ℹ️ Skipped - page is already crawled
| Filter | Status | Condition | Details |
|---|---|---|---|
| HTTP status | PASS | download_http_code = 200 | HTTP 200 |
| Age cutoff | PASS | download_stamp > now() - 6 MONTH | 2.6 months ago |
| History drop | PASS | isNull(history_drop_reason) | No drop reason |
| Spam/ban | PASS | fh_dont_index != 1 AND ml_spam_score = 0 | ml_spam_score=0 |
| Canonical | PASS | meta_canonical IS NULL OR = '' OR = src_unparsed | Not set |
| Property | Value |
|---|---|
| URL | https://www.health.harvard.edu/pain/when-to-get-help-for-low-back-pain |
| Last Crawled | 2026-01-30 10:27:42 (2 months ago) |
| First Indexed | not set |
| HTTP Status Code | 200 |
| Meta Title | When to get help for low back pain - Harvard Health |
| Meta Description | Image: ThinkstockPain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull ... |
| Meta Canonical | null |
| Boilerpipe Text | Image: Thinkstock
Pain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.
Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.
Sciatica is a term you've probably heard people use for pain in the lower back, radiating to the buttocks and down one or both legs. "When patients tell me they have sciatica, they could have one of two conditions—a leaking disc or spinal stenosis [narrowing of the spinal canal]," says Dr. Steven Atlas, associate professor of medicine at Harvard Medical School. These conditions in turn can put pressure on the sciatic nerve, which emerges from the lumbar (lower) spine, separates just above the buttocks, and runs down each leg.
Understanding your spine
The spine is a bony column formed by a stack of 24 vertebrae, which are open at the center, creating a channel or canal for the spinal cord. The spaces between the vertebrae are padded by gel-filled, fibrous-ringed discs, which absorb the force we put on the spine. Nerves run from the spinal cord at every vertebral space.
You might also be interested in...
Is joint pain holding you back? Perhaps an achy ankle or sore knee is making it difficult to enjoy a run through your favorite park or even taking a short walk. Or maybe a throbbing hip or shoulder prevents you from whacking a golf ball or performing simple tasks like carrying a bag of groceries. The exercises in this report, The Joint Pain Relief Workout: Healing exercises for your shoulders, hips, knees, and ankles, can help relieve ankle, knee, hip, or shoulder pain, and help you become more active again, which can help you stay independent long into your later years.
LEARN MORE
You get lower
back pain
that radiates into the leg when a disc or bone impinges on a nerve as it exits the spinal cord, most commonly between the 4th and 5th lumbar vertebrae. In people between ages 30 and 60, a ruptured disc is usually responsible; in people over 60, spinal stenosis is more likely to be the cause. In the latter, a reduction in the size of the spinal canal, often due to overgrown bone, puts pressure on the nerves.
Ruptured disc
Damage to discs can be caused by injury or simply by the activities of daily life. If a disc swells or slips out of place, it may press against a nerve. If it ruptures, the leaking gel can inflame the nerves. "Almost everyone has a ruptured disc at some time, but not everyone has symptoms," Dr. Atlas says.
Although the term sciatica is often used to describe the pain, your doctor may call it radicular leg pain—radiating pain due to a compressed nerve. The pain usually comes on suddenly after the disc ruptures. Sitting usually makes the pain worse, while standing and walking may relieve it.
Treatment usually begins with over-the-counter pain medication and exercise. Exercise helps because standing and moving can relieve the pressure on the disc.
Though it may be hard to believe, the pain will go away without medical attention once your body has absorbed the disc material—usually a matter of a few days or weeks. When the episode is over, there is no need for further treatment. "I know people want immediate relief, and I often have to convince them that they don't need surgery," Dr. Atlas says.
But there are rare exceptions, Dr. Atlas says. "If your leg is weak or numb, or if your bowel or bladder function is affected, you should get medical attention immediately to avoid permanent nerve damage," he advises.
Spinal stenosis
This condition becomes increasingly common with age. Over time, the cumulative effects of gravity bring the vertebrae closer together, and the discs also tend to dry out and become thinner. With less cushioning between them, the vertebrae rub against one another, causing arthritis. Arthritic bone deposits can narrow the channels through which nerves pass, putting pressure on them and producing pain.
Pain from
spinal stenosis
is known as neurogenic claudication (literally "difficulty walking originating in the nerves"). It is more subtle than pain caused by a damaged disc. You might have symptoms in your back, buttocks, or upper thighs, but the pain might not radiate all the way down your leg. The pain is also likely to affect both sides of your body. With spinal stenosis, your upper thighs or legs may hurt when you stand.
