Low back pain affects most adults at some point in their lives, and it's one of the leading reasons people visit a doctor or miss work. The good news: the vast majority of low back pain is mechanical in nature, meaning it comes from the muscles, joints, discs, or ligaments of the spine rather than a serious underlying disease — and it typically improves with the right care. Still, it's worth knowing what's causing your pain, which symptoms mean you should seek care right away, and when a chiropractor is the right provider to see.
What Usually Causes Low Back Pain
Most low back pain falls into a handful of common categories:
Muscle or ligament strain. Lifting something awkwardly, sudden movements, or simply overdoing it during exercise or yardwork can strain the soft tissue supporting the spine. This is the most common cause of low back pain and often the quickest to resolve with proper care.
Disc issues. The discs between your vertebrae can bulge or herniate, sometimes irritating a nearby nerve. This can cause pain that radiates into the buttock or leg (often called sciatica), along with numbness or tingling. See our page on disc herniation for more.
Joint dysfunction and arthritis. The small joints in the spine (facet joints) can become irritated or develop arthritic changes over time, leading to stiffness and localized pain that's often worse with certain movements or after periods of inactivity.
Degenerative changes. As we age, discs lose hydration and height, and the spine adapts. This is a normal part of aging and doesn't always cause pain, but it can contribute to episodes of low back discomfort or stiffness.
Poor posture and prolonged sitting. Desk jobs, driving, and screen time add up. Sustained poor positioning weakens supporting muscles and increases stress on the low back over time.
Spinal stenosis. A narrowing of the spinal canal, more common with age, can put pressure on nerves and cause pain, numbness, or weakness — often worse with walking or standing and relieved by sitting or bending forward.
Red Flags: When Low Back Pain Needs Urgent Medical Attention
While most low back pain is manageable and not dangerous, a small percentage of cases point to something more serious. These are the warning signs — often called "red flags" — that mean you should seek emergency or urgent medical care rather than starting with conservative treatment:
- Loss of bladder or bowel control, or numbness in the groin or inner thighs ("saddle numbness"). These can be signs of cauda equina syndrome, a surgical emergency.
- Progressive weakness in the legs, especially if it's affecting both legs or getting worse quickly.
- Severe pain following significant trauma, such as a fall or car accident, which could indicate a fracture.
- Unexplained weight loss combined with back pain, particularly in someone with a history of cancer.
- Fever, chills, or back pain that came on after a recent infection, surgery, or IV drug use, which could suggest a spinal infection.
- Back pain in someone with osteoporosis or long-term steroid use, which raises the risk of a compression fracture.
- Pain that is constant, worsens at night, and isn't relieved by rest or position changes.
- New back pain in someone under 20 or over 50 with no clear mechanical cause, especially alongside any of the signs above.
If any of these apply to you, don't wait — seek care from an emergency room or your primary care physician right away. These situations require medical evaluation and are not appropriate for chiropractic care as a first step.
When It's Time to See a Chiropractor
If your low back pain doesn't involve any of the red flags above, chiropractic care is often an excellent first step. You may be a good candidate for chiropractic evaluation if:
- Your pain developed gradually or after a specific activity, movement, or minor injury
- You have stiffness, muscle tightness, or pain that's worse with certain movements or positions
- You're dealing with recurring "flare-ups" of low back pain over months or years
- You have sciatica-type symptoms (pain, tingling, or numbness running down the leg) without progressive weakness or loss of bladder/bowel control
- Your pain is limiting your ability to work, exercise, sleep, or enjoy daily activities, and you'd like a hands-on, non-surgical, drug-free approach
At your first visit, a thorough history and exam (including orthopedic and neurological testing) helps confirm that chiropractic care is appropriate and rules out red flags before any treatment begins. From there, care may include spinal adjustments, soft tissue work, targeted exercises, and guidance on posture and movement to address both the pain and what's causing it. If a disc is involved, flexion distraction is often part of the plan. You can also read more about how we approach low back pain at our Lyell Ave office.
The Bottom Line
Low back pain is common, and most of the time it's a mechanical problem that responds well to conservative care. Knowing the difference between "this needs a chiropractor" and "this needs an ER" can save you time, worry, and, in rare cases, prevent a serious problem from being missed.
If you're dealing with low back pain and aren't sure what's causing it, Oak & Olive Chiropractic in Rochester is here to help. We'll start with a thorough evaluation to understand what's going on and build a plan that fits your specific situation.
Ready to get to the bottom of your back pain? Schedule an appointment with Oak & Olive Chiropractic today.
This article is for educational purposes and isn't a substitute for personalized medical advice. If you're experiencing any of the red flag symptoms above, seek immediate medical attention.