person with low back pain
April 19, 2019 | by James Linhoff PA-C, MPAS

Low back pain is extremely common. Most people can recall an episode of back pain after an injury, strenuous activity, illness, or a period of prolonged bedrest. Treating low back pain typically involves a combination of medication, lifestyle changes, physical therapy, and alternative treatments. Fortunately, the vast majority of patients with low back pain do not require surgery to manage it.

Many Factors Increase Your Risk for Low Back Pain

The cause and development of low back pain is multi-factorial – involving bones, joints, ligaments and muscles. Factors that increase your risk for low back pain include age, weight, deconditioning, and tobacco use. Training errors and ergonomic issues often also play a role.

Low Back Pain Red Flags

Patients with low back pain and any of these symptoms/factors may need additional diagnostic imaging or testing to rule out a more serious condition.

  • Known malignancy
  • Infection
  • Trauma
  • Fever
  • Weight loss
  • Cauda Equina Syndrome
  • Urgent neurologic symptoms
  • Age (younger than 20 or older than 50)

Several Specialties Treat Low Back Pain

Effective management of patients with low back pain requires addressing all of these factors, ruling out any red flags that might indicate more serious issues (see sidebar), and taking steps to minimize the risk of recurrence. At The Polyclinic, our physical medicine, sports medicine and orthopedic physician assistants typically manage patients with mechanical low back pain.

Care is Best Provided Over Several Visits

In most cases, our providers work with patients to treat low back pain over several visits. This approach of following a patient through their recovery over multiple visits ensures that treatment is effective and helps reduce the risk of recurrence.

When to Consider Surgery

Most patients recover from low back pain episodes with simple and straightforward treatment that includes medication, rest, rehabilitation and weight loss and/or tobacco cessation. Patients who do not respond to conservative management, or who initially respond and then relapse, may be candidates for advanced imaging and surgical referral.

If you’re concerned about low back pain, talk with your primary care doctor about a possible referral to our musculoskeletal care team.