Sitting down to take the stress off your lower spine will relieve pain. Bending over slightly can also help by opening the spaces between the vertebrae to reduce pressure on the nerves. If you have braved the pain to get to the grocery store, you may be delighted to find that pushing a shopping cart can provide relief.
Treating spinal stenosis
Unlike disc herniation, spinal stenosis is a chronic condition. It can't be cured, but the pain can be effectively managed with a combination of the following:
Oral analgesics.
 Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen (Aleve, Naprosyn) or the non-NSAID painkiller acetaminophen are generally safe to use for occasional flares, but they have side effects.
NSAIDs
are associated with an increased risk of heart attack and stroke, and acetaminophen with an increased risk of liver damage. Talk to your doctor about the right medication and dose for you.
Spinal injections.
 Injections of lidocaine to relieve pain and corticosteroids to reduce inflammation are commonly delivered to the area of the spine where the pain originates. However, controlled clinical trials have cast doubt on steroid use: after six weeks, patients treated with lidocaine alone had as much pain relief and functional improvement—with fewer side effects—as those treated with both drugs. "I usually reserve injections for patients who need immediate relief so they can get to a physical therapist," Dr. Atlas says.
Physical therapy.
 Exercise is the best long-term approach to managing spinal stenosis. A physical therapist can teach you the exercises that will strengthen your back muscles to better support your spine and compensate for the pain. Massage and manipulation may not help this kind of problem because it originates in your bones, not in your muscles or tendons. Acupuncture may be helpful, but it has to be repeated.
Walkers.
 These
devices
can enable you to exercise without pain. Bending slightly to grip the handles of a walker can open the spine and relieve pain. "I often suggest that people with spinal stenosis get wheeled walkers with a seat," Dr. Atlas says. "They can go out for a walk, and when their backs or legs begin to ache, they can sit down and get immediate relief."
Laminectomy.
 An option when more conservative treatment isn't effective, laminectomy involves removing the bony overgrowth that is impinging on the nerve. It usually requires one to three days of hospitalization, and often you can return to work within a couple of weeks. It may be performed with an open incision or through a tiny incision and guided by video from a miniaturized camera. "I often have a hard time convincing patients to have a laminectomy, and they may live in pain for a year or more before they agree, but they usually have relief," Dr. Atlas says.
Spinal fusion.
 A spinal fusion procedure includes a laminectomy to remove pressure on the nerve. In addition, the discs between the affected vertebrae are removed and the spaces filled with a material made of bone dust or another bone-like material. In an instrumented spinal fusion, the vertebrae are held together with metal plates, rods, or screws. Spinal fusion surgery has several drawbacks. The six-week recovery time, during which the spine is immobilized, leads to muscle loss and necessitates physical therapy. The fused area of the spine is no longer mobile, so you can't bend as far as you once could. The rigid spine section also puts more stress on the vertebrae above and below it, setting the stage for future problems. "Most patients with spinal stenosis will do fine with a laminectomy. Spinal fusion can be helpful, but for only a very small percentage of people. I recommend it only for people with degenerative spondylolisthesis—really bad arthritis where vertebrae have slipped out of alignment," Dr. Atlas says.
Two exercises to prevent back pain: Back rounds and spine stretches
Back rounds
Step 1: Slowly round your back as you pull your waist up. Let your head fall until your forehead is parallel to the floor. Hold 10-30 seconds.
Step 2: Slowly let your abdomen sag until your back is arched and your chin is parallel to the floor. Hold 10-30 seconds.
Repeat: Do two to four times, twice a day.
Photographer: Michael Carroll
Â
Spine stretches
Step 1: Lie on your back with your knees bent, feet on the floor, arms outstretched, and shoulders touching the floor.
Step 2: Without lifting your shoulders, roll your legs to the left. Hold 10-30 seconds. Return to starting position.
Step 3: Roll your legs to the right. Hold 10-30 seconds. Return to start.
