Pain in Lower Back on Both Sides of Spine: Key Causes

Pain in Lower Back on Both Sides of Spine? Here’s Why

Struggling With Chronic Pain?

Led by Kentucky’s leading interventional pain specialist, Dr. Ajith Nair, our team is here to help you find lasting, personalized relief.

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That constant, nagging ache can feel like it runs your life. When you’re dealing with pain in lower back on both sides of spine, even simple tasks become a huge challenge. It’s frustrating, and it can make you feel hopeless. But you don’t have to just “live with it.” Finding lasting relief starts with understanding exactly what’s causing your discomfort. For those of us seeking help for lower back pain in Louisville, KY, knowing the next steps is key. This guide will help you understand the potential causes and find a real path forward.

Just because back pain is a common condition doesn’t mean that you must tolerate this issue.

Many patients have tried multiple treatments without success. It can feel disheartening to visit with different doctors and still continue experiencing ongoing problems.

If you are ready for lasting relief, then pain management is a great option to consider. Through integrative treatments, we get to the root of your pain issues and help you feel better.

Understanding Pain in the Lower Back on Both Sides

If you’re experiencing lower back pain, you are far from alone. It’s one of the most common reasons people miss work or seek medical attention. The first step toward finding relief is understanding what you’re feeling and why. Lower back pain can show up in many different ways, from a persistent, dull ache to a sudden, sharp sensation that makes it difficult to move. Sometimes the pain is concentrated in one spot, but often it’s felt across the entire lower back, on both sides of the spine. This bilateral pain can be confusing and frustrating, but it often provides clues about its underlying cause. By paying close attention to your symptoms, you can give your doctor the information they need to create an effective treatment plan tailored just for you.

How Common is Lower Back Pain?

Lower back pain is incredibly common. In fact, research shows that about 80 out of every 100 adults will experience it at some point in their lives. This means that if you’re sitting in a room with four other people, chances are that four of you have dealt with back pain before. It’s a widespread issue that affects people of all ages and lifestyles, from office workers who sit for long hours to athletes who put their bodies through intense physical activity. The high prevalence of back pain highlights just how important it is to address the issue rather than trying to ignore it. Since it’s such a shared human experience, there has been extensive research and development in treatments designed to manage and alleviate the discomfort.

What Does This Pain Feel Like?

Lower back pain can feel different for everyone. For some, it’s a constant, dull ache that lingers in the background of their day. For others, it’s a sharp, stabbing pain that comes on suddenly with a specific movement. According to the Cleveland Clinic, the pain can be gradual or sudden, and you might also feel stiffness, have trouble standing up straight, or experience muscle spasms. Sometimes, the pain doesn’t stay in your back; it can travel down into your buttocks or leg, a condition commonly known as sciatica. Understanding the specific character of your pain—whether it’s burning, aching, or sharp—can help pinpoint the cause and guide you toward the most effective relief.

Associated Symptoms and Pain Patterns

Beyond the primary sensation of pain, you might notice other symptoms. Does the pain get worse after sitting for a long time or after physical activity? Does it feel better when you lie down or change positions? You might also experience numbness, tingling, or weakness in your legs, which can indicate that a nerve is being affected. The pattern of your pain is also a key piece of the puzzle. Is it worse in the morning and gets better as you move around, or does it build up throughout the day? Keeping a simple log of your symptoms and what makes them better or worse can be incredibly helpful when you discuss your condition with a pain management specialist.

Common Causes of Bilateral Lower Back Pain

When pain strikes on both sides of your lower back, it’s often related to the structures that support your spine. Your spine is a complex system of bones, discs, muscles, and ligaments, and when any part of that system is compromised, it can result in discomfort. The most frequent culprits are issues with the soft tissues, like muscle strains from lifting something heavy or twisting awkwardly. However, the pain can also stem from problems within the spine itself, such as degenerative disc disease or arthritis. In some cases, the pain you feel in your back isn’t coming from your back at all but is being referred from another organ. Identifying the root cause is the most critical step in finding a treatment that provides lasting relief rather than just masking the symptoms.

