Lower back pain: herniated disc, sciatica, red flags and which doctor to see
Low back pain is one of the most common reasons to see a doctor, and in most cases it settles within a few weeks. If the pain is severe, radiates to a leg or keeps coming back, see a neurologist.
Common causes
- Muscle strain after exertion or an awkward position
- Age-related changes of the spine (disc wear, locally called “osteochondrosis”)
- Herniated and bulging discs
- Long hours of sitting and weak back muscles
- Kidney problems — they can be felt as low back pain
When to seek urgent help
Do not wait for a scheduled visit if you have any of these signs:
- Pain with numbness in the groin area and urination problems — urgent, call 103
- Leg weakness, a foot that slaps when walking
- Pain after a fall or injury
- Pain with fever but no signs of a cold
- Night pain that does not depend on position and keeps growing
Ambulance: 103 (103 from a mobile) · Unified rescue service: 911
Your specialist
Neurologist
What to bring to the visit
- A description: when the pain started, where it radiates, what makes it worse
- MRI, CT or X-ray images, if you have had them
- A list of medicines you take
- Comfortable clothes for the examination
Frequently asked questions
My report says “osteochondrosis”: what does that mean?
In Armenia and other post-Soviet countries this word is used for age-related wear of the spine — of the discs and small joints; English-language reports usually call it degenerative disc disease or spondylosis. It is often linked to pain and stiffness in the lower back or neck after exertion or long sitting and, if a nerve root is pinched, to shooting pain, numbness or tingling in a leg or arm. But such changes also show up on scans of many people who have no pain, so a neurologist decides at the examination whether they explain yours.
Herniated disc: when is it an emergency?
Call 103 if back pain comes with numbness in the groin area or inner thighs, difficulty passing urine, or loss of control over urine or stool: these are signs of nerve compression that needs urgent help. If a leg is quickly getting weaker or your foot starts to slap when you walk, do not wait for a scheduled visit — see a doctor urgently. Without these signs a neurologist looks after a disc herniation and, if surgery is needed, refers you to a neurosurgeon.
Pain spreading from the lower back down the leg (sciatica): what is it?
Pain that shoots from the lower back into the buttock and leg, sometimes with numbness or tingling, usually means an irritated nerve root (radiculopathy); when it runs along the sciatic nerve, it is called sciatica. The most common cause is a herniated disc. See a neurologist; a weakening leg needs urgent care, and numbness in the groin area or trouble with urination means calling 103.
Neurologist, orthopedist or spine specialist: who should I see?
For shooting pain, numbness or pain spreading to a leg, see a neurologist; for joint problems, an orthopedist — and after a fall or injury, an orthopedist urgently. A “spine specialist” (vertebrologist) is usually a neurologist or orthopedist who focuses on the spine, so look among them. Choosing “wrong” is fine: the doctors will refer you.
Do I need an MRI right away?
Usually not: in the first weeks the doctor relies on the examination. An MRI is ordered when there are warning signs or the pain does not settle in 4–6 weeks.
Back and abdominal pain at the same time: could it be the kidneys?
It can be: kidney stones and kidney or urinary tract infections cause pain in the side of the lower back that may spread to the abdomen or groin, often with fever, pain when urinating or blood in the urine. Start with a general practitioner or a urologist; in women the cause can also be gynecological. For very severe pain, or pain with high fever, chills or vomiting, call 103.
More in “Back and joints”
- Neck pain
Neurologist
- Knee pain
Orthopedist
- Numbness in the hands
Neurologist
The information on this page is for reference only and does not replace a doctor's consultation. Only a doctor can make a diagnosis in person. If your condition worsens, call 103.