Repeat: Do two to four times, twice a day.
 |
| Markdown | 
[Harvard Health Publishing ](https://www.health.harvard.edu/)
[Harvard Health Publishing](https://www.health.harvard.edu/)
[HarvardHealthOnline+](https://www.health.harvard.edu/hho-plus?utm_source=site&utm_medium=web&utm_campaign=top_button)
Search
[Customer Service](https://www.health.harvard.edu/customer-service) [Content Licensing](https://www.health.harvard.edu/licensing) [About Us](https://www.health.harvard.edu/about-us)
[Log In](https://www.health.harvard.edu/login)
Open mobile menu
[Free HealthBeat Signup](https://www.health.harvard.edu/healthbeat)
Shop
[Subscriptions](https://www.health.harvard.edu/subscribe) [Special Health Reports](https://www.health.harvard.edu/special-health-reports) [Online Courses](https://www.harvardhealthonlinelearning.com/catalog)
[Pay Subscription Bill](https://www.health.harvard.edu/pay-bill)
[Common Conditions](https://www.health.harvard.edu/category/common-conditions) [Staying Healthy](https://www.health.harvard.edu/category/staying-healthy) [Resources](https://www.health.harvard.edu/resources) [Blog](https://www.health.harvard.edu/blog) [COVID-19 Updates](https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center)
Close menu
[HarvardHealthOnline+](https://www.health.harvard.edu/hho-plus?utm_source=site&utm_medium=web&utm_campaign=mobile_button)
## Main Content
- [Common Conditions](https://www.health.harvard.edu/category/common-conditions)
- [Staying Healthy](https://www.health.harvard.edu/category/staying-healthy)
- [Resources](https://www.health.harvard.edu/resources)
- [Blog](https://www.health.harvard.edu/blog)
## Helpful Links
- [Customer Service](https://www.health.harvard.edu/customer-service)
- [About Us](https://www.health.harvard.edu/about-us)
- [Content Licensing](https://www.health.harvard.edu/licensing)
- [Free Healthbeat Signup](https://www.health.harvard.edu/healthbeat)
- [Subscriptions](https://www.health.harvard.edu/subscribe)
- [Special Health Reports](https://www.health.harvard.edu/special-health-reports)
- [Online Courses](https://www.harvardhealthonlinelearning.com/)
- [Pay Subscription Bill](https://www.health.harvard.edu/pay-bill)
Close
Recent Articles
[ Trying to lose weight? Be careful not to lose muscle](https://www.health.harvard.edu/staying-healthy/trying-to-lose-weight-be-careful-not-to-lose-muscle)
[ Is your skin problem actually an autoimmune condition?](https://www.health.harvard.edu/diseases-and-conditions/is-your-skin-problem-actually-an-autoimmune-condition)
[ People with diabetes face higher risk of hearing loss](https://www.health.harvard.edu/diseases-and-conditions/people-with-diabetes-face-higher-risk-of-hearing-loss)
[ Antibiotic-free fixes for recurrent UTIs](https://www.health.harvard.edu/womens-health/antibiotic-free-fixes-for-recurrent-utis)
[ Musculoskeletal syndrome of menopause: When menopause makes you ache all over](https://www.health.harvard.edu/womens-health/musculoskeletal-syndrome-of-menopause-when-menopause-makes-you-ache-all-over)
[ When can older women stop getting mammograms?](https://www.health.harvard.edu/womens-health/when-can-older-women-stop-getting-mammograms)
[ To lose weight, especially harmful belly fat, combine diet and exercise](https://www.health.harvard.edu/staying-healthy/to-lose-weight-especially-harmful-belly-fat-combine-diet-and-exercise)
[ Can men hold off on treating recurring prostate cancer?](https://www.health.harvard.edu/blog/can-men-hold-off-on-treating-recurring-prostate-cancer-202512193108)
[ The 7 types of rest and why we need them all](https://www.health.harvard.edu/mind-and-mood/the-7-types-of-rest-and-why-we-need-them-all)
[ What are the early warning signs of cervical cancer?](https://www.health.harvard.edu/cancer/what-are-the-early-warning-signs-of-cervical-cancer)
1 / 10
[Pain](https://www.health.harvard.edu/topics/pain)
# When to get help for low back pain
September 25, 2019
Share
[Share this page to Facebook](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain&display=popup)
[Share this page to X](https://twitter.com/intent/tweet?original_referer=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain&text=When%20to%20get%20help%20for%20low%20back%20pain%20-%20Harvard%20Health&tw_p=tweetbutton&url=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain)
[Share this page via Email](<mailto:?subject=Great health news for you from the experts at Harvard&body=Check out this link from Harvard Health: When to get help for low back pain - https://www.health.harvard.edu/pain/when-to-get-help-for-low-back-pain>)
Copy this page to clipboard
Print This Page
Click to Print
| |
|---|
|  Image: Thinkstock |
*Pain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.*
Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.
Sciatica is a term you've probably heard people use for pain in the lower back, radiating to the buttocks and down one or both legs. "When patients tell me they have sciatica, they could have one of two conditions—a leaking disc or spinal stenosis \[narrowing of the spinal canal\]," says Dr. Steven Atlas, associate professor of medicine at Harvard Medical School. These conditions in turn can put pressure on the sciatic nerve, which emerges from the lumbar (lower) spine, separates just above the buttocks, and runs down each leg.
