The symptom region is a starting point, not a diagnosis.
Back, spine & sacroiliac conditions
Chronic / Low Back Pain
Chronic / Low Back Pain can reflect several different structures and mechanisms. The location and quality of symptoms help organize the evaluation, but they do not establish one diagnosis or treatment path.
Quick orientation
What to know first
History and examination determine which anatomy and tests matter.
Urgent, neurologic, infectious, vascular, traumatic, and systemic causes stay visible until reasonably excluded.
How we figure out what is causing the pain
Clarify the diagnosis first
Broad pain patterns can have more than one source. The next step is to narrow the diagnosis before choosing a procedure.
Clarify first
These diagnosis guides help narrow the cause of pain. They are not treatment steps.
Diagnosis guide
Degenerative Disc Disease
Clinically relevant disc degeneration, symptom attribution limits, evaluation, and treatment pathways.
Diagnosis guide
Lumbar Spondylosis
Degenerative lumbar-spine changes when clinically relevant to symptoms and care.
Diagnosis guide
Lumbar Facet Joint Pain
Region-specific lumbar facet-mediated pain, diagnostic medial branch block considerations, and possible RFA pathway.
Diagnosis guide
Lumbar Spinal Stenosis
Lumbar canal narrowing, neurogenic claudication, leg symptoms, and walking or standing intolerance.
Choose the guide that matches your question
Explore the specific guides.
Use these links to learn about related symptoms, conditions, and treatments. An individual evaluation is still needed to determine a diagnosis or whether a treatment may be appropriate.
Clinical guide
Degenerative Disc Disease
Clinically relevant disc degeneration, symptom attribution limits, evaluation, and treatment pathways.
Open this guideClinical guide
Lumbar Spondylosis
Degenerative lumbar-spine changes when clinically relevant to symptoms and care.
Open this guideClinical guide
Lumbar Facet Joint Pain
Region-specific lumbar facet-mediated pain, diagnostic medial branch block considerations, and possible RFA pathway.
Open this guideClinical guide
Lumbar Spinal Stenosis
Lumbar canal narrowing, neurogenic claudication, leg symptoms, and walking or standing intolerance.
Open this guideClinical guide
Lumbar Radiculopathy / Sciatica
Lumbar nerve-root pain and neurologic symptoms radiating into the leg.
Open this guideClinical guide
Herniated Disc
Disc herniation, regional symptoms, neurologic warning signs, and relevant evaluation and treatment pathways.
Open this guideClinical guide
Sacroiliac Joint Pain
Sacroiliac-joint pain patterns, evaluation, differential diagnosis, and treatment pathways.
Open this guideClinical guide
Persistent Post-Surgical Spine Pain
Persistent or recurrent pain after spine surgery, cause-oriented reassessment, and treatment pathways.
Open this guideClinical guide
Coccydynia
Tailbone pain, common causes, evaluation, conservative care, and appropriate interventional pathways.
Open this guideSymptoms are clues, not a diagnosis
What the pattern can feel like
Symptoms help define a syndrome, but they do not confirm which structure is responsible. Distribution, timing, aggravating factors, neurologic findings, function, and important alternatives all shape the evaluation.
Location, radiation, timing, quality, sensory change, weakness, stiffness, swelling, activity, position, sleep, and function help define the pattern.
Similar symptoms may arise from a joint, tendon, muscle, spine, peripheral nerve, circulation, or systemic condition.
Imaging and test abnormalities require clinical correlation and may not identify the symptom source.
Relevant anatomy
Anatomy and pain mechanisms
The region includes joints, muscles, tendons, nerves, blood vessels, and possible referral pathways. Their symptom territories overlap, so the examination and selective testing must answer a defined clinical question.
History and examination first
How the diagnosis is evaluated
Evaluation begins with the patient question, safety screen, history, and focused examination. Testing is selected only when it can clarify a competing diagnosis, guide treatment, or change referral urgency.
Keep the differential open
What else can look similar
Keep common and serious alternatives open until the evidence supports a narrower conclusion.
Local joint, tendon, muscle, ligament, bursa, bone, or soft-tissue disorders
Spinal referral, nerve-root, plexus, or peripheral-nerve disorders
Traumatic, infectious, inflammatory, vascular, metabolic, medication-related, or oncologic causes
Core care
Conservative and coordinated care
Procedure discussions belong inside a broader plan that protects neurologic function and daily activity.
Education, pacing, sleep and activity strategies matched to the diagnosis
Rehabilitation focused on mobility, strength, tolerance, and function when safe
Medication and comorbidity review with the appropriate clinician
Reassessment when symptoms, neurologic findings, function, or response changes
Evidence at a glance
Evidence at a glance
Evidence strength, comparator, follow-up, and selection affect interpretation.
Chronic low-back pain benefits from person-centered, biopsychosocial, non-surgical care matched to the clinical presentation.
A single imaging finding rarely explains the full experience of persistent low-back pain.
Procedures require a narrower working diagnosis and target than the broad symptom label.
Decision quality matters
Evidence, limits, and who it may fit
A listed option does not establish candidacy. Diagnosis, anatomy, prior care, risk, alternatives, goals, and evidence must align.
Referral and urgent signs
When urgent or different evaluation matters
These findings can change the timing or destination of care.
New loss of bowel or bladder control, saddle sensory loss, or rapidly progressive weakness
New problems with balance, hand dexterity, walking, or widespread numbness that may suggest spinal cord involvement
Fever, major trauma, cancer history, unexplained weight loss, severe night pain, or other concern for infection, fracture, vascular disease, or cancer
The visit
What to expect at an evaluation
The visit should narrow the diagnosis, identify safety and referral needs, review imaging and prior care in context, and choose the next useful decision. The clinician should explain uncertainty and what a treatment is expected to add before it is performed.
Define the location, timing, triggers, sensory features, functional effect, prior injury, and prior care
Examine the relevant joint, spine, muscles, nerves, circulation, gait, strength, sensation, and reflexes as appropriate
Use imaging, electrodiagnostic testing, laboratory work, or referral only when it answers a clinical question
Choose education, rehabilitation, medical care, further diagnostic work, a selected procedure discussion, or referral based on the working diagnosis
Common questions
Chronic / Low Back Pain FAQ
These answers are educational and cannot determine an individual diagnosis or treatment plan.
For Chronic / Low Back Pain, does the location alone establish the diagnosis?
No. Several tissues and referred pathways can produce pain in the same region.
Do I always need imaging for Chronic / Low Back Pain?
No. Testing is chosen when it can answer a clinical question or change care.
Why is a treatment guide listed with Chronic / Low Back Pain?
Related guides are educational and do not establish a diagnosis or treatment recommendation.
Diagnosis before procedure
Start with a careful evaluation
A focused evaluation can clarify the diagnosis, important alternatives, and the next step that fits the clinical picture.
