Lower Back Pain Treatment in Delhi, India

Lower back pain refers to discomfort, stiffness, or aching that occurs in the lumbar region — the area between the bottom of the rib cage and the top of the buttocks. It can be acute (lasting a few days to weeks), subacute (lasting up to 12 weeks), or chronic (persisting for more than three months). Pain can range from mild to debilitating and may radiate to the hips, thighs, or legs depending on the cause. In most instances, the pain is "non-specific," meaning it is not caused by any identifiable or serious underlying disease.

Lower back pain can be broadly classified based on its duration and the cause.

Based on Duration

• Acute Pain – Lasts less than 6 weeks, often due to sudden strain, injury, or minor muscle sprain.
• Chronic Pain – Persists for more than 3 months, frequently associated with degenerative changes or underlying medical conditions.

Based on the Cause

• Mechanical Lower Back Pain: This is the most prevalent type of back pain, typically related to problems with the spine's joints, discs, or soft tissues. It often worsens with movement or specific positions and usually improves with rest.
• Radicular Pain (Sciatica): This pain occurs when a nerve root in the spine is irritated or compressed. It often radiates from the lower back down one or both legs, sometimes accompanied by a burning, tingling, or "pins and needles" sensation. This is often caused by a herniated or slipped disc.
• Inflammatory Back Pain: This is a less common type of chronic pain caused by an underlying inflammatory condition, such as a form of arthritis. The pain may be worse in the morning or after prolonged rest and can improve with activity.

Lower back pain can develop due to a variety of reasons. In many cases, it is linked to issues with the spine's structure or the surrounding soft tissues.

• Muscle or Ligament Strain: This is the most common cause of back pain. It can result from a sudden, awkward movement, heavy lifting, or poor posture, which can overstretch or tear the muscles and ligaments that support the spine.
• Disc Problems: The discs between the vertebrae can cause pain when they are damaged. A herniated or "slipped" disc occurs when the disc's inner material bulges out and presses on nearby nerves. Over time, discs can also lose water content and wear down, a process known as degenerative disc disease, which can lead to chronic pain.
• Spinal Stenosis: This condition is a narrowing of the spinal canal, the space that contains the spinal cord and nerves. This narrowing can put pressure on the nerves, causing pain, weakness, or numbness in the back and legs.
• Arthritis: Osteoarthritis, a common "wear-and-tear" type of arthritis, can affect the joints in the spine, leading to stiffness, pain, and reduced mobility.
• Structural Issues: Conditions that alter the spine's natural shape, such as scoliosis (an abnormal curvature of the spine), can create uneven pressure and cause chronic discomfort.
• Injury or Trauma: Accidents, falls, or fractures can cause direct damage to the spinal structures, leading to immediate and sometimes severe back pain.
• Other Conditions: In some cases, lower back pain can be a symptom of an underlying medical condition not directly related to the spine. These can include kidney issues, infections, or, in rare cases, gynaecological problems or tumours. This is why a proper medical evaluation is crucial to ensure an accurate diagnosis.

While lower back pain can affect anyone, certain factors can increase a person's chances of developing it. These are often related to a person’s physical condition, daily habits, or lifestyle.

• Age: As people grow older, the natural wear and tear on the body can affect the spine. The discs between the vertebrae can lose their fluid content and flexibility, which increases the risk of pain.
• Sedentary Lifestyle: A lack of regular physical activity and a weak core can make a person more susceptible to back pain. Strong core muscles—those in the abdomen and lower back—are essential for providing stability and support to the spine.
• Excess Weight: Carrying extra weight, especially in the midsection, places significant and continuous stress on the muscles, discs, and joints of the lower back. This added strain can lead to pain and injury.
• Occupation: Certain jobs or daily activities that involve frequent heavy lifting, pushing, or pulling can put a person at higher risk. Similarly, jobs that require prolonged sitting at a desk or repetitive twisting motions can also contribute to back problems.
• Smoking: Smoking is a known risk factor for back pain. It can reduce blood flow to the discs in the spine, which can lead to a faster rate of degeneration and delay the healing process if an injury occurs.

