Lumbar strain has been a common out-patient diagnosis in athletes. Most commonly presenting with a dull gnawing pain which increases sharply on bending or lifting any weights. Most common causes are exercises schedule without pre-conditioning and warm and supra-physiological loading of the postural muscles.

Chronic bad posture, smoking, weight gain, improper exercises and weight training may be the cause in non-atheletic population. This can be associated with numbness, tingling or abnormal sensations in various areas of the lower limb which indicate a nerve compression or radiculopathy.

Majority patients improve with rehabilitation and exercises while a small subset is likely to have significant symptoms not improving with conservative treatment. Patients with a long standing problems have changes in soft tissues and bony architecture which might need a surgery in long term failure of coservative treatment. Red Flag signs usually denoted by sudden increase in pain, symptoms pertaining to nerve compression and bowel bladder involvement.