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Table of Contents
Common Causes
Rare Causes
When to Seek Help
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Treatment
Prevention
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Many back pain causes resolve within several days or weeks with rest, over-the-counter painkillers, and other self-help measures. Others require ongoing care and treatment, including surgery for conditions likesciatica.
This article lists 17 possible causes of back pain, including how they are diagnosed and treated. It will also help you to know ifback pain is seriousand when it is time to see a healthcare provider.
Verywell / Alexandra Gordon
Common Back Pain Causes
There are many possible causes of back pain involving the spine, muscles, and spinal nerve. Here are some of the more common:
Strain or Sprain
Strainsandsprainsare the most common causes of back pain, especially in thelower back. A strain refers to the tearing of a muscle or tendon (which connects muscles to bones), while a sprain refers to the tearing of aligament(which connects bones in a joint).
A torn tendon or ligament may be the result of a fall, sports injury, or overuse of a joint (known as arepetitive stress injury).
The pain can range from mild to severe and is often described as an “all-over pain” that moves into the buttocks. The pain tends to worsen with movement and improve with rest. Back stiffness is also common.
The Difference Between a Sprain and a Strain
Slipped or Ruptured Disc
Spinal discs located between the bones of the spine serve as shock-absorbing cushions. Over time, the discs can start to bulge due to aging, obesity, or repetitive stress or occur spontaneously as a result of a traumatic back injury.
When this happens, a disc can start to protrude outward, causing a bulging orslipped disc. The pain from a slipped disc is often described as throbbing, burning, or tingling due to the compression of nerves emanating from the spine (called spinal nerve roots.
A ruptured disc can cause sharp lower pain that can into the buttocks, groin, or leg. A ruptured disc in the neck can cause pain that moves down an arm. Muscle weakness, numbness, and tingling are also common.
Muscle Spasm
Back spasms are due to some form of mechanical stress on the back muscles, such as sleeping in an awkward position, lifting heavy objects, or standing or sitting for long periods. Stress and anxiety can also cause an upper or lower back spasm in some people.
Why Does My Back Hurt When I Breathe?
Osteoarthritis
Spinal osteoarthritis tends to be persistent. It is generally worse in the morning and eases as you get on with your day. You may also have back stiffness and a popping sensation known ascrepitus.
Spinal arthritis is the most frequent cause of lower back pain.Repetitive motion injuries, poor posture, and prior spinal trauma can all contribute to this aging-related condition.
Disc Desiccation: Treatment and Support for Aging Bodies
Sciatica
Sciaticais pain that shoots down the leg via the sciatic nerve originating in thelumbar (lower) spine.
Sciatica causes shooting, burning, or cramping pain that extends from the lower back into a buttock (and occasionally down the leg and into the sole of the foot). Tingling, numbness, and muscle weakness are also common.
When Surgery Is Needed for Sciatica
Spinal Stenosis
As you get older, the spinal canal which contains the spinal cord can begin to narrow. This is referred to asspinal stenosis.
Spinal stenosis can cause the compression of the spinal nerve roots, leading to shooting pains in your lower back and buttocks. Muscle weakness, numbness, burning, and tingling sensations can also occur.
Spinal arthritis can cause the overgrowth of bone within the canal, leading to spinal stenosis. Other causes of spinal stenosis include scoliosis,Paget’sdisease of the bone, and spinal trauma.
4 Things to Stop Doing If You Have Spinal Stenosis
Spondylolysis and Spondylolisthesis
Spondylolysisis a stress fracture in one of the bones of the spine. It is most common in children who play sports that place repeated stress on the lower back (such as gymnastics or football). Spondylolysis can also be due to a spinal injury or the aging-related weakness of the spine.
If the fracture weakens the spine too much, the vertebra may start to slip, leading to a condition calledspondylolisthesis. The slippage may either be forward (anterolisthesis) or backward (retrolisthesis).
Spondylolysis and spondylolisthesis both cause a dull, generalized pain extending from your back to your buttocks and thighs. There will also be significant back stiffness. Spinal nerve root compression can lead to shooting pain, tingling, numbness, and weakness.
