What causes lower left back pain? Related conditions and treatments

Overview: What does lower left back pain feel like?

Like most back pain, pain in the lower left back is most commonly caused by muscle strain. Sometimes, however, it may be related to problems with the spine or the internal organs in the abdomen, such as the kidney, pancreas, colon, or uterus. 

When muscle strain or muscle cramping causes lower back pain, it typically feels like a dull or aching pain that quickly worsens when moving or twisting the back. Getting up out of a chair or bed can provoke a sharp pain that will make you wince or groan. In addition to pain, the back will be stiff. It’s harder to move, limiting the range of motion that people are used to. 

When pain is due to a spinal problem, that pain is usually located in the middle of the back, but it can radiate to one side of the back. Other symptoms include tingling, numbness, leg pain, hip pain, or back stiffness. 

Organ problems are more complex in their presentation. Pain in one area, like the upper abdomen or the side of the body, may spread to other areas, like the lower left back. Abdominal organ dysfunction or disorders usually have other symptoms besides pain, including urination issues, nausea, vomiting, fever, or weight loss, depending on the underlying cause.

What causes lower left back pain?

Lower back pain, or “lumbar pain,” usually means that you’ve pulled, strained, sprained, or overused a muscle in your back. However, the pain could be a sign of a more serious condition involving the spine, joints, or abdominal organs.

Muscle strain

Like any other muscle in the body, back muscles can be overused or used too carelessly, causing a muscle sprain or pulled muscle. Muscle strain in the lower back typically feels like a dull pain that gets markedly worse with minor movements, especially getting up from a chair or bed. Other symptoms include stiffness, decreased range of motion, muscle spasms, and inability to maintain normal posture. Common causes of lower back muscle strain include:

• Heavy lifting

• Improper lifting

• Exercise

• Twisting

• Poor posture

• Back injury

• Injury or arthritis involving the back, which causes back muscles to overcompensate

RELATED: Lower back pain treatments and medications

Spinal problems

Injuries or disorders of the spine usually cause pain in the center of the back, but that pain can radiate to the right or left side. Additional symptoms might include tingling or numbness, pain that affects an entire leg (sciatica), pelvic pain, or stiffness. Common causes of spinal pain include:

• Slipped disc

• Degenerative disc disease

• Spondylolisthesis (slippage of the bones in the spine)

• Bone spurs

• Spinal stenosis (nerve compression at the spinal cord)

• Joint disorders, such as the joint that connects the spine to the pelvis (the sacroiliac joint)

Internal organ problems

Internal organs in the abdominal cavity could cause pain that feels located in the lower left back. In many cases, the pain will start somewhere in the abdomen and radiate to the lower left back. These include:

• Kidney infections

• Kidney stones

• Pancreatitis

• Ulcerative colitis

• Uterine fibroids

• Endometriosis

All of these causes usually have other symptoms. The most apparent accompanying symptom is pain somewhere in the abdomen or flank. Other possible symptoms include urination problems, dark urine, blood in the urine, fever, fatigue, nausea, and vomiting.

Chronic pain syndromes

Another possible cause of lower left back pain is chronic pain syndromes, such as:

• Fibromyalgia

• Myofascial pain syndrome

Fibromyalgia will have additional symptoms, including pain in other parts of the body and fatigue. 

Myofascial pain syndrome is due to an injury of a muscle, muscle ligaments, or other soft tissues in the muscles. The tissues are permanently damaged, causing chronic or recurring muscle pain.

RELATED: Fibromyalgia symptoms: What are the early signs of fibromyalgia?

Should I be worried about lower left back pain?

Low back pain due to a muscle sprain or strain is common and will improve in a week or more. However, see a healthcare professional if back pain lasts longer than two weeks. You should see a healthcare professional if you have other symptoms, such as urination problems, abdominal pain, nausea, vomiting, or a fever. The pain may be due to a problem unrelated to back muscles. Untreated spine or internal organ disorders can result in serious or lifelong complications.

If the pain is severe or if there are serious symptoms associated with the pain, such as a high fever, then get emergency medical care. 

How is the cause of lower left back pain diagnosed?

Patients presenting with lower left back pain probably have muscle strain, but they could have other, more serious problems. A healthcare provider will start the diagnosis by reviewing symptoms, taking a medical history, and examining the affected area. If the signs point to a muscle strain, then that’s usually enough to make a diagnosis and prescribe treatment.

If pain has lasted longer than six weeks and rest and physical therapy haven’t worked, the clinician may order an X-ray, CT scan, or MRI to determine if there are bone, disc, joint, or nerve root problems with the spine. 

The symptoms and history may point to a problem with the kidneys, pancreas, colon, or uterus. Diagnosing these problems will require further workup and tests. The clinician may refer the case to an orthopedist, gastroenterologist, urologist, or gynecologist.

For suspected abdominal organ disorders, tests might include:

• Blood tests

• Urine tests

• Urine cultures

• Stool tests

• CT scan

• Ultrasound

• Endoscopic exam

• Biopsy

How long does lower left back pain last?

If lower left back pain is caused by a muscle strain, the pain should go away in 10 to 14 days. If it lasts longer or doesn’t get better, the pain may be due to another problem. Healthcare providers will look for other causes if back pain lasts six weeks or longer without improvement.

Back pain due to a herniated disc, degenerative disc disease, or problems with the bones or joints in the back may not get better until the underlying issues are successfully treated. Some conditions, such as ulcerative colitis and endometriosis, may be long-term or lifelong disorders.

Chronic pain disorders, such as fibromyalgia, are usually lifelong disorders. Though incurable, symptoms can be managed.

How to stop lower left back pain

Lower left back pain treatments depend on the underlying cause. The standard treatment options for pain caused by a muscle strain involve rest, massages, OTC pain relievers, ice, and possibly physical therapy. If low back pain is particularly hard to bear, a healthcare professional may prescribe a muscle relaxant to reduce muscle cramping and spasms.

Treatments for spine problems will vary. Some conditions can only be treated with symptom relief, braces, and physical therapy, while others may be treatable with surgery. Pain management usually involves nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, anticonvulsants, corticosteroids, opioids, and physical therapy.

Treatments for disorders of the abdominal organs depend on the underlying cause. Some conditions, like a small kidney stone, may only require symptomatic treatment. Others might require prescription medications or surgery.

Chronic pain disorders are not curable, but pain can be managed with pain relievers, antidepressants, and benzodiazepines, as well as physical therapy, exercise, and self-care.

RELATED: Your guide to fighting lower back pain while working at home

Living with lower left back pain

Living with lower left back pain requires taking daily measures to manage or reduce the pain. Many home remedies can provide rapid relief, while others are longer-term solutions:

• Start with OTC painkillers, but use them conservatively

• Try to move around, stretch, or walk—get medical advice from your healthcare provider or physical therapist first

• Practice any physical therapy exercises or movements at home if instructed to do so

• Maintain proper posture if possible

• Try using anti-inflammatory herbal remedies or adopt an anti-inflammatory diet to help reduce swelling in the back, spine, or joints

RELATED: What’s the best diet for inflammation?

What’s next? Additional resources for people with lower left back pain

Test and diagnostics

• 4 reasons you may only have back pain on only one side, Penn Medicine (2020)

• Low back strain and sprain, American Association of Neurological Surgeons (AANS)