Patients with chronic low back pain may experience pain that is limited to the midline lumbar region, or pain that is referred to any of a large number of sites, including paraspinal region; posterior pelvis, hips, or buttocks; posterior or lateral thigh, knee or leg; or anywhere in the foot. If the pain is below the knee, it suggests that the origin is not just damage to the spine and surrounding tissues, but also damage to the nerve roots that travel out of the spine and into the leg. Pain that radiates down the buttock and back of the thigh and leg is termed sciatica.
The pain may be described as aching, sharp, or throbbing. If nerve compression is involved, the pain also may be described as aching, or may have a "neuropathic" quality, such as burning, electrical-like, or lightening-like. If the pain is caused by nonmalignant disease, it is often improved by sitting or lying and worsened by activity. If a nerve root is compressed, the pain may be worsened by coughing, sneezing or straining.
The pain may be associated with tenderness at any of these sites. There also may be stiffness.
If nerve compression occurs and is severe, it may be accompanied by a loss of sensation, weakness in the leg, or disturbed functioning of the bladder. In some cases, this indicates the need for surgery. Patients who are experiencing these symptoms should be evaluated by their doctors. If these symptoms are increasing rapidly, it may even require emergency treatment
Other symptoms that can accompany chronic low back pain include insomnia, fatigue, and depressed mood. Some patients become disabled.