Causes of Chest and Back Pain Based on Location
Osteoporosis
Osteoporosisis the thinning and weakening of the bones. Back pain associated with osteoporosis is usually due to a compression fracture in the spinal column. In severe cases, a break can occur without warning, often after doing something as simple as sneezing or bending over.
The pain can range from dull and aching to sharp and debilitating. It is often felt in the lower or middle back and tends to get worse with activity. In rare cases, the pain may radiate to the legs and abdomen or cause a condition known askyphosis(“hunchback”).
An Overview of Osteoporosis
Scoliosis
Scoliosisis a condition in which the spine curves or twists like the letter “S” or “C.” It usually develops in childhood.
In most cases, the cause of scoliosis is unknown, although it is linked to conditions likecerebral palsyandmuscular dystrophy. It can also result from a birth defect or family genetics (as multiple family members are sometimes affected).
Scoliosis can cause chronic back or neck pain as well as a reduced range of motion. Spinal compression can cause shooting pains, numbness, heaviness, and weakness in the buttocks and legs.
In severe cases, a person may have trouble breathing due to the compression of the thorax (chest cavity) ordiaphragm(the muscle that separates the chest and abdomen).
Sacroiliitis
Sacroiliitisis the inflammation of the joints that connect your spine and pelvis, called thesacroiliac joint. This condition can cause pain in the lower back, buttocks, and upper legs.
Sacroiliitis pain is often described as deep and aching and can occasionally affect the entire expanse of your leg from the groin all the way down to your feet. Walking upstairs can make symptoms worse.
5 Scoliosis Treatments You Should Know About
Rare Back Pain Causes
Ankylosing Spondylitis
Ankylosing spondylitisis an inflammatory disease that causes the small bones of the spine to fuse together. Thisleads to lower back painsimilar to spinal osteoarthritis. Spinal stiffness and a hunched posture are also characteristic, often occurring before the age of 40. The pain tends to improve with exercise and worsen at night.
Spinal Cancer
Osteomyelitis
An infection in the spine, calledosteomyelitis, causes severe and constant back pain along with local, swelling, and warmth. It can occur due to recent spinal surgery or when a local infection (such as a staph infection) enters the bloodstream.
Unlike most infections, fever is not common.
Cauda Equina Syndrome
Other symptoms include “foot drop” (difficulty lifting the front of your foot) and problems with bladder or bowel control.
When to See a Healthcare Provider
Most cases of back pain last for a few days and resolve completely within a few weeks. If you have sudden, new back pain, contact your healthcare provider.
There are a few warning signs that immediate care is needed:
The diagnosis of back pain starts with a review of your medical history and a physical exam. You will be asked when the pain started, what it feels like, what makes the pain better or worse, and what other symptoms you have (such as numbness or swelling).
Based on the findings, your healthcare provider will order lab and imaging tests to explore the suspected causes.
Physical Exam
During your exam, your healthcare provider will gently press on muscles and parts of the spine, on or near the site of your pain. You will be asked to describe the location and type of pain.
You will have a neurological exam to assess your nerve and motor responses. The aim of the exam is to identify any areas of sensory changes, muscle weakness, or reflex changes.
One example is thestraight leg raise testin which the healthcare provider lifts your leg while you lie flat on your back. If the movement causes pain below the knee, it suggests that nerves are being pinched at a specific part of the spine.
Lab Tests
Your healthcare provider may order lab tests, such as:
Imaging Tests
Imaging tests are generally not needed for a flare-up of back pain unless there are signs of cancer, infection, a fracture, or cauda equina syndrome. They are typically done if pain persists for several weeks or if muscle weakness is getting worse.
If needed,magnetic resonance imaging(MRI) is usually the test of choice, with acomputed tomography(CT) scan being the alternative.
Differential Diagnosis
As part of your assessment, your healthcare provider will consider other medical conditions that can cause back pain. This involves a process called adifferential diagnosisin which other possible causes are investigated and ruled out to ensure that the correct diagnosis is made.
