Getting an accurate diagnoses and a clear understanding of the underlying cause of lower back pain is a critical factor to resolving or effectively managing the problem. It is often, however, more challenging than people expect. Diagnosing the underlying cause of lower back pain will help your physician make a preliminary diagnosis and determine the appropriate treatment plan. It may be a simple process or it may involve a combination of doctors, physical examination, and diagnostic tests to accurately identify the problem. It is important to know if the condition is caused by a soft tissue problem such as muscle, ligament or tendon, or a more serious conditions such as a fracture, infection, or tumor. It's also important to know if the condition is caused by a structural problem in the spine such as a herniated disc, arthritis, or facet joint disorder.

Radiographs (X-rays) are a useful tool to pinpoint broken bones and skeletal defects. X-rays may be needed for trauma such as a fall or a car accident. Computed Axial Tomography (CT or CAT) scan, or a Magnetic Resonance Imaging (MRI) scan are useful tools to analyze soft tissue damage. An Electromyogram (EMG) is useful to determine possible nerve or muscle damage.