Muscle and Ligament Issues

The most common reason for lower back pain is a simple strain or sprain of the muscles and ligaments that support your spine. Think about all the work these soft tissues do every day—they help you bend, lift, and twist. It’s easy to overdo it, whether by lifting a heavy box with improper form, making a sudden awkward movement, or even sitting with poor posture for too long. This type of injury typically causes a localized ache or soreness across the lower back that might feel worse with movement. The good news is that muscle and ligament strains usually heal with rest, gentle stretching, and over-the-counter pain relievers. However, if the pain is severe or doesn’t improve after a week or two, it’s a good idea to get it checked out.

Spinal Disc Problems

Your spine is made up of vertebrae stacked on top of each other, with cushion-like discs in between. These discs act as shock absorbers, but over time, they can wear down. This process is known as degenerative disc disease, and it’s a natural part of aging. As discs lose their cushioning, the vertebrae can get closer together, which may lead to pain and stiffness. Sometimes, a disc can also bulge or herniate, meaning the soft center pushes out through the tougher exterior. If this material presses on a nerve root, it can cause significant pain, numbness, or weakness, often radiating down a leg. While it sounds serious, many people find relief through non-surgical treatments focused on reducing inflammation and pressure.

Arthritis and Joint Problems

Just like the joints in your knees or hands, the joints in your spine can develop arthritis. This inflammation of the joints can cause pain, stiffness, and a decreased range of motion, making everyday activities difficult. There are several types of arthritis that can affect the lower back, each with its own unique characteristics. The pain is often worse in the morning or after periods of inactivity. At Kentuckiana Pain Specialists, we see many patients whose joint pain is caused by different forms of arthritis. Understanding which type you have is key, as it allows us to target the inflammation and discomfort with specific procedures like injections or nerve blocks, helping you regain mobility and improve your quality of life.

Osteoarthritis (Facet Syndrome)

Osteoarthritis is the “wear and tear” type of arthritis, and when it affects the spine, it often targets the facet joints. These are small joints located between your vertebrae that help guide your spine’s movement. When the protective cartilage wears down, the bones can rub against each other, causing pain, stiffness, and inflammation. This condition is often called facet syndrome or spinal arthritis. The pain is typically a dull ache in the lower back that can spread to the buttocks and thighs. It often feels worse when you stand, twist, or bend backward. Treatments like lumbar facet joint injections can provide significant relief by reducing inflammation directly at the source.

Sacroiliac (SI) Joint Dysfunction

The sacroiliac (SI) joints connect your lower spine to your pelvis. They don’t move much, but they are critical for absorbing shock between your upper body and your legs. When these joints become inflamed or aren’t moving correctly, it can cause significant pain in the lower back and buttocks. While the pain is often on one side, it can occur on both. SI joint pain can be tricky to diagnose because it often mimics other conditions like sciatica or a herniated disc. If your pain is centered over your SI joints and gets worse with activities like climbing stairs or standing up from a seated position, this could be the cause. A sacroiliac joint injection can be used both to diagnose and treat this condition.

Ankylosing Spondylitis

Ankylosing spondylitis is a less common but more serious type of inflammatory arthritis that primarily affects the spine. Over time, the chronic inflammation can cause some of the vertebrae in your spine to fuse together. This fusing makes the spine less flexible and can result in a hunched posture. The pain and stiffness are usually most severe in the lower back and hips, especially in the morning or after being inactive. Unlike osteoarthritis, this condition often begins in early adulthood. Early diagnosis and treatment are crucial to manage symptoms and slow the progression of the disease. Treatment typically involves medication, physical therapy, and lifestyle adjustments to maintain flexibility and reduce pain.

Structural Spine Issues

Sometimes, lower back pain is caused by the actual structure of your spine changing in a way that puts pressure on your nerves or spinal cord. These are not issues with muscles or joints but with the bones and spaces within your spinal column. Conditions like spinal stenosis or spondylolisthesis can develop over time due to aging or can be present from birth. The symptoms often develop gradually and may include pain, numbness, or weakness in the back and legs. These structural problems require a careful diagnosis, often with imaging like an MRI or CT scan, to see exactly what is happening inside your spine. Based on the diagnosis, a pain specialist can recommend targeted treatments to relieve the pressure and manage the pain.

