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What is causing my lower back pain?

When your lower back is hurting, it’s only natural to want answers about what is causing the pain. And it can be frustrating when your provider tells you, “I’m not sure what’s causing your back pain”.

But let me break down why it’s so tricky to figure out the cause of lower back pain and why this is actually a good thing.

The honest answer is we may not know. 90% of lower back pain is what we call non-specific. This essentially translates to we’re not totally sure what’s causing your lower back pain.

Now before you get upset and close your browser, hear me out. It is okay that we don’t know what is causing your lower back pain because we still know how to go about treating it.

And while it can be easy to feel frustrated with your provider when you don’t get an answer about what’s causing your lower back pain, it’s important to remember that even with imaging on board it is challenging to determine the exact cause.  

But this is good news! When your provider tells you that you have non-specific lower back pain, it means that they have ruled out any red flags that could be signs of serious issues. And it means you are likely to respond well to conservative treatment options.

What is referred pain?

You also may have heard your doctor tell you that you have referred pain from your back. This term tends to come up if you are feeling pain in the region surrounding your lower back or into your buttocks and hips.

Referred pain means that your pain is most likely being referred from some tissue in your lower back. Now we can’t say for certain which exact tissue is referring the pain.

The reason we can’t say for certain what causes your lower back pain is back pain is influenced by so many things. Your lower back pain could be impacted by changes in your tissue and structures, your metabolic state, your emotional and mental well-being, and the list goes on.  

Do I need a MRI or X-ray?

Oftentimes we jump to thinking that we need some sort of image to understand exactly what is going on in our lower back. While there are a few select cases where imaging may be helpful, the vast majority of people with lower back pain do NOT need an MRI or X-ray.

The results you may find on this image are rarely related to the cause of your lower back pain. And images often do not help further direct your treatment plan in the case of nonspecific lower back pain.

Check out my YouTube video to learn more about why images are often an unnecessary expense when it comes to your lower back pain.

Treat Your Back Pain at Home

If you’re tired of living a life that’s controlled by your lower back pain, then you will definitely want to check out my self-directed lower back pain course. The course has the value of 8-12 therapy sessions and can be performed at your own pace in the comfort of your home.

Check out my self-guided lower back pain course today!

Want to Learn More?

For more information about lower back pain and what you can do about it, be sure to check out my YouTube video where I explain more about how to understand what is causing your back pain and dig into my blogs that are loaded with tips and tricks to help you feel better today!

Subscribe to my blog today!


1. Chenot, J. F., Greitemann, B., Kladny, B., Petzke, F., Pfingsten, M., & Schorr, S. G. (2017). Non-Specific Low Back Pain. Deutsches Arzteblatt international, 114(51-52), 883–890. 2. Non-Specific Low Back Pain at

Dr. Michael Derry is a Doctor of Physical Therapy and board certified in orthopedics. He is very passionate about treating lower back pain and helping people build their resiliency. He has spent time assisting at universities as well as managing large clinics before starting his own practice in Jacksonville, FL.

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