Chronic low back pain can be shooting, stabbing, localized in nature, or referred from another part of the body. They may experience this pain only when walking, sitting or standing, each action suggesting a specific root cause. Whatever its degree and nature, chronic low back pain should always be evaluated by a physician to rule out any serious problems. There are many pain-sensitive structures in the back. Injuries, infection or inflammation affecting these structures are often the origin of chronic low back pain.
Most cases result from simple sprains or strains of the muscles and ligaments.
Others may be related to bruises and disk herniations. Diagnosis of chronic low back pain, as well as of its many related syndromes, relies heavily on a thorough physical examination and blood work-up, a complete medical and psychosocial history, and a description of the pain, including its location and how it started. While a good physical exam focuses on obvious deformities, tender areas, range of motion and neurologic function, it also can shed light on problems not easily diagnosed that involve the muscles, connective tissue, nerves and spine. There are special maneuvers that should be performed so that the physician can correctly assess and distinguish the many possible causes of chronic low back pain. Imaging techniques may be necessary if there is tenderness over the spine or the patient's history indicates the possibility of a tumor or infection.