The symptoms can vary widely in type and severity. They may be acute and short-lived or chronic and persistent.

• A dull or aching pain localised to the lower back area.
• Sharp, shooting pain that radiates down the back of the leg
• Muscle spasms or stiffness, making it difficult to stand up straight.
• Limited flexibility or range of motion in the back.
• Pain that worsens with sitting, standing, or bending and improves when lying down.

It is important to seek urgent medical attention if back pain is accompanied by any of the following "red flag" symptoms:

• Loss of bladder or bowel control.
• Numbness or weakness in one or both legs.
• Pain that is severe, constant, and not relieved by rest.
• Fever, chills, or unexplained weight loss.

A precise diagnosis is the foundation of effective treatment. At Max Hospitals, our doctors use a combination of physical examinations, medical history assessment, and advanced imaging to pinpoint the cause of the pain.

Physical Examination and Medical History Review

During the physical examination, the doctor assesses a person’s mobility and range of motion. They observe how a person sits, stands, walks, and lifts their legs to check for any limitations or signs of discomfort. The doctor also checks for muscle strength and reflexes to determine if there is any nerve involvement.

The medical history review portion is equally important. The doctor may ask a series of questions to understand the specific characteristics of the pain. These questions may include:

• When did the pain begin? Was it a sudden onset or did it develop gradually?
• What does the pain feel like? Is it a sharp, stabbing pain, a dull ache, or a burning sensation?
• Where is the pain located? Does it stay in one spot or does it radiate to the buttocks or legs?
• What makes the pain better or worse? Does it improve with rest or does it worsen with certain activities or positions?
• Have there been any past injuries or medical conditions that might be related?
• Are there any other symptoms, such as numbness, tingling, or weakness in the legs?

This detailed information helps doctors understand the likely cause of the pain, rule out more serious conditions, and create a personalised treatment plan.

Imaging Studies

In cases where a more serious cause is suspected, imaging studies may be recommended.

• X-ray – Shows bone alignment, structural changes, and rules out fractures.
• MRI (Magnetic Resonance Imaging) – Provides detailed images of soft tissues such as discs, nerves, and ligaments, useful for detecting herniated discs or spinal stenosis.
• CT Scan (Computed Tomography) – Offers cross-sectional views of bones and soft tissues, often used when an MRI is not suitable.

Laboratory Tests

If an infection, inflammatory disorder, or another systemic condition is suspected, blood tests and urine tests may be carried out. For example, elevated inflammatory markers can point towards arthritis, while kidney-related issues can sometimes mimic back pain.

Diagnostic Injections

In selected cases, doctors may use nerve blocks or facet joint injections not only as a treatment but also as a diagnostic tool. If pain relief follows the injection, it helps confirm the exact structure causing the discomfort.

The treatment for lower back pain depends on several factors, including its cause, severity, and whether it's acute or chronic. Our approach at Max Hospitals is to provide a personalised treatment plan that is most appropriate for a person's individual needs.

Non-Surgical Treatment

In many cases, lower back pain can be managed effectively without surgery.

Medication: For short-term pain relief, doctors may recommend over-the-counter anti-inflammatory medicines. For more severe pain, a doctor may prescribe stronger painkillers or muscle relaxants to alleviate discomfort and spasms.

Rest and Light Activity: While a day or two of rest can help with initial, acute pain, prolonged bed rest is generally not recommended. It can lead to muscle stiffness and actually delay recovery. Instead, gentle activity and movement, such as walking, can help reduce pain and improve flexibility.

Physical Therapy: This is one of the most effective treatment options for many types of back pain. A physiotherapist can teach specific exercises and stretches to strengthen the core muscles, improve flexibility, and correct posture. The physiotherapist also uses various modalities such as cold or hot compresses, therapeutic equipment, and manual therapy as required. This helps to reduce pain, improve mobility, and prevent future recurrences.