### **Understanding your spine**
The spine is a bony column formed by a stack of 24 vertebrae, which are open at the center, creating a channel or canal for the spinal cord. The spaces between the vertebrae are padded by gel-filled, fibrous-ringed discs, which absorb the force we put on the spine. Nerves run from the spinal cord at every vertebral space.
You might also be interested in...

## The Joint Pain Relief Workout: Healing exercises for your shoulders, hips, knees, and ankles
Is joint pain holding you back? Perhaps an achy ankle or sore knee is making it difficult to enjoy a run through your favorite park or even taking a short walk. Or maybe a throbbing hip or shoulder prevents you from whacking a golf ball or performing simple tasks like carrying a bag of groceries. The exercises in this report, The Joint Pain Relief Workout: Healing exercises for your shoulders, hips, knees, and ankles, can help relieve ankle, knee, hip, or shoulder pain, and help you become more active again, which can help you stay independent long into your later years.
[LEARN MORE](https://servedbyadbutler.com/redirect.spark?MID=186626&plid=2650436&setID=812675&channelID=0&CID=862911&banID=522376601&PID=0&textadID=0&tc=1&rnd=1516133189&scheduleID=2486843&adSize=0x0&matches=%5B%22pain%22%5D&mt=1769768864338998&spr=1&referrer=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain&request_uuid=b0d212eb-22c8-4c19-8233-1bb804b341df&hc=28f1e0e822bf352a2686a3ec94469c85fa6dcf7a&location=)
You get lower [back pain](https://www.health.harvard.edu/pain/back-pain-what-you-can-expect-from-steroid-injections) that radiates into the leg when a disc or bone impinges on a nerve as it exits the spinal cord, most commonly between the 4th and 5th lumbar vertebrae. In people between ages 30 and 60, a ruptured disc is usually responsible; in people over 60, spinal stenosis is more likely to be the cause. In the latter, a reduction in the size of the spinal canal, often due to overgrown bone, puts pressure on the nerves.
### **Ruptured disc**
Damage to discs can be caused by injury or simply by the activities of daily life. If a disc swells or slips out of place, it may press against a nerve. If it ruptures, the leaking gel can inflame the nerves. "Almost everyone has a ruptured disc at some time, but not everyone has symptoms," Dr. Atlas says.
Although the term sciatica is often used to describe the pain, your doctor may call it radicular leg pain—radiating pain due to a compressed nerve. The pain usually comes on suddenly after the disc ruptures. Sitting usually makes the pain worse, while standing and walking may relieve it.
Treatment usually begins with over-the-counter pain medication and exercise. Exercise helps because standing and moving can relieve the pressure on the disc.
Though it may be hard to believe, the pain will go away without medical attention once your body has absorbed the disc material—usually a matter of a few days or weeks. When the episode is over, there is no need for further treatment. "I know people want immediate relief, and I often have to convince them that they don't need surgery," Dr. Atlas says.
But there are rare exceptions, Dr. Atlas says. "If your leg is weak or numb, or if your bowel or bladder function is affected, you should get medical attention immediately to avoid permanent nerve damage," he advises.
### **Spinal stenosis**
This condition becomes increasingly common with age. Over time, the cumulative effects of gravity bring the vertebrae closer together, and the discs also tend to dry out and become thinner. With less cushioning between them, the vertebrae rub against one another, causing arthritis. Arthritic bone deposits can narrow the channels through which nerves pass, putting pressure on them and producing pain.
Pain from [spinal stenosis](https://www.health.harvard.edu/diseases-and-conditions/when-you-visit-your-doctor-spinal-stenosis) is known as neurogenic claudication (literally "difficulty walking originating in the nerves"). It is more subtle than pain caused by a damaged disc. You might have symptoms in your back, buttocks, or upper thighs, but the pain might not radiate all the way down your leg. The pain is also likely to affect both sides of your body. With spinal stenosis, your upper thighs or legs may hurt when you stand.
Sitting down to take the stress off your lower spine will relieve pain. Bending over slightly can also help by opening the spaces between the vertebrae to reduce pressure on the nerves. If you have braved the pain to get to the grocery store, you may be delighted to find that pushing a shopping cart can provide relief.
