Health Library · Musculoskeletal

Back pain / sciatica

Overview

Most acute back pain is mechanical — muscle or ligament strain — and resolves in 4–6 weeks. Sciatica is nerve pain radiating down the leg from lumbar disc or foraminal compression.

Symptoms to watch for

  • Localized low back pain worse with movement (mechanical)
  • Radiating pain down the leg (sciatica)
  • Numbness or tingling in leg
  • Weakness in foot dorsiflexion or plantarflexion

What else could this be?

  • Vertebral fracture
  • Kidney stone or infection
  • Aortic aneurysm
  • Metastatic cancer

How it's diagnosed

History and exam. Imaging (MRI) only for red flags, radiculopathy not improving, or before injection/surgery.

Treatment

First-line: activity as tolerated, NSAIDs, heat, physical therapy. Muscle relaxants short-term. Epidural steroid injections for persistent radiculopathy. Surgery for red flags or refractory nerve compression.

When to book a visit

Book for pain lasting more than a few days or for sciatica.

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Frequently asked

Should I get an MRI?

Not for uncomplicated acute back pain — findings are common in asymptomatic people and often lead to unnecessary procedures. MRI is for red flags or persistent radiculopathy.