A differential diagnosis is part of the process that will help you to tell the difference between muscle pain and kidney pain, for example. In the end, your back pain may be a part of a condition that doesn’t directly involve the back muscles or spine.
Examples include:
The diagnosis of back pain involves a physical exam and a review of your medical history. Based on the findings, your healthcare provider will order lab or imaging tests to help pinpoint the cause.
Back Pain Treatment
Self-Care
Rest, along withice applicationorheat application, is among the fastest ways to relieve back pain. This treatment may speed the healing process because ice can help reduce swelling. Heat is good for back pain because it promotes blood flow and helps to relax tissues.
Keep in mind, though, that rest doesn’t necessarily mean prolonged bed rest. Low-intensity physical activity is important to help shorten your recovery time.
It is also important to change certain habits, including sleep habits, to protect your back.
Back Pain Relief: 8 Ways to Feel Better
Medications
If rest and ice/heat application are not enough to ease your pain,medicationsmay be prescribed.
Over-the-counter nonsteroidal anti-inflammatories (NSAIDs) and prescription muscle relaxants are among the most commonly used medications for back pain relief.
Epidural spinal injections, in which steroids are injected into the space around your spine, may be used to treat sciatica and spondylolisthesis.For spine osteoarthritis, a steroid injection into the spinal joint can be used if the pain is severe.
Physical Therapy
Your healthcare provider may also advise physical therapy to help strengthen and stretch your back muscles, improve mobility, and ease back pain.
Walking is good for lower back pain, as are other low-impact exercises like swimming and biking that can help to improve your range of motion and flexibility.
Is Walking Good for Sciatica Relief?
Complementary and Alternative Medicine
Some examples of complementary therapies used to ease back pain include:
Speak with your healthcare provider before taking any vitamins, herbs, or supplements to ensure they are right and safe for you.
The Best Massage Chairs to Relieve Aches and Pains
Spinal Surgery
There are some conditions for which surgery may be beneficial, such as conditions that undermine the stability of the spine.
A spine surgeon can help you to determine if surgery is the right option for you and what risks are involved.
Back pain is one of the most common ailments affecting people of all ages. There are ways to reduce your risk factors for back pain and prevent it from worsening.
Some of the more useful prevention tips include:
Summary
The causes of back pain are many. While strains, sprains, ruptured disks, sciatica, and spinal arthritis are common causes, there are others that do not involve the back muscles or the spine at all.
The diagnosis of back pain involves a physical exam and a review of your medical history. Based on the findings, lab and imaging tests will be ordered to help narrow the causes.
Back pain is often treated with rest, ice or heat application, and pain medications. People with persistent back pain or a severe back injury may benefit from physical therapy. Spinal surgery may be used when all other attempts to resolve the pain have failed.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.See QY, Tan JNB, Kumar DS.Acute low back pain: diagnosis and management.Singapore Med J.2021 Jun;62(6):271–275. doi:10.11622/smedj.2021086Allegri M, Montella S, Salici F, et al.Mechanisms of low back pain: a guide for diagnosis and therapy.Version 2. F1000Res.2016;5:F1000 Faculty Rev-1530. doi:10.12688/f1000research.8105.2Goel A.Is it necessary to resect osteophytes in degenerative spondylotic myelopathy?J Craniovertebr Junction Spine. 