### **Treating spinal stenosis**
Unlike disc herniation, spinal stenosis is a chronic condition. It can't be cured, but the pain can be effectively managed with a combination of the following:
- ***Oral analgesics.*** Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen (Aleve, Naprosyn) or the non-NSAID painkiller acetaminophen are generally safe to use for occasional flares, but they have side effects. [NSAIDs](https://www.health.harvard.edu/heart-health/heart-safer-nsaid-alternatives) are associated with an increased risk of heart attack and stroke, and acetaminophen with an increased risk of liver damage. Talk to your doctor about the right medication and dose for you.
- ***Spinal injections.*** Injections of lidocaine to relieve pain and corticosteroids to reduce inflammation are commonly delivered to the area of the spine where the pain originates. However, controlled clinical trials have cast doubt on steroid use: after six weeks, patients treated with lidocaine alone had as much pain relief and functional improvement—with fewer side effects—as those treated with both drugs. "I usually reserve injections for patients who need immediate relief so they can get to a physical therapist," Dr. Atlas says.
- ***Physical therapy.*** Exercise is the best long-term approach to managing spinal stenosis. A physical therapist can teach you the exercises that will strengthen your back muscles to better support your spine and compensate for the pain. Massage and manipulation may not help this kind of problem because it originates in your bones, not in your muscles or tendons. Acupuncture may be helpful, but it has to be repeated.
- ***Walkers.*** These [devices](https://www.health.harvard.edu/staying-healthy/5-tools-to-maintain-your-mobility) can enable you to exercise without pain. Bending slightly to grip the handles of a walker can open the spine and relieve pain. "I often suggest that people with spinal stenosis get wheeled walkers with a seat," Dr. Atlas says. "They can go out for a walk, and when their backs or legs begin to ache, they can sit down and get immediate relief."
- ***Laminectomy.*** An option when more conservative treatment isn't effective, laminectomy involves removing the bony overgrowth that is impinging on the nerve. It usually requires one to three days of hospitalization, and often you can return to work within a couple of weeks. It may be performed with an open incision or through a tiny incision and guided by video from a miniaturized camera. "I often have a hard time convincing patients to have a laminectomy, and they may live in pain for a year or more before they agree, but they usually have relief," Dr. Atlas says.
- ***Spinal fusion.*** A spinal fusion procedure includes a laminectomy to remove pressure on the nerve. In addition, the discs between the affected vertebrae are removed and the spaces filled with a material made of bone dust or another bone-like material. In an instrumented spinal fusion, the vertebrae are held together with metal plates, rods, or screws. Spinal fusion surgery has several drawbacks. The six-week recovery time, during which the spine is immobilized, leads to muscle loss and necessitates physical therapy. The fused area of the spine is no longer mobile, so you can't bend as far as you once could. The rigid spine section also puts more stress on the vertebrae above and below it, setting the stage for future problems. "Most patients with spinal stenosis will do fine with a laminectomy. Spinal fusion can be helpful, but for only a very small percentage of people. I recommend it only for people with degenerative spondylolisthesis—really bad arthritis where vertebrae have slipped out of alignment," Dr. Atlas says.
| | | | |
|---|---|---|---|
| Two exercises to prevent back pain: Back rounds and spine stretches | | | |
| Back rounds  Step 1: Slowly round your back as you pull your waist up. Let your head fall until your forehead is parallel to the floor. Hold 10-30 seconds. Step 2: Slowly let your abdomen sag until your back is arched and your chin is parallel to the floor. Hold 10-30 seconds. Repeat: Do two to four times, twice a day. Photographer: Michael Carroll | | Spine stretches  Step 1: Lie on your back with your knees bent, feet on the floor, arms outstretched, and shoulders touching the floor. Step 2: Without lifting your shoulders, roll your legs to the left. Hold 10-30 seconds. Return to starting position. Step 3: Roll your legs to the right. Hold 10-30 seconds. Return to start. Repeat: Do two to four times, twice a day. | |
Share
[Share this page to Facebook](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain&display=popup)
[Share this page to X](https://twitter.com/intent/tweet?original_referer=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain&text=When%20to%20get%20help%20for%20low%20back%20pain%20-%20Harvard%20Health&tw_p=tweetbutton&url=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain)
