AI explains what your pain pattern means for you. A physician attests the right next step — PT, imaging, or specialist — so you go in informed, not guessing.
Educational triage — not a diagnosis. Free, no login.
Four questions. Under a minute. Tells you whether to rest, see a doctor, or see a specialist.
Most back pain is not surgical. Knowing which path fits your situation saves time, money, and worry.
Key conditions and treatment paths — so you walk in informed.
Pain radiating from the low back down one leg is caused by disc herniation pressing on a nerve root. L5–S1 disc herniation causes pain down the back of the leg into the heel. Approximately 90% of sciatica patients recover without surgery within 3 months. Surgery (microdiscectomy) provides faster leg pain relief but does not improve 1–2 year outcomes compared to conservative care. (SPORT Trials, NEJM)
Ask Sage →Narrowing of the spinal canal that compresses nerve roots. Classic presentation: leg pain, cramping, or weakness that worsens with standing and walking and relieves with sitting or forward bending. People often describe relief when pushing a shopping cart. Most patients manage well without surgery. Physical therapy with flexion-based exercises and epidural steroid injections are first-line. (SPORT Trials; AAOS Stenosis Guideline)
Ask Sage →Nonspecific low back pain — where no specific structural cause is identified — accounts for 90–95% of back pain seen in primary care. Most acute cases resolve within 4–6 weeks with rest, heat, NSAIDs, and continued activity. Bed rest delays recovery. Heat applied to the low back is the most evidence-supported physical modality for acute LBP. (ACP 2017; StatPearls NBK538173)
Ask Sage →Chronic low back pain (>3 months) affects 23% of adults worldwide and is the leading cause of disability globally. Exercise therapy and cognitive behavioral therapy are evidence-based first-line treatments. TENS units, passive modalities, and long-term opioids are not recommended. Pain does not equal damage — a sensitized nervous system drives most chronic LBP. (WHO GBD; ACP 2017)
Ask Sage →PT (6–12 sessions) combining individual exercise, manual therapy, and pain neuroscience education is as effective as surgery for most disc herniation and stenosis patients at 1–2 years. McKenzie extension exercises help when pain centralizes with extension. Flexion-based exercises (pelvic tilts, knee hugs) help stenosis. Core stabilization (plank, bird-dog, dead bug) reduces chronic LBP. A PT should identify your directional preference first. (APTA 2021)
Learn more →Surgery helps a minority of back pain patients — but helps dramatically when appropriate. Microdiscectomy for sciatica with persistent neurological deficit after 6 weeks. Decompression laminectomy for stenosis causing disabling neurogenic claudication. Spinal fusion for structural instability or progressive deformity — NOT for nonspecific back pain. Failed back surgery syndrome occurs in 10–40% of fusions for nonspecific pain. (SPORT Trials; Cochrane Spinal Fusion Review 2021)
Learn more →The same treatment works very differently depending on whether your pain is new, lingering, or has been there for months. Evidence-based first-line treatment shifts significantly across the three phases.
Less than 6 weeks
About 90% of acute back pain resolves within 4–6 weeks without specific treatment.
Rest is not the answer — gentle movement is.
Evidence-based first-line treatment
Bed rest delays recovery. Staying active within tolerable limits — walking, light stretching, normal daily activities — produces better outcomes than rest. Patient education that emphasizes continued movement is the single most important first-line intervention. (ACP 2017)
Applied to the low back for 15–20 minutes, 3–4 times daily, heat is the most evidence-supported physical modality for acute low back pain. More effective than ice for muscle-dominant acute pain.
Ibuprofen (400–600mg with food, up to 3 times daily) or naproxen provide moderate pain relief. Acetaminophen is an alternative for those who cannot take NSAIDs. Use the lowest effective dose for the shortest time needed.
Not recommended for this phase
ACP Low Back Pain Guideline 2017; StatPearls NBK538173
Take the assessmentThis educational guide does not replace clinical evaluation. Pain with neurological deficits, fever, trauma, or bowel/bladder changes requires prompt medical attention.
See a healthcare provider or go to urgent care if you have any of these.
Back pain after a fall or injury
Pain radiating down the leg with numbness
Weakness in the legs or difficulty walking
Bladder or bowel control problems
Back pain with fever or unexplained weight loss
Night pain that wakes you from sleep
Progressive worsening despite rest
Back pain in a child or teenager
Real questions patients ask about back pain. Answers reviewed by Josh Emdur, DO, board-certified internal medicine physician.
This information is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare provider for diagnosis and treatment.
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