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Lower Left Back Pain Causes

What causes lower left back pain? This is commonly asked of physiotherapists by the patients, as is a similar question about the right side. There are many potential back pain causes and they are not well understood and some of these causes can give back pain on one side or the other.

Further information can be found at and there is a nice symptom checker at


Discogenic Pain

The spinal discs are tough and in younger people they don't give problems unless under severe physical stresses. Discs cope with vertical pressures but combined this with torsion (twisting) means they can suffer damage much more easily and give lower back pain.

If a disc is injured or develops degenerative changes over time the changes occur at one side of the disc, with the back corners being most likely to undergo changes to the disc's outer lining. This can refer pain to one side or the other. This type of disc change can be the reason for right side back pain causes or lower right back pain causes.

Sacroiliac Joint Pain

The sacroiliac joints (SIJs) are the large joints which joint the sacrum, the triangular piece of bone at the base of the spine, with the big wings of the pelvis. The sacroiliac joints are stability joints with very limited movement but there is evidence for causing for low back pain in up to 15% of cases of chronic back pain.

Sacroiliac joint pain is mostly indicated to be over the joint itself on the one side and may be referred down the same side buttock or round to the same side groin.

Facet Joint Pain or Rib Joint Pain

The facet joints and the rib or costovertebral joints are situated at each side of the thoracic spine and are known to be causes of pain from injury or prolonged poor posture. These are very small joints which take little force but they can still be the source of pain which can be very sharp and restricting.


Upper back pain causes and middle back pain causes are mostly not the same as the causes of low back pain which is more often related to disc pathology although other structures may be involved. In the thoracic spine disc symptoms occur very seldom and pain is much more likely to originate from the facet or rib joints.

One sided back pain symptoms include sharp pain from a sudden injury or a slow onset pain from repetitive activities or poor posture. This reduces to a strong, continuous unpleasant ache with sharp pains on any movement of the area, becoming a lesser ache and intermittently painful on stressing until it settles down fully.

Back pain treatment from a physiotherapist includes the Mackenzie technique, a disc based treatment with some evidence of effectiveness, mobilisation techniques, manipulation, general fitness and specific exercises for the symptomatic area. Exercise for back pain has reasonable evidence for relief of back pain but this is general exercise as there is less support for specific exercises being useful.

Physio treatments can provide good back pain relief although they can rarely provide a back pain cure and most of the onus must be on the patient to change the way they are behaving and to take on the things they need to do to improve their situation.

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