Hi, There are many potential causes of persistent lower back pain along with fatigue and lack of energy, including but not limited to the following: * Musculoskeletal conditions such as spinal stenosis, herniated disc, degenerative disc disease, and sciatica * Neurological disorders such as peripheral neuropathy or radiculopathy * Infections or inflammation, such as ankylosing spondylitis * Medical conditions like fibromyalgia, chronic fatigue syndrome, and depression * Hormonal imbalances such as hypothyroidism * Sleep disturbances and sleep disorders You should see a doctor for a proper evaluation and diagnosis. They may also suggest further tests and examinations determine the cause and develop an appropriate treatment plan for your symptoms. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician