What are the Most Common Causes of Back Pain?
Author: Dr. Hamid Abbasi
DATE: 10 Sep 2018
Back Pain & Injuries
Back pain is one of the top reasons that people see their doctor or miss work.1 The good news: Most back pain causes are related to conditions that are not serious. And they get better with the proper treatment. Here’s a rundown of what is most likely behind your aching back.
Common Causes of Acute Back Pain
Acute back pain can show up simply as an aching muscle. Or you may experience a shooting or stabbing pain, especially when you bend, lift, stand, or walk. In most cases, the source of the problem is a pulled muscle or ligament. If it’s a muscle that is pulled, it’s called a strain. When a ligament is stretched past its limit, a sprain occurs. If a muscle or ligament is pulled too far, it can tear.
Any number of circumstances — a fall, an accident, or a sports injury — can set you up for a strain or a sprain. The back pain that results is considered acute because it usually gets better within a few weeks with proper care. When it lasts for more than three months, the pain is considered chronic.
Acute back pain can come on suddenly, or it can develop over time, as is the case when repetitive movements overwork and damage your muscles or ligaments. Think of the lifting that your job requires — and maybe you’re not always mindful of good body mechanics. Or your muscles are in not-so-great shape because you’ve skipped too many workouts at the gym. Are you sitting up straight at your desk? Poor posture contributes to acute back pain. Sports injuries are also a culprit, especially when twisting or high-force impact is involved. In any case, the pain, stiffness, and muscle spasms that follow let you know that there’s a problem. With acute back pain, rest and physical therapy are usually the only treatments that are needed.
Common Causes of Chronic Back Pain
Chronic back pain is less common than acute pain and is typically caused by a disc or joint problem that puts pressure on an irritated nerve. A number of fairly common medical conditions can be responsible for chronic back pain. These include:
- Bulging or ruptured disc: Discs are like little cushions so that the bones in your spine don’t rub against each other. The gel-like material inside the discs can bulge or rupture, but not as much as with a herniated disc. In some cases, this causes pain if the disc is pressing on a nerve.
- Herniated disc: A herniated disc occurs when the cushioning substance inside the disc breaks through its protective outer layer and irritates a nerve root. In most cases, this is caused by long-term wear and tear. The result can be severe pain because of the abundance of nerve fibers that are found in the disc wall.
- Osteoporosis: Osteoporosis occurs when bones become brittle and weak. When osteoporosis affects the spine, compression fractures can occur. In severe cases, just sneezing is enough to cause a fracture.
- Arthritis: Arthritis is a degenerative disease. In the spine, it wears down the cartilage on the joint surfaces, causing pain and inflammation. It can also lead to spinal stenosis.
- Degenerative disc disease: Discs are the spine’s shock absorbers. As we age, our discs dry out and wear down. Older discs are less able to absorb force and can weaken or tear, making them more likely to herniate. Or the disc may collapse, leading to stenosis.
- Spinal stenosis: Spinal stenosis is a deterioration of the discs between the vertebrae. The spinal canal narrows, usually because of age, and puts pressure on the spine and nerves. The increased pressure on the nerve roots within the narrowed spinal canal can cause numbness in the legs or shoulders. Stenosis occurs most frequently in people who are over the age of 60.
- Sciatica: Sciatica is an irritation of the sciatic nerve. It causes a burning or tingling pain that runs along the sciatic nerve from the base of the spine down one or both legs and sometimes into the feet. It is usually caused by a herniated disc that puts pressure on the sciatic nerve.
- Cervical radiculopathy: Cervical radiculopathy is a medical term for a pinched nerve in the neck. It is usually caused by a herniated disc. It can cause pain, weakness, or numbness that spreads down the arms or into the chest.
- Injury or trauma: An injury that causes a fracture or other significant trauma to the spine, such as what might occur as a result of an auto accident or a fall, is a common cause of back pain.
- Irregular skeletal structure: If the skeleton is not formed normally, back pain can result. In scoliosis, for example, the spine is curved and can cause back pain, but usually not until mid-life.
- Spondylolisthesis: Spondylolisthesis happens when a vertebra slips out of alignment. The vertebra can move if the narrow bridge of bone in the back of the vertebra fractures. In most cases, this happens in the lower back.
- Sacroiliac joint dysfunction: The sacroiliac joint is where your spine and pelvis meet. If the sacroiliac joint becomes inflamed, back pain follows.
- Compression fractures: A compression fracture can occur because the bone has become weak and brittle. This lack of bone density causes bones to crumble just from the weight of supporting the spine. These fractures are most likely to occur in older people. Osteoporosis contributes to compression fractures.
Major Risk Factors for Back Pain
So who is most likely to develop back pain? Although age is a factor, back pain can afflict even children and teenagers. For most people, though, it shows up between the ages of 30 and 50. It is most common in older adults because, with age, the fluid between the vertebrae dries out so discs become more vulnerable. Increasingly brittle bones and the loss of muscle tone that comes with time also contribute.
Other risk factors include:
- Excessive weight,which puts stress on the muscles in your back.
- Improper lifting technique, by using your back rather than the big muscles in your legs to lift heavy objects.
- Poor physical condition because a lack of muscle tone in your back and abdomen fails to support your spine properly.
- Smoking, which restricts blood flow to the lower spine so the flow of nutrients to your back is not sufficient to maintain good health.
- Psychological conditions, such as anxiety or depression, which appear to be related to a higher incidence of back pain2.
Treatment always depends on determining what’s causing the back pain. When back pain becomes troublesome or goes on for too long, it’s best to get expert medical advice. A doctor can determine what’s causing the pain and what to do about it.
If you need help to determine what’s causing your back pain, contact the spine care specialists at Inspired Spine.