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Low Back Pain

Lower back pain is one of the leading causes of disability worldwide and affects people of all ages and activity levels. Whether it develops after lifting something heavy, spending long hours at a desk, or gradually over time, lower back pain can make everyday activities difficult. The good news is that most cases improve with conservative care and an active rehabilitation approach.

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Dr. Michael Hoiles is a Calgary chiropractor with more than 15 years of experience helping people with low back pain, sports injuries, and other musculoskeletal conditions. He created this resource to help you better understand common causes of low back pain, symptoms, treatment options, recovery expectations, and when it may be appropriate to seek an assessment. Whether you're dealing with a new injury or recurring back pain, the goal is to provide clear, evidence-informed information to help you make informed decisions and get back to moving with confidence.

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What Is Low Back pain?

Lower back pain is one of the most common musculoskeletal conditions and can affect people of all ages. It may develop suddenly after lifting, bending, or exercising, or gradually over time due to repetitive strain, poor movement habits, prolonged sitting, or age-related changes. Lower back pain can involve muscles, joints, discs, ligaments, nerves, or a combination of these structures. 

While lower back pain can be frustrating and limiting, most cases respond well to conservative treatment and an active rehabilitation approach. 

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Quick Facts

✅ Low back pain is extremely common and can affect people of all ages.

✅ Most episodes improve with conservative care and a gradual return to normal activity.

✅ Staying active is generally better than prolonged bed rest.

✅ Back pain can arise from muscles, joints, discs, nerves, or a combination of factors.

✅ Findings such as disc degeneration or arthritis on imaging do not always explain why someone is experiencing pain.

✅ Exercise and progressive rehabilitation can help restore strength, movement, and confidence.

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Lumbar spine and pelvis anatomy showing the vertebrae, sacrum, pelvis and surrounding lower back muscles.

​Anatomy

The lower back, or lumbar spine, is made up of five vertebrae supported by discs, facet joints, ligaments, muscles, and surrounding connective tissues.

These structures work together to support the body while allowing you to bend, twist, walk, lift, run, and perform everyday activities.

The lumbar spine is also closely connected with the hips, pelvis, abdominal muscles and gluteal muscles. Because so many structures contribute to movement in this area, hip pain can sometimes be mistaken for lower back pain, and vice versa.

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Common Causes & Risk Factors 

Low back pain often develops from a combination of factors rather than one specific injury. 

Common contributors include: 

  • Muscle or ligament strains 

  • Repetitive bending or lifting 

  • Sudden increases in exercise or physical activity 

  • Prolonged sitting 

  • Reduced strength or physical conditioning 

  • Previous episodes of low back pain 

  • Repetitive work activities 

  • Age-related changes in the spine 

Sometimes back pain develops without an obvious injury or identifiable structural cause. 

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Common Symptoms 

Symptoms vary depending on the tissues involved and may include: 

  • Dull aching pain in the lower back  

  • Sharp pain with certain movements  

  • Stiffness after sitting or resting  

  • Difficulty bending forward or backward  

  • Pain when standing up from a seated position  

  • Muscle tightness or spasms  

  • Pain that travels into the buttock or hip  

  • Reduced mobility and flexibility  

In some cases, pain may radiate into the leg, which may indicate nerve involvement such as sciatica. 

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Could My Pain Be Coming From Somewhere Else?

Not every pain felt in the lower back originates directly from the lumbar spine.

Conditions that can sometimes produce similar symptoms include:

  • Sciatica – irritation of a spinal nerve that may cause pain, numbness, or tingling into the leg

  • Disc injuries – irritation or injury involving one of the spinal discs

  • Facet joint pain – pain arising from the small joints at the back of the spine

  • SI joint pain – pain arising where the pelvis connects to the sacrum

  • Hip problems – hip joint conditions can occasionally refer pain toward the buttock or lower back

  • Muscle strains – muscles surrounding the spine, hips, and pelvis can produce localized pain

  • Non-musculoskeletal conditions – occasionally pain from the kidneys, abdominal organs, or other medical conditions may be felt in the back

This is one reason an assessment can be helpful when pain is persistent, recurrent, unusual, or accompanied by other symptoms.

