Lower back

When it comes to symptoms in the lower back it is important to first screen for seriously pathology. If any of the below symptoms are present then emergency care should be sought. The symptoms are:

- A change in bladder and bowel function. this can include incontinence, an inability to identify if properly emptied or if you need to go to the loo.

- A change in sexual function, or difficulty having sex.

- A loss or change of sensation between the legs.

- Symptoms including pain or nerve referrals in both legs. 

- Issues with gait, such as a loss of control of the feet, or increased tripping. 

Appearance of these symptoms are characteristic of serious spinal pathology and require imitate screening in A&E

Facet joints sit to either side of the spine. Pain in these will be identifiable as either left or right sided, though you may have some symptoms over both as the muscles work to protect the joint. Facet joint pain will be worse with movements that compress the joint but will feel better leaning away from it as this opens up the joint. 

Disc pain is usually more central in the back, but can have associated muscular tightness causing pain in either or both sides. Disc pain can also be the cause of nerve irritation cause pins and needles, numbness or tingling in the buttock and leg. 

Occasionally people will "twinge" their back. This sudden sharp pain can be unnerving due to the intensity of it. However these types of pain usually settle with in a few days. In these cases ongoing gentle movement while it settles will help speed up the process and afterwards some strengthening should be done to avoid reoccurrence. 

Chronic back pain means that the pain is lasting for greater than three months, and non-specific refers to an unknown source of pain. These presentations are usually linked to an initially injury which wasn't fully addressed at the time, or an initial injury with psychological impacts added on preventing the pain response from passing. In both of theses cases progress can be made to improve symptoms. 

Various postures can result in pain in the lower back, some of these include scoliosis, sway back, or an excessive lordosis.  All of these cause extra pressure on joints and muscular imbalances. prolonged sitting in fixed positions can also be the cause of back pain.

Symptoms of sciatica are pain traveling down the back of the leg. This can include sharp stabbing pain, tingling, pins & needles or numbness. The pain can originate in the back or from the gluteal and may only travel part way down the leg or can reach down to the toes.  

Never symptoms can take between 3 and 6 months to resolve. 

If these symptoms are in both legs then it is important to go to A&E for urgent care.