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How to Assess Back Pain

Low back pain affects most adults at some time in their lives. If your pain is creeping up the scale from one to 10, use these tips to find out what might be the cause of your aching back.


  • Step 1: Look at duration Look at the duration of your pain. Acute back pain is pain that has been present for six weeks or less. Subacute back pain has lasted six to 12 weeks, and chronic back pain lasts more than 12 weeks.
  • Step 2: Examine type Examine the types of back pain. Symptoms in the lower extremities may mean nerve-related sciatica. Underlying conditions like spinal fractures, tumors, or infections are more serious type of pain. The third category of back pain includes mechanical back pain. Every type requires different evaluations and treatment.
  • Step 3: Evaluate history Evaluate your health history to determine the cause. List any health problems, including diseases or infection, type and duration of medications, and trauma.
  • Step 4: Do a lumbar test Do an at-home lumbar test. Get on the floor on all fours and round your back upward toward the ceiling like a cat. If your pain worsens, you have pain upon lumbar flexion. Then arch your back toward the floor. You have lumbar extension pain if your pain worsens in the second position.
  • TIP: If you have lumbar extension pain, you likely have long-term or recurrent back pain.
  • Step 5: Get a thorough physical exam Get a thorough physical exam that evaluates range of motion, palpation of the spine, heel-toe walk, squat and rise, palpation of the sciatic notch, straight leg rising test, reflexes and motor testing, and neurologic testing.
  • TIP: Laboratory tests usually are not necessary unless tumor or infection is suspected.
  • Step 6: Have a radiographic test Consider radiographic tests, such as MRI or CT scans, if your symptoms last for more than one month and the cause has not been determined or red flags appear in your health history or after the examination. With proper treatment, your pain will start creeping back down the scale from 10 to one.
  • FACT: Low back pain is one of the top 10 reasons patients seek care from a family physician.

You Will Need

  • Duration of pain
  • Medical history
  • Lumbar test
  • Physical examination
  • Radiographic tests
  • Laboratory tests (optional)

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