[Share this page via Email](<mailto:?subject=Great health news for you from the experts at Harvard&body=Check out this link from Harvard Health: When to get help for low back pain - https://www.health.harvard.edu/pain/when-to-get-help-for-low-back-pain>)
Copy this page to clipboard
Print This Page
Click to Print
## Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Recent Articles
[ Trying to lose weight? Be careful not to lose muscle](https://www.health.harvard.edu/staying-healthy/trying-to-lose-weight-be-careful-not-to-lose-muscle)
[ Is your skin problem actually an autoimmune condition?](https://www.health.harvard.edu/diseases-and-conditions/is-your-skin-problem-actually-an-autoimmune-condition)
[ People with diabetes face higher risk of hearing loss](https://www.health.harvard.edu/diseases-and-conditions/people-with-diabetes-face-higher-risk-of-hearing-loss)
[ Antibiotic-free fixes for recurrent UTIs](https://www.health.harvard.edu/womens-health/antibiotic-free-fixes-for-recurrent-utis)
[ Musculoskeletal syndrome of menopause: When menopause makes you ache all over](https://www.health.harvard.edu/womens-health/musculoskeletal-syndrome-of-menopause-when-menopause-makes-you-ache-all-over)
[ When can older women stop getting mammograms?](https://www.health.harvard.edu/womens-health/when-can-older-women-stop-getting-mammograms)
[ To lose weight, especially harmful belly fat, combine diet and exercise](https://www.health.harvard.edu/staying-healthy/to-lose-weight-especially-harmful-belly-fat-combine-diet-and-exercise)
[ Can men hold off on treating recurring prostate cancer?](https://www.health.harvard.edu/blog/can-men-hold-off-on-treating-recurring-prostate-cancer-202512193108)
[ The 7 types of rest and why we need them all](https://www.health.harvard.edu/mind-and-mood/the-7-types-of-rest-and-why-we-need-them-all)
[ What are the early warning signs of cervical cancer?](https://www.health.harvard.edu/cancer/what-are-the-early-warning-signs-of-cervical-cancer)
1 / 10
## Related Topics
[ Pain Managing chronic back pain](https://www.health.harvard.edu/pain/managing-chronic-back-pain)
[ Pain Walking tied to less back pain](https://www.health.harvard.edu/pain/walking-tied-to-less-back-pain)
[ Pain Create a plan to relieve your back pain](https://www.health.harvard.edu/pain/create-a-plan-to-relieve-your-back-pain)
[Back Pain](https://www.health.harvard.edu/topics/back-pain)
## Free Healthbeat Signup
Get the latest in health news delivered to your inbox\!
[Sign Up](https://www.health.harvard.edu/healthbeat)
## Footer
[Harvard Health Publishing ](https://www.health.harvard.edu/)
[Facebook](https://www.facebook.com/HarvardHealthPublications)
[X (formerly known as Twitter)](https://x.com/harvardhealth)
[Linkedin](https://www.linkedin.com/company/harvard-health-publications/)
[YouTube](https://www.youtube.com/channel/UC-jj29vMMB1ulz_uEU5kUrA)
### My Account
- [Customer Service](https://www.health.harvard.edu/customer-service)
- [Log in](https://www.health.harvard.edu/login)
### Order Now
- [Online Learning Courses](https://www.harvardhealthonlinelearning.com/)
- [Digital Subscriptions](https://www.health.harvard.edu/subscribe)
- [Special Health Reports](https://www.health.harvard.edu/special-health-reports)
- [Print Subscriptions](https://www.health.harvard.edu/newsletters)
### More
- [About Us](https://www.health.harvard.edu/about-us)
- [Permissions](https://www.health.harvard.edu/permissions)
- [Content Licensing](https://www.health.harvard.edu/licensing)
- [Topics](https://www.health.harvard.edu/topics)
- [Trademark Notice](https://trademark.harvard.edu/pages/trademark-notice)
© 2026 [Harvard Health Publishing®](https://trademark.harvard.edu/pages/trademark-notice) of The President and Fellows of Harvard College
[Do not sell my personal information](https://www.health.harvard.edu/privacy-policy#california-residents) \| [Privacy Policy and Terms of Use](https://www.health.harvard.edu/privacy-policy)
[Scroll To Top](https://www.health.harvard.edu/pain/when-to-get-help-for-low-back-pain#app)
Close

Thanks for visiting. Don't miss your FREE gift.
**25 Gut Health Hacks is yours absolutely FREE when you sign up to receive health information from Harvard Medical School.**
Sign up to get tips for living a healthy lifestyle, with ways to lessen **digestion** problems…keep **inflammation** under control…learn simple exercises to improve your **balance**…understand your options for **cataract** treatment…all delivered to your email box FREE.
Close

Health Alerts from Harvard Medical School
**And a FREE copy of the new report 25 Gut Health Hacks\!**

Sign up to receive HealthBeat emails from Harvard Health Publishing and get helpful tips and guidance for ways to lessen digestion problems… keep inflammation under control… learn simple exercises to improve your balance… understand your options for cataract treatment… all delivered to your email inbox FREE. PLUS, you'll get the latest news on medical advances and breakthroughs from Harvard Medical School experts, and special offers on content from Harvard Health Publishing.