2013;4(1):1-2. doi:10.4103/0974-8237.121615Johns Hopkins Medicine.Lower Back Pain: What Could It Be?Marco C, Miguel-Pérez M, Pérez-Bellmunt A, et al.Anatomical causes of compression of the sciatic nerve in the pelvis. piriform syndrome.Rev Esp Cir Ortop Traumatol. 2019;63(6):424-30. doi:10.1016/j.recot.2019.06.002National Institute of Arthritis and Musculoskeletal and Skin Diseases.Spinal stenosis.American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.Horne JP, Flannery R, Usman S.Adolescent idiopathic scoliosis: diagnosis and management.Am Fam Physician. 2014;89(3):193-8.Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key. JInflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494.Kumar N, Tan WLB, Velavapan BA.An overview of the tumors affecting the spine—inside to out.Neurooncol Pract.2020 Nov;7(Suppl 1) i10–i17. doi:10.1093/nop/npaa049Kamath SU, Kamath SS.Lasègue’s sign.J Clin Diagn Res.2017 May; 1(5) RG01–RG02. doi:10.7860/JCDR/2017/24899.979Amirdelfan K, McRoberts P, Deer TR.The differential diagnosis of low back pain: a primer on the evolving paradigm.Neuromodulation. 2014 Oct;17 Suppl 2:11-7. doi:10.1111/ner.12173Amorim AB, Pappas E, Simic M, Ferreira ML, Jennings M, Tiedemann A,et al.Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial.BMC Musculoskelet Disord. 2019 Feb 11;20(1):71. doi:10.1186/s12891-019-2454-y.National Center for Complementary and Integrative Health.Mind and body approaches for chronic pain: What the science says.American Academy of Orthopedic Surgeons.Low back pain.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.See QY, Tan JNB, Kumar DS.Acute low back pain: diagnosis and management.Singapore Med J.2021 Jun;62(6):271–275. doi:10.11622/smedj.2021086Allegri M, Montella S, Salici F, et al.Mechanisms of low back pain: a guide for diagnosis and therapy.Version 2. F1000Res.2016;5:F1000 Faculty Rev-1530. doi:10.12688/f1000research.8105.2Goel A.Is it necessary to resect osteophytes in degenerative spondylotic myelopathy?J Craniovertebr Junction Spine. 2013;4(1):1-2. doi:10.4103/0974-8237.121615Johns Hopkins Medicine.Lower Back Pain: What Could It Be?Marco C, Miguel-Pérez M, Pérez-Bellmunt A, et al.Anatomical causes of compression of the sciatic nerve in the pelvis. piriform syndrome.Rev Esp Cir Ortop Traumatol. 2019;63(6):424-30. doi:10.1016/j.recot.2019.06.002National Institute of Arthritis and Musculoskeletal and Skin Diseases.Spinal stenosis.American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.Horne JP, Flannery R, Usman S.Adolescent idiopathic scoliosis: diagnosis and management.Am Fam Physician. 2014;89(3):193-8.Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key. JInflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494.Kumar N, Tan WLB, Velavapan BA.An overview of the tumors affecting the spine—inside to out.Neurooncol Pract.2020 Nov;7(Suppl 1) i10–i17. doi:10.1093/nop/npaa049Kamath SU, Kamath SS.Lasègue’s sign.J Clin Diagn Res.2017 May; 1(5) RG01–RG02. doi:10.7860/JCDR/2017/24899.979Amirdelfan K, McRoberts P, Deer TR.The differential diagnosis of low back pain: a primer on the evolving paradigm.Neuromodulation. 2014 Oct;17 Suppl 2:11-7. doi:10.1111/ner.12173Amorim AB, Pappas E, Simic M, Ferreira ML, Jennings M, Tiedemann A,et al.Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial.BMC Musculoskelet Disord. 2019 Feb 11;20(1):71. doi:10.1186/s12891-019-2454-y.National Center for Complementary and Integrative Health.Mind and body approaches for chronic pain: What the science says.American Academy of Orthopedic Surgeons.Low back pain.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.See QY, Tan JNB, Kumar DS.Acute low back pain: diagnosis and management.Singapore Med J.2021 Jun;62(6):271–275. doi:10.11622/smedj.2021086Allegri M, Montella S, Salici F, et al.Mechanisms of low back pain: a guide for diagnosis and therapy.Version 2. F1000Res.2016;5:F1000 Faculty Rev-1530. doi:10.12688/f1000research.8105.2Goel A.Is it necessary to resect osteophytes in degenerative spondylotic myelopathy?J Craniovertebr Junction Spine. 