The Source / A field guide to feeling better
Lower Back
Back pain is a location. Sciatica is a symptom pattern. A disc is one structure that may be involved. Knowing the difference helps.
Can you point to it?
Select a label to explore its side of the body
Choose the closest area.
Pick a point on the close-up, or choose from the list below. Each one covers what might be going on, the details that help at a visit, and the research behind it.
Put the symptoms in context
Most decisions start with your symptoms, what you can and can’t do, and the exam. A scan is one part of the picture, and the same changes can also show up in people who have no pain.
Follow the question
Explore lower back
Each guide explains what the condition is, what the research shows and where it runs out, and when it calls for a different kind of care than ours. An exam is how we look for which one, if any, fits you.
- Condition guide
Back pain
Common back-pain patterns, the warning signs, and what progress looks like in everyday life.
Understand this condition - Condition guide
Sciatica
Leg pain from an irritated nerve, what a scan can and can’t tell you, and when to get help.
Understand this condition - Condition guide
Disc injury
Disc changes, symptoms and treatment choices, and why not every disc finding on a scan explains your pain.
Understand this condition
Back pain, sciatica or a disc injury?
They mean different things. Back pain says where it hurts. Sciatica is a pattern of leg symptoms that goes with an irritated nerve. A disc injury names one structure that may or may not explain your symptoms.
Start with the urgent warning signs in our back pain guide. If one fits, you need an emergency room or a prompt medical assessment, not a routine visit. If none fits, the most useful things to tell us are how far you can walk, if pain runs into a leg, and what it's stopped you doing.
What can a scan of your lower back tell you?
The imaging review below found degenerative changes in many people with no pain, so a scan has to be read next to your symptoms and an exam. Scans still have their place, and worsening nerve symptoms shouldn't wait for a routine visit. Each guide above covers its own next step, including when that's care other than ours.
Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians
Adults with acute, subacute or chronic low-back pain considering noninvasive management.
What it foundThe guideline prioritizes non-drug options for chronic low-back pain, including exercise. Spinal manipulation is one of several options, supported by lower-quality evidence.
What it can't tell usA guideline pulls together existing evidence; it doesn't report a new experiment. It doesn't establish disc realignment, a cure for everyone, or superiority over all other care.
Publication details & citation
Qaseem et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine. 2017. DOI: 10.7326/M16-2367.
Read the publication recordSystematic literature review of imaging features of spinal degeneration in asymptomatic populations
33 studies reporting imaging findings in 3,110 people without symptoms.
What it foundDegenerative findings were common in people without pain and became more frequent with age. A scan needs interpretation alongside symptoms and examination findings.
What it can't tell usThat doesn't make every disc finding harmless, or imaging never necessary. And a review like this can't identify what's causing one person's pain.
Publication details & citation
Brinjikji et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology. 2015. DOI: 10.3174/ajnr.A4173.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.