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Lower back pain can be caused by pulled back muscle, arthritis in the spine with degenerative change especially of facet joints, herniated disc disease or spinal stenosisie the tightness of spinal canal around the spinal cord.
Facet arthritis usually causes dull aching nagging low back pain radiate up to knees herniated disc causes radiating pain in legs with numbness and tingling. Spinal stenosis can cause low back pain or leg pain that may go numb and weak with walking short distance.
A physical exam by pain physician, X-ray of spine and MRI usually is helpful in diagnosis. In some cases your physician may perform diagnostic facet injection to confirm the diagnosis of facet joints.
A common sense approach is to perform regular exercise, lose weight and adopt a healthy lifestyle. Physical therapy and NSAIDS will help with chronic back pain. If you do not respond to above measures you may be a candidate of facet injection or epidural steroid injection depending on the diagnosis. If you still have no relief, a small selective group of patients may use surgical intervention