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How Is Low Back Pain Diagnosed?

Most low back pain can be assessed through a detailed history and physical examination.

An assessment may include:

  • How and when the pain started

  • Where the pain is located

  • Movements or activities that aggravate symptoms

  • Lumbar spine and hip movement

  • Strength and neurological testing

  • Joint and muscle assessment

  • Functional movements such as bending, squatting, or lifting

The goal is not simply to identify a painful structure but to understand the factors contributing to the problem and determine the most appropriate treatment and rehabilitation plan.

Imaging may be recommended when the examination suggests that additional investigation is necessary.

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What Makes It Worse? 

Common aggravating factors include: 

  • Prolonged time in one position

  • Repeated bending or lifting  

  • Heavy lifting

  • Sudden twisting movements  

  • Long periods of driving  

  • Inactivity or bed rest  

  • Returning to activity too quickly after injury  

Identifying and modifying aggravating factors is often an important part of recovery. 

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What Helps? 

Many people find improvement with: 

  • Staying as active as symptoms allow  

  • Regular walking  

  • Appropriate stretching and mobility exercises  

  • Strengthening the core, hips, and glutes  

  • Improving lifting mechanics  

  • Taking regular movement breaks from sitting  

  • Heat or ice, depending on the stage of injury  

  • Gradually returning to normal activities 

Research consistently shows that remaining as active as symptoms allow is often one of the most effective ways to recover from lower back pain. While temporary activity modification may be necessary, prolonged bed rest is generally associated with slower recovery and reduced function. 

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How Chiropractic Can Help 

A chiropractic assessment aims to identify the factors contributing to your pain and develop an individualized treatment plan. 

Treatment may include: 

  • Joint mobilization and spinal adjustments  

  • Soft tissue therapy  

  • Myofascial release techniques  

  • Instrument-assisted soft tissue therapy (Graston/FAKTR)  

  • Movement assessment  

  • Exercise prescription  

  • Postural and ergonomic recommendations  

  • Education regarding activity modification and recovery strategies  

Treatment is individualized based on your examination, symptoms, activity level, and goals. The goal is not simply to reduce pain temporarily, but to restore movement, rebuild strength and confidence, and help you return to work, exercise, sport, and the activities you enjoy.

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Do I Need an X-Ray or MRI?

Usually not.

Most uncomplicated episodes of low back pain do not require immediate imaging. An examination can often provide enough information to begin an appropriate treatment and rehabilitation plan.

An X-ray or MRI may be considered when:

  • Significant trauma has occurred

  • Progressive neurological symptoms are present

  • A fracture or other serious condition is suspected

  • Symptoms are not improving as expected

  • Imaging results would change the treatment plan

It is also important to remember that findings such as disc bulges, arthritis, and degenerative changes are common and may be present in people who have no back pain.

Imaging should therefore be interpreted together with your symptoms and physical examination rather than viewed in isolation.

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Can I Still Exercise? 

In most cases, yes. Complete rest is rarely necessary. Modifying activity while remaining active is often one of the fastest ways to recover. During your assessment, recommendations can be made regarding which exercises to continue, modify, or temporarily avoid while healing. 

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Exercises Commonly Recommended 

Exercise recommendations vary based on the specific cause of symptoms, but commonly:

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Early Phase 

  • Walking  

  • Pelvic tilts  

  • Cat-Cow 

  • Prone press-ups  

  • Gentle stretching  

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Recovery Phase 

  • Bird Dogs  

  • Glute Bridges  

  • Dead Bugs  

  • Side Planks  

  • Hip mobility exercises (particularly helpful when hip pain or reduced hip mobility is contributing to back symptoms).