Spinal Stenosis

Spinal stenosis is a condition where the spinal canal, the hollow space that contains your spinal cord and nerves, begins to narrow. This narrowing can put pressure on the nerves traveling through the lower back into the legs. The most common cause is wear-and-tear changes in the spine related to osteoarthritis. Symptoms often include pain, cramping, or numbness in the lower back, buttocks, and legs. People with spinal stenosis often find that their symptoms worsen when they stand or walk and feel better when they lean forward or sit down, as this posture opens up the spinal canal and temporarily relieves the pressure. Treatments like epidural steroid injections can help reduce inflammation and pain.

Spondylolisthesis

Spondylolisthesis occurs when one of the vertebrae in your spine slips forward over the one below it. This misalignment can happen due to a defect in the bone, a fracture, or degeneration from arthritis. When the vertebra slips, it can narrow the spinal canal or press on nerve roots, causing lower back pain and often leg pain similar to sciatica. The pain might feel like a muscle strain that doesn’t go away and can be worse with activity, especially when bending backward. In many cases, this condition can be managed effectively with non-surgical treatments like physical therapy and targeted injections to strengthen the core muscles and reduce nerve irritation.

Referred Pain from Other Organs

It’s important to remember that not all lower back pain originates in the back. Sometimes, a problem with an internal organ can “refer” pain to your back. This happens because the nerves that serve the organs share pathways with the nerves in your back, and your brain can get the signals mixed up. This type of pain often feels deep and is hard to pinpoint. It usually isn’t affected by movement in the same way that musculoskeletal pain is. If your back pain is constant, not related to activity, and accompanied by other symptoms like fever, nausea, or changes in urination, it’s essential to consider that the cause might not be your spine.

Kidney Problems

Your kidneys are located on either side of your spine, just below your rib cage. Because of their location, problems like a kidney infection or kidney stones can cause a deep, severe ache in your flank, which is the area on your side between your ribs and your hip. This pain is often mistaken for back pain. However, kidney pain is usually felt higher and deeper than typical muscle pain and can be on one or both sides. It’s often accompanied by other symptoms such as fever, chills, nausea, or pain during urination. If you suspect your pain might be related to your kidneys, it’s crucial to see a doctor right away, as these conditions can be serious if left untreated.

Female-Specific Conditions

For women, certain gynecological conditions can cause lower back pain. Endometriosis, a condition where tissue similar to the lining of the uterus grows outside of it, can cause chronic pelvic pain that often radiates to the lower back. Uterine fibroids, which are noncancerous growths in the uterus, can also press on nerves and cause back pain, depending on their size and location. This type of pain often coincides with the menstrual cycle, becoming more intense before or during a period. If your back pain seems to follow a cyclical pattern and is accompanied by other gynecological symptoms, discussing it with both your primary care doctor and a gynecologist is a good idea to ensure you get a comprehensive diagnosis.

Are You at Risk for Lower Back Pain?

While anyone can experience lower back pain, certain factors can increase your likelihood of developing it. Some of these are within your control, while others, like age and genetics, are not. Your job, daily habits, and overall health all play a significant role. For example, a sedentary lifestyle can lead to weak core muscles, which provide less support for your spine, making you more susceptible to injury. On the other hand, a job that requires heavy lifting or repetitive twisting can also put you at risk. Understanding your personal risk factors is the first step toward prevention. By identifying areas where you might be vulnerable, you can make proactive changes to protect your back and reduce your chances of experiencing debilitating pain.

Lifestyle and Occupational Risk Factors

Your daily life and job can have a big impact on your back health. Jobs that involve a lot of physical labor, like construction or nursing, put constant strain on the back. But office jobs aren’t risk-free either; sitting for long periods, especially with poor posture, can weaken back muscles and put pressure on your spinal discs. Lifestyle choices matter, too. Being overweight or obese adds extra stress to your spine, and smoking can reduce blood flow to the lower spine, which can contribute to disc degeneration. The good news is that you can modify these risks by adopting healthier habits, such as taking regular breaks to stand and stretch, using ergonomic furniture, maintaining a healthy weight, and quitting smoking.

Physical and Health-Related Risk Factors

Beyond your lifestyle, certain physical and health factors can predispose you to back pain. Age is a big one; most lower back pain starts after age 30 as spinal discs begin to lose fluid and flexibility. Genetics can also play a part, as some conditions that cause back pain, like ankylosing spondylitis, can run in families. Your overall fitness level is another key factor. Weak core muscles—the muscles in your abdomen and back—can’t properly support your spine, leaving it vulnerable to strain. Additionally, pre-existing conditions like arthritis or scoliosis can directly contribute to back pain. While you can’t change your age or genes, you can focus on improving your physical fitness to build a stronger, more resilient back.