2013;4(1):1-2. doi:10.4103/0974-8237.121615Johns Hopkins Medicine.Lower Back Pain: What Could It Be?Marco C, Miguel-Pérez M, Pérez-Bellmunt A, et al.Anatomical causes of compression of the sciatic nerve in the pelvis. piriform syndrome.Rev Esp Cir Ortop Traumatol. 2019;63(6):424-30. doi:10.1016/j.recot.2019.06.002National Institute of Arthritis and Musculoskeletal and Skin Diseases.Spinal stenosis.American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.Horne JP, Flannery R, Usman S.Adolescent idiopathic scoliosis: diagnosis and management.Am Fam Physician. 2014;89(3):193-8.Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key. JInflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494.Kumar N, Tan WLB, Velavapan BA.An overview of the tumors affecting the spine—inside to out.Neurooncol Pract.2020 Nov;7(Suppl 1) i10–i17. doi:10.1093/nop/npaa049Kamath SU, Kamath SS.Lasègue’s sign.J Clin Diagn Res.2017 May; 1(5) RG01–RG02. doi:10.7860/JCDR/2017/24899.979Amirdelfan K, McRoberts P, Deer TR.The differential diagnosis of low back pain: a primer on the evolving paradigm.Neuromodulation. 2014 Oct;17 Suppl 2:11-7. doi:10.1111/ner.12173Amorim AB, Pappas E, Simic M, Ferreira ML, Jennings M, Tiedemann A,et al.Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial.BMC Musculoskelet Disord. 2019 Feb 11;20(1):71. doi:10.1186/s12891-019-2454-y.National Center for Complementary and Integrative Health.Mind and body approaches for chronic pain: What the science says.American Academy of Orthopedic Surgeons.Low back pain.
National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.
See QY, Tan JNB, Kumar DS.Acute low back pain: diagnosis and management.Singapore Med J.2021 Jun;62(6):271–275. doi:10.11622/smedj.2021086
Allegri M, Montella S, Salici F, et al.Mechanisms of low back pain: a guide for diagnosis and therapy.Version 2. F1000Res.2016;5:F1000 Faculty Rev-1530. doi:10.12688/f1000research.8105.2
Goel A.Is it necessary to resect osteophytes in degenerative spondylotic myelopathy?J Craniovertebr Junction Spine. 2013;4(1):1-2. doi:10.4103/0974-8237.121615
Johns Hopkins Medicine.Lower Back Pain: What Could It Be?
Marco C, Miguel-Pérez M, Pérez-Bellmunt A, et al.Anatomical causes of compression of the sciatic nerve in the pelvis. piriform syndrome.Rev Esp Cir Ortop Traumatol. 2019;63(6):424-30. doi:10.1016/j.recot.2019.06.002
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Spinal stenosis.
American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.
Horne JP, Flannery R, Usman S.Adolescent idiopathic scoliosis: diagnosis and management.Am Fam Physician. 2014;89(3):193-8.
Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key. JInflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494.
Kumar N, Tan WLB, Velavapan BA.An overview of the tumors affecting the spine—inside to out.Neurooncol Pract.2020 Nov;7(Suppl 1) i10–i17. doi:10.1093/nop/npaa049
Kamath SU, Kamath SS.Lasègue’s sign.J Clin Diagn Res.2017 May; 1(5) RG01–RG02. doi:10.7860/JCDR/2017/24899.979
Amirdelfan K, McRoberts P, Deer TR.The differential diagnosis of low back pain: a primer on the evolving paradigm.Neuromodulation. 2014 Oct;17 Suppl 2:11-7. doi:10.1111/ner.12173
Amorim AB, Pappas E, Simic M, Ferreira ML, Jennings M, Tiedemann A,et al.Integrating Mobile-health, health coaching, and physical activity to reduce the burden of chronic low back pain trial (IMPACT): a pilot randomised controlled trial.BMC Musculoskelet Disord. 2019 Feb 11;20(1):71. doi:10.1186/s12891-019-2454-y.
National Center for Complementary and Integrative Health.Mind and body approaches for chronic pain: What the science says.
American Academy of Orthopedic Surgeons.Low back pain.
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