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Performance Phase 

  • Squats  

  • Lunges  

  • Hip Hinges  

  • Loaded Carries  

  • Core strengthening progressions  

  • Sport-specific or work-specific exercises 

 

Exercises should be individualized based on your condition and stage of recovery. 

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Recovery Timeline 

Every case is different, but general timelines include: 

Mild: Minor strains and episodes of stiffness often improve within 1-3 weeks. 

Moderate: More significant injuries may require 4-8 weeks of treatment and rehabilitation. 

Severe: Disc injuries, persistent nerve irritation, or chronic conditions may require 2-6 months or longer for optimal recovery. 

Factors such as age, activity level, overall health, and adherence to rehabilitation recommendations can influence recovery time. 

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Common Mistakes That Can Slow Recovery

Some common mistakes can make low back pain more difficult to manage:

  • Staying in bed or avoiding movement for too long

  • Completely stopping exercise because of fear of causing damage

  • Returning to heavy lifting too quickly

  • Repeatedly aggravating the back without modifying activity

  • Relying only on passive treatment without rebuilding strength and movement

  • Trying to find one “perfect posture”

  • Assuming that every painful movement is damaging the spine

  • Ignoring persistent leg weakness, numbness, or other neurological symptoms

A gradual return to movement and activity is usually more helpful than either complete rest or trying to push through significant symptoms.

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When To Seek An Assessment 

Consider seeking an assessment if: 

  • Pain has lasted longer than 1-2 weeks  

  • Symptoms are limiting work, exercise, or daily activities  

  • Pain repeatedly returns  

  • Pain is spreading into the leg  

  • You are unsure how to safely return to activity  

  • Home management strategies are not helping  

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Why an Accurate Diagnosis Matters 

Lower back pain can arise from many different structures, including muscles, joints, discs, nerves, ligaments, and surrounding soft tissues. Because different conditions often produce similar symptoms, identifying the underlying source of your pain is an important first step toward effective treatment. A thorough assessment helps determine the factors contributing to your symptoms and guides an individualized treatment plan designed to help you return to work, sport, and the activities you enjoy. 

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When Should I worry?  

Seek urgent medical attention or call 911 if you experience:

  • Loss of bowel or bladder control  

  • Significant weakness in the legs  

  • Numbness in the groin, genitals, or inner thigh 

  • Significant tingling, numbness, or weakness that affects BOTH legs 

  • Severe trauma  

  • Unexplained weight loss or fever accompanying back pain  

 These symptoms may indicate a more serious condition requiring urgent medical evaluation. 

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Summary 

Lower back pain often responds well to conservative treatment. 

✔ Stay active within your comfort level. 

✔ Avoid prolonged bed rest. 

✔ Begin rehabilitation exercises early when appropriate. 

✔ Seek an assessment if symptoms persist, worsen, or spread into the leg. 

✔ Seek immediate medical attention if you experience bowel or bladder changes, numbness in the saddle region, or significant leg weakness. 

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Ready to Get Back to Moving Comfortably?

If your low back pain isn't improving, keeps returning, or is preventing you from doing the activities you enjoy, an assessment can help identify the underlying cause and determine the most appropriate treatment plan.

Dr. Michael Hoiles is a Calgary chiropractor who provides evidence-informed care combining hands-on treatment, exercise-based rehabilitation, and practical advice to help people recover from injury, move better, and stay active.

Book an appointment today to start your recovery and get back to doing what you enjoy.

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Related Lower Back Conditions

Low back pain is a symptom rather than a diagnosis. Some of the most common conditions that cause lower back pain include:

  • Disc Injuries — often painful with bending and prolonged sitting.

  • Sciatica — nerve irritation causing leg pain, numbness or tingling.

  • Facet Joint Pain — commonly worse with standing, twisting or extension.

  • SI Joint Pain — pain around the pelvis and buttock that can mimic back pain.

  • Hip Pain — hip conditions can sometimes refer pain into the lower back.

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