Most people will experience lower back pain on their left side at some point in their lives. Approximately 75–85% of Americans experience back pain¹ in their lifetime. Generally, this discomfort can be anything from a mild annoyance to debilitating pain, depending on its cause. This article delves into lower left back pain and its causes.
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Pain in the lower back and pain that radiates into the buttocks can come from several parts of your body, including muscles, tendons, ligaments, bones (vertebrae), discs (cartilage between vertebrae), nerves, blood vessels, and skin.
Three common types of back pain that can affect your left side include:
Acute pain comes on suddenly and usually only lasts for a short time. This type of pain is often caused by an injury, like a fall.
Subacute pain usually lasts for a few weeks to a few months. It may result from illness or injury.
Chronic pain is pain that lasts for more than three months. It usually stems from a long-term health condition, such as arthritis.
Many conditions can cause low back pain or pain radiating to your buttocks. These conditions commonly include:
A hernia is a common cause of back and posterior pain. A low back hernia occurs when the soft inside of the lumbar disc between your vertebrae pushes out through a weak spot.
This injury might happen if there’s excessive stress on your back or when you’ve strained or overused the muscles in your lower back.
A 2021 study² reported that herniated discs are most common among 30–50 year-olds. The same study describes that roughly 5–20 hernia cases will happen annually, per every 1,000 adults, with twice as many men experiencing low back hernias as women.
Spinal stenosis is a spinal column narrowing, resulting in pressure on the spinal cord or nerve roots. The cause for this can be degenerative disc disease (arthritis) or congenital disease (from birth). Also, the condition is relatively common in older adults and causes pain on the left side.
Sciatica is a condition that occurs when the sciatic nerve gets compressed. Your sciatic nerve is the largest and longest nerve in the body. It runs from your lower back to the hips and buttocks into each leg and down to each foot. Sciatica can result from nerve irritation, either from a herniated disc or another cause.
Spondylosis is an age-related degenerative condition. With this condition, spurring develops on the vertebral body and can cause irritation to the nerve root as it exits through its bony canal. This inflammation causes pain that spreads into the lower back and one or both legs.
Osteoarthritis (OA) is the most common type of arthritis. It’s a degenerative joint disease that causes the cartilage in the joints to wear away. OA can lead to pain, stiffness, and swelling in the low back. Osteoarthritis is more common in older adults but can occur in anyone at any age.
Sacroiliitis is inflammation of your sacroiliac (SI) joint. The SI joint connects your sacrum (a triangular bone at the base of the spine) to the ilium (uppermost part of the pelvis). Sacroiliitis can also cause pain on the left side of the back, buttocks, and down the leg.
A muscle strain or sprain results from a muscle or ligament being overstretched or torn. It can occur from sudden trauma (such as a fall) or repetitive activities (like sports or heavy labor). The pain is usually local to the injured muscle or ligament in most cases.
During pregnancy, the body undergoes many changes. These changes can include an increase in weight, a change in posture, more laxity in the pelvis to prepare for the baby's birth. This can place more stress on the ligaments in the lower back and result in pain. Back pain is also common during labor.
Endometriosis is a painful disorder caused by endometrial tissue that has grown outside the uterus (instead of inside). Each month during the menstrual cycle, the misplaced tissue thickens and sheds. The result is often severe pain in the back, legs, lower abdomen, pelvic area, bladder, or rectum.
Here are the risk factors for back pain.
A rounded shoulder and forward head posture are two of the most common postural problems leading to back pain. These postures stress the muscles and ligaments in the neck and back, leading to low back pain.
Being overweight can put added pressure on your joints and lumbar discs, resulting in more wear and tear on the lower back and subsequent pain.
Smoking can severely limit your spine’s blood supply, causing it degenerate and break down more quickly.
Older adults are at an increased risk of developing lower back pain because their discs and joints in the spine have had wear and tear.
People who injure their backs are at an increased risk of developing chronic back pain. This is because a back injury can damage the discs, ligaments, and muscles in the back, leading to long-term pain.
People who are not physically fit are also at an increased risk of developing back pain because they may be more susceptible to injury.
Many of the conditions that can cause back pain are genetic. For example, a person's predisposition to developing osteoporosis results from their genetics. Other examples include sacroiliitis and spondylosis.
Below are the common procedures used to diagnose left-back and above-the-buttocks pain.
These are tests used to measure the electrical activity in muscles and nerves. Electrodiagnostic tests include:
The Nerve Conduction Velocity Test
This test³ measures the speed of electrical signals as they travel through a nerve. This can help determine if there is a problem with the nerve itself.
This test measures the electrical activity of muscles, and it can help determine if there is a problem with the muscle or the nerve controlling the muscle.
Evoked potential tests
This group of tests measures the electrical activity in the brain in response to stimuli. These tests help determine a problem with the nerve transmitting signals from the brain to the spinal cord.
