Harvard Men's Health Watch

Low back pain: Causes, symptoms, and diagnosis

Oh my aching back! If you've never uttered that lament, you are one of the lucky few who have been spared. Some 70%–80% of men (and nearly as many women) have endured a bout of moderate to severe low back pain — and lots of us have suffered through many such episodes. All in all, back pain is the fifth most common problem that sends Americans to their physicians. And the problem goes well beyond pain and inconvenience; the annual cost of medical care and lost productivity is more than $50 billion.

It would be encouraging to report that this investment of time and money results in recovery. But in most cases, back pain will resolve as quickly (or as slowly) without medical attention as it will with a doctor's care. In most cases, in fact, you can take care of your back yourself. The trick is to know what to do and to recognize symptoms that really do call for prompt medical tests and treatments.

The normal back

Like every part of the human body, the back is complex. Your "backbone," of course, is not a bone at all but a column of 24 individual bones, the vertebral bodies, or vertebrae. The lowest five vertebrae are in the lumbosacral spine, which is just above the sacrum. The sacrum, in turn, is attached to two iliac bones at the sacroiliac joints, thus forming the pelvis (see figure 1). Most back pain occurs in the vicinity of these structures.

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