What to Do About Lower Back Pain

When lower back pain strikes, your first instinct might be to power through it, but that’s not always the best approach. The right course of action depends on the severity and duration of your pain. For minor aches and strains, some simple home care strategies can often provide relief within a few days. However, if the pain is severe, persistent, or accompanied by other concerning symptoms, it’s time to seek professional medical advice. Ignoring chronic pain can lead to worsening symptoms and a greater impact on your quality of life. A pain management specialist can offer a precise diagnosis and a range of advanced treatments and procedures that go beyond what you can do at home, helping you get back to living your life with less pain.

Initial Home Care Strategies

For mild to moderate back pain that has just started, you can often manage it at home. While it used to be common to recommend bed rest, we now know that staying active is usually better. Gentle movement, like walking and stretching, can help reduce stiffness and prevent muscles from weakening. Over-the-counter pain relievers like ibuprofen or naproxen can help reduce pain and inflammation. Applying heat with a heating pad can relax tight muscles, while an ice pack can help numb the area and reduce swelling, especially in the first 48 hours after an injury. Listen to your body—avoid activities that make the pain worse, but try to keep moving as much as you comfortably can.

When to Seek Medical Care

While home care is often effective for minor back pain, there are times when you absolutely need to see a doctor. If your pain doesn’t start to improve after a week or two of self-care, it’s time to make an appointment. You should also seek medical attention if the pain is severe, constant, or wakes you up at night. It’s important to distinguish between symptoms that require a doctor’s visit and those that signal a true medical emergency. Paying close attention to your body and knowing the warning signs can help you get the right level of care at the right time, preventing potential long-term complications and ensuring you get on the path to recovery as quickly as possible.

When to See a Doctor

You should schedule a visit with a doctor if your back pain lasts for more than a few weeks or if it’s severe and not improving. Other key signs that warrant a doctor’s visit include pain that spreads down one or both legs, especially if it goes below the knee. Numbness, tingling, or weakness in your legs are also red flags that a nerve might be compressed. If your back pain is the result of a specific injury, like a fall or car accident, it’s always best to get it checked out. When you’re ready to find a solution for your chronic back pain, a specialist can provide a thorough evaluation and discuss advanced treatment options.

When to Go to the Emergency Room

Some symptoms accompanying back pain are signs of a serious medical condition that requires immediate attention. Go to the emergency room if your back pain is accompanied by a fever, unexplained weight loss, or new problems with bladder or bowel control. The loss of bladder or bowel control, combined with numbness or weakness in your legs and saddle area (the parts of your body that would touch a saddle), could indicate a rare but serious condition called cauda equina syndrome. This condition involves severe compression of the nerves at the bottom of the spinal cord and requires urgent surgery to prevent permanent damage, such as paralysis.

Why Traditional Back Pain Treatments Don’t Work

One of the drawbacks to traditional medical treatments for low back pain is that many doctors are only focused on alleviating immediate discomfort. You can take medication to reduce the pain, but the results only last for a few hours.

When the pain is constant and severe, it often turns into a never-ending cycle of using medication. Eventually, you depend on prescriptions to get through the day. Unfortunately, certain pharmaceuticals (such as opioids) can result in addictions.

Other medical treatments might include surgery or invasive methods in an attempt to manage the pain. Sometimes, these treatments are effective for reducing pain. But it’s never guaranteed that you will feel better after the surgery is over.

If you are one of the many patients suffering from chronic lower back pain and you can’t find the answers you need, then it’s time for you to learn about our comprehensive pain management services.

Two-Part Holistic Approach for Pain Management

At Kentuckiana Pain Specialists, we provide personalized support to help you reclaim your life once again. Our treatment plans focus on two critical goals:

  1. Reduce Current Pain: You are in pain right now and desperate to find a solution that alleviates the issue. We offer immediate treatments to bring down the inflammation so you can experience relief as quickly as possible.
  2. Prevent Future Pain: Since we use an integrative approach, we always focus on solutions to help you avoid more pain in the future. Lifestyle changes and holistic treatments right now can help you enjoy a pain-free life in the future.

