Orthopedist Questions Orthopedist

How do you tell if lower back pain is muscle or disc?

I have lower back pain. I wonder how can you tell if lower back pain is muscle or disc?

5 Answers

There is not really a way to tell them apart by the pain. MRI would be the way to see if you have disc problems. Usually disc issues will result in something called radiculopathy, which is symptoms going down one or both legs, however that is not always the case. Radiculopathy is rare with just muscle issues. So if you have radiculopathy it's more likely to be a disc problem. If you don't, there is no way to tell aside from MRI.
In most people, it is both. Usually the disc becomes inflamed due to wear and tear or overuse. Once the disc becomes inflamed the muscles begin to spasm. That's why many doctors give both an anti-inflammatory med and muscle relaxant at the same time.

Hope it helps!!

Dr. Bose
Disc pain usually radiates down your leg, whereas muscle pain is usually more localized to your lower back.

Thanks for sharing and allowing me to respond with my thoughts, tips and suggestions.

Much of my professional work revolves around hearing a history of the problem (for you, lower back pain and ‘what is it’?). A disc problem means that the house that holds the disc in (the ligaments or ‘annulus fibrosis’ when it comes to back ‘discs’) place has failed. So, your problem is either muscular or ligamentous. How the problem began sheds a lot of light on which it may be. Sometimes it is both. Muscle pain can be felt easier (by someone pushing on the sore area), and can be made worse with movement. Ligament or disc pain is a deeper pain and can exist even at stillness (or at rest, no movement). The initial ‘treatment’ is basically the same. See this link:

https://www.pop-doc.com/joint-preactive.html

If the pain gets worse, or there are feelings of numbness, tingling, burning or cramping to your legs, and this does not resolve or feel like it is getting better after 5-7 days, then a visit to your primary care doctor is suggested.

I hope you heal well and soon.
Low back pain may have several causes. Classic disc problems present as leg symptoms like pain radiating down the leg, numbness in the leg foot or toes, and may be associated with muscle weakness. Disc disease can also cause low back pain and muscle spasm in the lower back. Strictly muscular strain presents with tenderness in the muscles on either side of the spine. Prostate problems, kidney stones and certain infections may present with similar symptoms.

Note the location of pain or numbness and what activities increase symptoms. Accurately describing your symptoms will help your doctor determine the best course of action.

Back or leg pain associated with loss of control of bladder, or numbness in the "saddle" area (where your bottom contacts a saddle) is an emergency, and requires immediate attention.

Hope that helps.