X-rays can help determine if the vertebrae are out of alignment or show other bone and tissues injuries.
Computerized Tomography (CT) Scan
A CT scan identifies problems with the back's discs, ligaments, and muscles.
Magnetic Resonance Imaging (MRI)
This test uses a magnetic field and radio waves to create images of the inside of the body. An MRI is used to identify problems with the discs, ligaments, and muscles in the back.
Several tests can be conducted to determine the root cause of left-back and above-the-buttocks pain. They include:
Bone scans help detect bone tumors and fractures.
Spinal tap (lumbar puncture)
A spinal tap is a procedure⁴ used to measure the spinal canal's pressure and test for infection or bleeding.
A blood test can help determine if an infection could be contributing to your back pain.
Also known as a discogram⁵, this test is usually reserved for difficult-to-treat back pain and involves injecting a needle into lumbar discs. The patient then reports whether they feel pain, pressure, or nothing at all.
There are a wide variety of treatments available, including:
Non-steroidal anti-inflammatory drugs
NSAIDs are used to relieve pain and inflammation. They include drugs such as ibuprofen, naproxen, and aspirin.
Over-the-counter topical pain relievers
Many creams, sprays, patches, and gels contain menthol, camphor, and eucalyptus ingredients. They are beneficial for providing temporary relief from pain and stiffness. The common ones include lidocaine, menthol, and capsaicin and can be purchased over the counter without a prescription.
These drugs help to relieve pain and muscle spasms. They include medications such as cyclobenzaprine and tizanidine.
Opioids are for severe pain. They include medications such as morphine, hydrocodone, and oxycodone.
Exercises that strengthen and stretch the back muscles can help relieve pain.
Heat and cold therapy
Applying hot or cold packs to the lower back may ease muscle pain.
Ultrasound, electrical stimulation, and massage are examples of therapies that provide relief from pain.
This therapy involves the injection of numbing medication and steroid medication such as epidural corticosteroid⁶ into the area of pain. This can provide short-term relief, but it is not considered a long-term solution.
The concept of self-management traces its roots to Orem's theory⁷ and Bandura's Social Cognitive Theory on self-efficacy. Self-efficacy is a person's belief in their ability to impact their problems. Below are the self-efficacy actions to help alleviate lower back pain:
Taking breaks during extended periods of sitting or standing
Wearing comfortable shoes with good arch support and firm heel counter
Applying a cold pack to the painful area for 10–15 minutes, twice a day
If other treatments have failed to relieve back pain, surgery may be your doctor’s next recommendation. The type of surgery will depend on the underlying cause of the pain.
Alternative/ holistic methods include:
This Traditional Chinese Medicine (TCM) technique involves inserting thin needles at different points on the body. This practice is believed to trigger the release of pain-relieving chemicals in the body.
Massages are performed by trained therapists using different techniques, including stretching, kneading, and percussion. This is believed to relieve tension, increase blood flow, and relax your muscles.
Chiropractors manually adjust the joints in the spine to relieve pressure.
Tai Chi is a martial art that combines deep breathing and relaxation with slow and gentle movements. This is believed to improve flexibility, balance, and strength.
Maintaining a healthy weight
Carrying excess weight puts undue stress on the back muscles and can lead to pain. Talk to your doctor about a weight loss plan if you are overweight.
Posture refers to how you position your body. Poor posture can cause stress on the back muscles, leading to pain. Try keeping your shoulders down and relaxed and pulling your stomach in, as this will help support your back. Also, keep your knees slightly bent as you stand and keep your feet shoulder-width apart.
Performing different yoga poses such as a downward dog or locust pose will stretch your lower back muscles and increase flexibility. This can help to strengthen your back and improve your range of motion.
Sleeping in an ergonomically designed bed
An ergonomically designed bed will help maintain the natural curve of your spine while you sleep. This can help reduce the number of times you wake up with pain in the morning.
Using back support
Back support is beneficial in keeping your back in a neutral position when sitting or standing. This can help to reduce stress on the muscles and prevent pain.
Avoiding bending and heavy lifting
This will prevent a strain on your lower back muscles, which could lead to back pain. Use a buddy system when performing heavy tasks, including moving furniture or carrying bags, as this can reduce the risk of strain or injury.
There is no one-size-fits-all approach to managing left back pain, and what works for you might not work for another individual. If you have tried one or more of the methods mentioned and have not found relief, be sure to talk to your doctor. They may recommend other treatments or refer you to a specialist.
Low back pain | American Association of Neurological Surgeons
Disc herniation (2021)
Nerve conduction studies | Johns Hopkins Medicine
Lumbar puncture | NHS
Lumbar discography for back pain diagnosis | Spine Health
Epidural corticosteroid injections | Johns Hopkins Medicine
Orem self care model | Science Direct