Talk to our staff to learn about available services for chronic lower back pain. We provide a hands-on approach to educate and support our patients in every aspect of their recovery.

Back Surgery vs. Pain Management Services

When lower back pain is unbearable, and other treatments aren’t working, then many orthopedic specialists recommend surgery as the final option to alleviate the pain. However, before you go under the knife, it’s wise to talk to other medical experts to learn about your options.

Whether you are experiencing continued pain after back surgery or you are trying to prevent surgery, pain management can help. Through this process, we address the root cause of your back pain using integrative treatments.

Pain management works with your lifestyle to help you achieve better function and movement. Many patients can avoid back surgery by using pain management treatments instead.

Full-Service Pain Management for Back Pain

Lower back pain happens because of spinal and musculoskeletal conditions. When pain management is used for these problems, the diagnosis and treatment serve a variety of purposes.

Here is an overview of how pain management can help with lower back pain:

  • Diagnosis: We start by identifying the source and cause of your pain. An accurate diagnosis is essential in determining the ideal treatments that will work for your condition.
  • Prevention: We focus on integrative treatments to prevent the need for invasive surgical procedures. By aggressively addressing the cause of your pain, we can help you experience relief without the need for surgery.
  • Rehabilitation: If you are having pain after an accident or surgery, then rehabilitative support is available from our pain management clinic. We focus on treatments that speed up healing to assist with your recovery.
  • Future: Our goal is to offer immediate relief and long-lasting solutions. When you are working with a pain management team, we support your healing to help you thrive in the years to come.

Our pain management treatments use a variety of techniques that address your pain. In addition, we are proactive about listening to your needs so you can return to full health once again.

Non-Surgical Medical Treatments

When you’re looking for relief from lower back pain, surgery can feel like the only option left on the table. But for many people, minimally invasive and non-surgical treatments offer a powerful path to recovery without the long downtime and risks of an operation. The goal of these procedures is to target the precise source of your pain, reduce inflammation, and help your body heal so you can get back to your life. At Kentuckiana Pain Specialists, we focus on these advanced techniques as a cornerstone of our care, creating personalized plans that prioritize your comfort and long-term well-being. These treatments are often performed right in our office, allowing you to find significant relief and return home the same day.

Injections for Pain Relief

Therapeutic injections are one of the most effective tools for managing lower back pain. They serve a dual purpose: not only do they deliver powerful, anti-inflammatory medication directly to the source of the pain, but they also act as a diagnostic tool. For example, a sacroiliac joint injection can help relieve pain and also help our doctors confirm if that joint is truly the problem. By pinpointing the exact location, we can create a more effective long-term treatment plan. Depending on your specific condition, we might recommend an epidural steroid injection to calm irritated nerves or a lumbar facet joint injection to address pain stemming from arthritis in the spine.

Advanced Procedures for Chronic Pain

For pain that is more persistent, we can turn to more advanced, yet still minimally invasive, procedures. If diagnostic injections confirm that a specific nerve is causing your pain, a procedure called radiofrequency ablation (RFA) can offer longer-lasting relief. RFA uses a gentle heat to disrupt the pain signals from that nerve for months or even years at a time. For more complex or widespread chronic pain, spinal cord stimulation (SCS) is another excellent option. Think of it like a pacemaker for pain—it uses mild electrical pulses to interrupt pain signals before they can reach your brain, replacing the feeling of pain with a gentle tingling sensation or, with newer technology, no sensation at all.

Prevention Strategies for Long-Term Health

Getting you out of pain right now is our top priority, but our work doesn’t stop there. True pain management is about giving you the tools to build a healthier, more resilient future. Since we use an integrative approach, we always focus on solutions to help you avoid more pain down the road. This means looking beyond a single procedure and creating a holistic plan that supports your entire well-being. We’ll work with you to identify lifestyle factors that may be contributing to your back pain, such as posture, ergonomics at work, or daily movement patterns. By making small, sustainable changes, you can significantly reduce the strain on your back and prevent flare-ups.