Close

Stay on top of latest health news from Harvard Medical School.
Plus, get a FREE copy of **25 Gut Health Hacks**.
Close

Stay on top of latest health news from Harvard Medical School.
Plus, get a FREE copy of **25 Gut Health Hacks**.
 |
| Readable Markdown | 
Image: Thinkstock
*Pain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.*
Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.
Sciatica is a term you've probably heard people use for pain in the lower back, radiating to the buttocks and down one or both legs. "When patients tell me they have sciatica, they could have one of two conditions—a leaking disc or spinal stenosis \[narrowing of the spinal canal\]," says Dr. Steven Atlas, associate professor of medicine at Harvard Medical School. These conditions in turn can put pressure on the sciatic nerve, which emerges from the lumbar (lower) spine, separates just above the buttocks, and runs down each leg.
### **Understanding your spine**
The spine is a bony column formed by a stack of 24 vertebrae, which are open at the center, creating a channel or canal for the spinal cord. The spaces between the vertebrae are padded by gel-filled, fibrous-ringed discs, which absorb the force we put on the spine. Nerves run from the spinal cord at every vertebral space.
You might also be interested in...

Is joint pain holding you back? Perhaps an achy ankle or sore knee is making it difficult to enjoy a run through your favorite park or even taking a short walk. Or maybe a throbbing hip or shoulder prevents you from whacking a golf ball or performing simple tasks like carrying a bag of groceries. The exercises in this report, The Joint Pain Relief Workout: Healing exercises for your shoulders, hips, knees, and ankles, can help relieve ankle, knee, hip, or shoulder pain, and help you become more active again, which can help you stay independent long into your later years.
[LEARN MORE](https://servedbyadbutler.com/redirect.spark?MID=186626&plid=2650436&setID=812675&channelID=0&CID=862911&banID=522376601&PID=0&textadID=0&tc=1&rnd=1516133189&scheduleID=2486843&adSize=0x0&matches=%5B%22pain%22%5D&mt=1769768864338998&spr=1&referrer=https%3A%2F%2Fwww.health.harvard.edu%2Fpain%2Fwhen-to-get-help-for-low-back-pain&request_uuid=b0d212eb-22c8-4c19-8233-1bb804b341df&hc=28f1e0e822bf352a2686a3ec94469c85fa6dcf7a&location=)
You get lower [back pain](https://www.health.harvard.edu/pain/back-pain-what-you-can-expect-from-steroid-injections) that radiates into the leg when a disc or bone impinges on a nerve as it exits the spinal cord, most commonly between the 4th and 5th lumbar vertebrae. In people between ages 30 and 60, a ruptured disc is usually responsible; in people over 60, spinal stenosis is more likely to be the cause. In the latter, a reduction in the size of the spinal canal, often due to overgrown bone, puts pressure on the nerves.
### **Ruptured disc**
Damage to discs can be caused by injury or simply by the activities of daily life. If a disc swells or slips out of place, it may press against a nerve. If it ruptures, the leaking gel can inflame the nerves. "Almost everyone has a ruptured disc at some time, but not everyone has symptoms," Dr. Atlas says.
Although the term sciatica is often used to describe the pain, your doctor may call it radicular leg pain—radiating pain due to a compressed nerve. The pain usually comes on suddenly after the disc ruptures. Sitting usually makes the pain worse, while standing and walking may relieve it.
Treatment usually begins with over-the-counter pain medication and exercise. Exercise helps because standing and moving can relieve the pressure on the disc.
Though it may be hard to believe, the pain will go away without medical attention once your body has absorbed the disc material—usually a matter of a few days or weeks. When the episode is over, there is no need for further treatment. "I know people want immediate relief, and I often have to convince them that they don't need surgery," Dr. Atlas says.
But there are rare exceptions, Dr. Atlas says. "If your leg is weak or numb, or if your bowel or bladder function is affected, you should get medical attention immediately to avoid permanent nerve damage," he advises.
### **Spinal stenosis**
This condition becomes increasingly common with age. Over time, the cumulative effects of gravity bring the vertebrae closer together, and the discs also tend to dry out and become thinner. With less cushioning between them, the vertebrae rub against one another, causing arthritis. Arthritic bone deposits can narrow the channels through which nerves pass, putting pressure on them and producing pain.
Pain from [spinal stenosis](https://www.health.harvard.edu/diseases-and-conditions/when-you-visit-your-doctor-spinal-stenosis) is known as neurogenic claudication (literally "difficulty walking originating in the nerves"). It is more subtle than pain caused by a damaged disc. You might have symptoms in your back, buttocks, or upper thighs, but the pain might not radiate all the way down your leg. The pain is also likely to affect both sides of your body. With spinal stenosis, your upper thighs or legs may hurt when you stand.
