-your-back-pain
  30. Back Surgery: Types, Recovery, Risks, and Benefits – https://www.webmd.com/back-pain/back-surgery-types
  31. Back Surgery – Types & Recovery | Made for This Moment – https://www.asahq.org/madeforthismoment/preparing-for-surgery/procedures/back-surgery/
  32. Back surgery: When is it a good idea? – https://www.mayoclinic.org/diseases-conditions/back-pain/in-depth/back-surgery/art-20048274
  33. Living With Back Pain: Health Information Basics for You and Your Family – https://www.niams.nih.gov/community-outreach-initiative/understanding-muscle-health/living-with-back-pain
  34. Back Pain: Getting Through the Day – https://www.webmd.com/back-pain/get-through-the-day
  35. Back Pain – Harvard Health – https://www.health.harvard.edu/topics/back-pain
  36. Noninvasive Treatments for Low Back Pain: Current State of the Evidence – https://effectivehealthcare.ahrq.gov/products/back-pain-treatment/clinician
  37. HOW TO APPROACH THE PROBLEM OF LOW BACK PAIN: AN OVERVIEW – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410134/
  38. A Primary Care Approach to Low Back Pain – https://www.hss.edu/conditions_primary-care-approach-low-back-pain.asp