Our preventative strategies often include guidance on therapeutic exercises, stretching routines, and anti-inflammatory nutrition to support your body’s natural healing processes. We believe in empowering you with knowledge and support for every step of your recovery. In some cases, we may even suggest supportive therapies like IV Nutrition Therapy to ensure your body has all the essential vitamins and minerals it needs to repair tissue and reduce inflammation from the inside out. This comprehensive approach helps you not only find relief today but also enjoy a more active, pain-free life for years to come.

Hope is Available: Low Back Pain Treatments

You might feel like low back pain is an inevitable part of your life. When you have been living with pain for years, it can be hard to imagine what life would be like without the ongoing effects of chronic back issues.

Our team at Kentuckiana Pain Specialists is here to tell you that there is hope for recovery. We offer full-service solutions that address the unique needs of each patient who walks through the door.

Through integrative treatments, we provide personalized support to get to the root of your pain.

If you have lower back pain and would like to schedule a pain management consultation, we invite you to call us at Kentuckiana Pain Specialists. Available services include acupuncture, IV nutrition therapy, spinal cord stimulation, radiofrequency ablation, intrathecal pain pump implants, and more.

We serve patients in Louisville, Kentucky, and all of the surrounding areas. You can learn more by calling our office at (502) 995-4004 or requesting an appointment on the website.

Frequently Asked Questions

My back pain feels like a dull ache on both sides. Does that mean it’s just a muscle strain? While a muscle strain is a very common cause of that kind of dull, bilateral ache, it’s not the only possibility. Persistent pain that doesn’t improve with rest could also point to issues with the joints in your spine, like the facet joints, or problems with your spinal discs. The only way to know for sure is to get a proper diagnosis. Treating it like a muscle strain when it’s actually a joint problem won’t lead to lasting relief, which is why identifying the true source of the pain is always our first step.

I’ve tried physical therapy and rest, but nothing has worked. What makes your approach to pain management different? It can be incredibly frustrating when the standard treatments don’t provide the relief you need. Our approach is different because we focus intensely on diagnosis first. Instead of just treating the general area of pain, we use specialized techniques to pinpoint the exact nerve, joint, or disc that’s causing the problem. This allows us to create a highly targeted treatment plan. We’re not just managing symptoms; we’re addressing the root cause with advanced, minimally invasive procedures designed for your specific condition.

You mentioned injections. Are they just a temporary fix for the pain? That’s a great question, and it’s a common concern. While injections do provide significant, often immediate, pain relief by reducing inflammation, we use them for more than that. They are also a powerful diagnostic tool. If we numb a specific joint or nerve and your pain disappears, we’ve confirmed the source of your discomfort. This information is crucial for building an effective long-term plan, which might include other procedures like radiofrequency ablation for more durable relief.

My doctor mentioned surgery might be an option. Can pain management help me avoid it? Absolutely. Helping patients avoid major surgery is one of our primary goals. Many people believe surgery is their only remaining option when, in fact, there are highly effective, minimally invasive treatments available. By targeting the precise source of your pain with procedures that don’t require a long recovery, we can often resolve the issue and restore your quality of life. We always explore these conservative, yet powerful, options before considering a surgical referral.

How do I know if my back pain is a real emergency versus something I can wait to see a doctor about? Knowing when to seek immediate care is critical. You should go to the emergency room if your back pain is paired with a high fever, sudden and unexplained weight loss, or—most importantly—a loss of bladder or bowel control. These can signal a serious condition that needs immediate medical attention. For pain that is severe but not improving after a week, or pain that travels down your leg, you should schedule an appointment with a specialist, but it typically doesn’t require an ER visit.

Key Takeaways

  • Understand the ‘Why’ Behind Your Pain: Discomfort on both sides of your lower back can stem from various sources, including muscle strains, spinal disc issues, or joint problems like arthritis. Identifying the specific cause is the most important step toward finding a treatment that provides lasting relief.
  • Know When Home Care Isn’t Enough: While gentle movement and over-the-counter remedies can help minor aches, you should see a specialist if the pain is severe, lasts for weeks, or is joined by numbness or weakness in your legs. Persistent pain is your body’s signal that it’s time for professional help.
  • Explore Solutions Beyond Surgery: Effective pain relief doesn’t always mean a major operation. Minimally invasive treatments like targeted injections and radiofrequency ablation can address the root of the problem, offering significant results without the long recovery associated with surgery.

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