Sitting down to take the stress off your lower spine will relieve pain. Bending over slightly can also help by opening the spaces between the vertebrae to reduce pressure on the nerves. If you have braved the pain to get to the grocery store, you may be delighted to find that pushing a shopping cart can provide relief.
### **Treating spinal stenosis**
Unlike disc herniation, spinal stenosis is a chronic condition. It can't be cured, but the pain can be effectively managed with a combination of the following:
- ***Oral analgesics.*** Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen (Aleve, Naprosyn) or the non-NSAID painkiller acetaminophen are generally safe to use for occasional flares, but they have side effects. [NSAIDs](https://www.health.harvard.edu/heart-health/heart-safer-nsaid-alternatives) are associated with an increased risk of heart attack and stroke, and acetaminophen with an increased risk of liver damage. Talk to your doctor about the right medication and dose for you.
- ***Spinal injections.*** Injections of lidocaine to relieve pain and corticosteroids to reduce inflammation are commonly delivered to the area of the spine where the pain originates. However, controlled clinical trials have cast doubt on steroid use: after six weeks, patients treated with lidocaine alone had as much pain relief and functional improvement—with fewer side effects—as those treated with both drugs. "I usually reserve injections for patients who need immediate relief so they can get to a physical therapist," Dr. Atlas says.
- ***Physical therapy.*** Exercise is the best long-term approach to managing spinal stenosis. A physical therapist can teach you the exercises that will strengthen your back muscles to better support your spine and compensate for the pain. Massage and manipulation may not help this kind of problem because it originates in your bones, not in your muscles or tendons. Acupuncture may be helpful, but it has to be repeated.
- ***Walkers.*** These [devices](https://www.health.harvard.edu/staying-healthy/5-tools-to-maintain-your-mobility) can enable you to exercise without pain. Bending slightly to grip the handles of a walker can open the spine and relieve pain. "I often suggest that people with spinal stenosis get wheeled walkers with a seat," Dr. Atlas says. "They can go out for a walk, and when their backs or legs begin to ache, they can sit down and get immediate relief."
- ***Laminectomy.*** An option when more conservative treatment isn't effective, laminectomy involves removing the bony overgrowth that is impinging on the nerve. It usually requires one to three days of hospitalization, and often you can return to work within a couple of weeks. It may be performed with an open incision or through a tiny incision and guided by video from a miniaturized camera. "I often have a hard time convincing patients to have a laminectomy, and they may live in pain for a year or more before they agree, but they usually have relief," Dr. Atlas says.
- ***Spinal fusion.*** A spinal fusion procedure includes a laminectomy to remove pressure on the nerve. In addition, the discs between the affected vertebrae are removed and the spaces filled with a material made of bone dust or another bone-like material. In an instrumented spinal fusion, the vertebrae are held together with metal plates, rods, or screws. Spinal fusion surgery has several drawbacks. The six-week recovery time, during which the spine is immobilized, leads to muscle loss and necessitates physical therapy. The fused area of the spine is no longer mobile, so you can't bend as far as you once could. The rigid spine section also puts more stress on the vertebrae above and below it, setting the stage for future problems. "Most patients with spinal stenosis will do fine with a laminectomy. Spinal fusion can be helpful, but for only a very small percentage of people. I recommend it only for people with degenerative spondylolisthesis—really bad arthritis where vertebrae have slipped out of alignment," Dr. Atlas says.
| | | | |
|---|---|---|---|
| Two exercises to prevent back pain: Back rounds and spine stretches | | | |
| Back rounds  Step 1: Slowly round your back as you pull your waist up. Let your head fall until your forehead is parallel to the floor. Hold 10-30 seconds. Step 2: Slowly let your abdomen sag until your back is arched and your chin is parallel to the floor. Hold 10-30 seconds. Repeat: Do two to four times, twice a day. Photographer: Michael Carroll | | Spine stretches  Step 1: Lie on your back with your knees bent, feet on the floor, arms outstretched, and shoulders touching the floor. Step 2: Without lifting your shoulders, roll your legs to the left. Hold 10-30 seconds. Return to starting position. Step 3: Roll your legs to the right. Hold 10-30 seconds. Return to start. Repeat: Do two to four times, twice a day. | | |
| Shard | 102 (laksa) |
| Root Hash | 2971912334127662702 |
| Unparsed URL | edu,harvard!health,www,/pain/when-to-get-help-for-low-back-pain s443 |