Lifestyle Modifications: Adjusting daily habits can make a significant difference. This includes maintaining a healthy weight to reduce stress on the spine, quitting smoking to improve blood flow to the discs, and practising proper lifting techniques.

Advanced Procedures and Surgery

For persistent or severe pain that does not respond to non-surgical methods, more advanced interventions may be considered.

Injections: Procedures such as epidural steroid injections can be used to deliver powerful anti-inflammatory medication directly to the area around the affected nerves. This can provide significant relief from pain and inflammation.

Surgical Intervention: Surgery is typically a last resort and is only considered for specific conditions, such as a major herniated disc, spinal stenosis, or spinal instability, when other treatments have failed. Our surgeons use advanced, minimally invasive techniques to ensure a faster recovery and less discomfort for the patient.

While most cases of lower back pain improve with conservative care, untreated or severe pain can sometimes lead to complications. These may affect mobility, daily activities, and overall quality of life. Common complications include:

• Chronic Pain: Acute pain that is not properly managed can progress to long-lasting discomfort, significantly reducing activity levels.
• Reduced Mobility: Persistent stiffness and pain may limit movement, making it difficult to perform routine tasks or maintain an active lifestyle.
• Nerve Damage: Conditions such as herniated discs or spinal stenosis can compress nerves, leading to numbness, tingling, or weakness in the legs.
• Bladder or Bowel Dysfunction: Severe nerve compression (such as in cauda equina syndrome) can cause loss of bladder or bowel control, requiring urgent medical intervention.
• Emotional and Mental Health Impact: Ongoing pain may lead to stress, anxiety, depression, and sleep disturbances.
• Decreased Quality of Life: Inability to work, reduced independence, and limitations in daily activities can affect both physical and emotional well-being.
• Sciatica: This complication occurs when the pain from the back travels down the large sciatic nerve into the leg. Sciatica can cause sharp, shooting pain, numbness, and tingling, and in some cases, can make it difficult to walk or stand.
• Cauda Equina Syndrome: This is a rare but very serious complication. It occurs when a sudden, severe compression of the bundle of nerves at the end of the spinal cord (the cauda equina) happens. This is a medical emergency and can lead to a loss of sensation in the groin and inner thighs, as well as a loss of bladder and bowel control. Immediate medical attention is required to prevent permanent paralysis.

Although back pain may not be entirely avoidable, many cases can be reduced or prevented with healthy lifestyle choices.

• Maintain a Healthy Weight: This reduces the strain on the spine and its supporting structures.
• Practise Good Posture: Be mindful of posture, whether sitting, standing, or lifting. Use ergonomic chairs and sit with the back straight and feet flat on the floor.
• Strengthen Core Muscles: Regular exercises that strengthen the abdominal and back muscles provide better support for the spine.
• Lift Safely: When lifting heavy objects, bend at the knees and hips and use the leg muscles, keeping the back straight.

Can back pain go away on its own?

Yes, most cases of acute lower back pain resolve on their own within a few days to a few weeks. Staying active with gentle movement and using simple pain relief can help.

What is the difference between acute and chronic back pain?

Acute pain is sudden and short-lived, usually lasting less than six weeks. Chronic pain is persistent and continues for more than 12 weeks, even after the initial injury or cause has healed.

Should I continue working out if my lower back hurts?

In most cases, yes. While a few days of rest may be helpful, prolonged bed rest is often counterproductive. Gentle exercises like walking, swimming, or specific stretches recommended by a physiotherapist can help relieve pain and improve mobility.

Can stress or anxiety cause lower back pain?

Mental and emotional stress can contribute to back pain. Stress can cause muscles to tense up, leading to stiffness and discomfort. It can also make a person more sensitive to pain.

When should I see a doctor?

A person should see a doctor if the pain is severe, does not improve with self-care, radiates down the leg, or is accompanied by other concerning symptoms like fever, numbness, or loss of bladder/bowel control.

Reviewed by Dr. Tarun Lala (PT), Head - Zonal Head South Zone, Head - Neurorehab, Physiotherapy and Rehab Services, Rehabilitation Medicine, on 19 September 2025.