Lower back pain is the most common musculoskeletal complaint in Lagos — and most of it is mechanical and gets better. But some back pain has a serious cause that needs urgent investigation. This guide helps you tell the difference.
90% of lower back pain is mechanical — from muscles, joints, or discs. The remaining 10% has a cause that needs specific treatment. Red flag features identify which category you are in.
The most common cause — sudden or gradual onset, worse with movement, better with rest. Usually resolves in 2–6 weeks with NSAIDs and activity.
Disc material pressing on a nerve root — back pain radiating down one leg (sciatica), often with tingling or weakness in the foot. An MRI confirms.
Age-related wear of the lumbar vertebrae — stiffness, morning pain, chronic ache. X-ray or MRI confirms. Common over age 45.
Back pain at the flank (kidney area) + fever + urinary symptoms — this is not musculoskeletal. Urine culture confirms.
Sudden severe one-sided flank pain radiating to the groin — "loin-to-groin" pattern. Blood in urine. Kidney ultrasound confirms.
Back pain in a known cancer patient, or in an older adult after minimal trauma — must exclude metastatic disease or compression fracture. Requires urgent imaging.
Urine Dipstick + Culture — First: exclude kidney infection or stone as the cause — takes 5 minutes.
X-Ray Lumbar Spine — Identifies spondylosis, compression fracture, or significant structural abnormality.
MRI Lumbar Spine — Gold standard for disc prolapse, nerve compression, and soft tissue causes — required for sciatica or red flag features.
Kidney Ultrasound — For flank pain with blood in urine — identifies stones, hydronephrosis, kidney infection.
Full Blood Count + ESR + CRP — If infection or malignancy is suspected — elevated inflammatory markers guide urgency.
Bed rest worsens mechanical back pain. Continue gentle activity. NSAIDs (ibuprofen or diclofenac) with food, for 3–5 days. Heat application helps muscle spasm.
If any red flag is present — come in the same day. Do not manage at home.
Sciatica (pain radiating below the knee) suggests nerve involvement. A clinical examination and possibly MRI is required.
This is probably not a back muscle — it may be a kidney infection. A urine test is needed urgently.
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