There are 59 possible causes of back pain

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Back pain (medically referred to as “lumbago”) is not a disease; it is a symptom.

Back pain usually refers to a problem with one or more of the structures of the lower back such as ligaments, muscles, nerves, or the vertebral bodies (the bony structures that make up the spine). It can also describe pain caused by a problem with nearby organs, such as the kidneys or lungs.

Eighty to 90 percent of Americans will experience back pain in their lifetime. Of these, 50 percent will have more than one episode. Eighty-five percent of the time, no cause for this problem is found. Back pain is a major cause of missed days at work and costs the American public $50 billion annually.

Understanding the Back

To understand the causes of back pain, it helps to understand the back. Your back is composed of many parts, including:

  • the spine
  • muscles
  • tendons
  • ligaments
  • nerves
  • blood vessels

The spine is one of the keys to back pain. It is made up of lumbar and sacral vertebrae (the bones of the spine), disks of cartilage between the vertebrae, nerves and your spinal cord, and muscles and ligaments that hold it together.

What Causes Back Pain?

The most common causes for back pain are strain and problems with back structures.


Strained muscles and ligaments often cause back pain. Strain commonly occurs with improper lifting of heavy objects and sudden awkward movements. However, strain can also result from over-activity. An example is the sore feeling and “stiffness” that might occur after a few hours of yard work or after playing a sport.

Structural Problems

Vertebrae are interlocking bones that are stacked on top of one another at the back of the torso or trunk of your body. Disks made of cartilage cushion the area between each vertebra. Disk injuries are a fairly common cause of back pain.

Sometimes these disks can bulge (herniate) or rupture. When this happens, nerves can get compressed. Herniated disks can be very painful. If a bulging disk presses on the nerve that travels from your back down your leg, it can cause sciatica or irritation of the sciatic nerve. Sciatica can be experienced as a pain, tingling, numbness, or weakness in the leg.

Abnormalities of the skeleton such as scoliosis or narrowing of the spinal canal due to arthritis can also cause back pain.

Osteoporosis, loss of bone density and thinning of the bone, is a very common bone condition that can lead to fractures in the vertebral bodies of your spine. These fractures, which can cause serious pain, are referred to as compression fractures.

Other Causes of Back Pain

There are many other potential causes of back pain, but most of these are fairly rare. If you experience regular back pain that does not go away, be sure to see your doctor. After ruling out the more common causes of back pain, your doctor will perform tests to determine if you have one of these rarer causes of pain:

  • spinal stenosis (narrowing of the spinal canal)
  • degenerative spondylolisthesis (displacement of one vertebral body onto another)
  • cauda equine syndrome (loss of nerve function at the lower spinal cord)
  • infection of the spine (fungal or bacterial—typically Staphylococcus or E. Coli)
  • cancer or non-malignant tumor in the spine

What Are the Characteristics of Back Pain?

Back pain can have any of the following characteristics:

  • dull, aching sensation in the lower back
  • stabbing or shooting pain that can radiate down the leg to the foot
  • inability to stand up straight
  • decreased range of motion and diminished ability to flex the back

The symptoms of back pain, if due to strain or misuse, are usually short-lived but can last for days or weeks. Back pain is chronic when symptoms have been present for longer than three months.

Back Pain Symptoms That May Indicate a Serious Problem

The Mayo Clinic states that you should see your doctor if back pain does not improve within the first 72 hours of self-care. There are times when back pain can be a symptom of a serious medical problem. Symptoms that can indicate a more serious medical problem are:

  • loss of bowel or bladder control
  • numbness, tingling, or weakness in one or both legs
  • onset following trauma such as a fall or a blow to the back
  • intense, constant pain that gets worse at night
  • presence of unexplained weight loss
  • pain associated with a throbbing sensation in the abdomen
  • presence of fever

Risk Factors For Back Pain

You are at an increased risk for back pain if:

  • You work in a sedentary environment. Going from a sedentary workplace to high-impact activity can lead to back strain.
  • You are of older age.
  • You are female
  • You are obese
  • You are a smoker

Studies show that your emotional health also has an effect on your risk for back pain. If you have a stressful job or suffer from depression and anxiety, you are at a high risk for back pain.

How Is Back Pain Diagnosed?

Most of the time, a physical exam is all that is needed to diagnose back pain. During the physical exam, your doctor will test the range of motion of your spine and your ability to sit, stand, and walk. The doctor may also test your reflexes, leg strength, and your ability to detect sensations in your legs.

If a more serious condition is suspected, your doctor might order other tests. These might include:

  • blood and urine tests to check for underlying conditions
  • X-rays of the spine to show alignment of your bones and check for breaks
  • computed tomography (CT) scan, or magnetic resonance imaging (MRI) to assess your disks, muscles, tendons, ligaments, nerves, and blood vessels
  • bone scan
  • electromyography (EMG) to test nerve conduction



The majority of back pain episodes are relieved by treatment with nonsteroidal anti-inflammatory medications such as: aspirin, ibuprofen (Motrin), or naproxen (Aleve) or analgesics (pain relievers) such as acetaminophen (Tylenol). Except for acetaminophen, these medications should be taken with food because they can irritate the stomach and cause it to bleed.

If back pain is severe, your physician may prescribe medications that contain a narcotic such as codeine. Low dose amitriptyline, a tricyclic antidepressant, can also relieve back pain.

At times, your doctor might recommend cortisone steroid injections for severe back pain. Pain relief from steroid injections lasts no longer than a few months; the body builds up immunity to the effects of cortisone.

Home Remedies

In the acute phase of back pain, ice packs may relieve discomfort and help lessen inflammation. When inflammation has subsided, warm compresses may relieve pain.

Exercises to improve posture and strengthen the muscles of the back and all abdominal muscles (core muscles) are a treatment option that should be strongly considered. Improving posture, using proper lifting techniques, and having stronger back and abdominal muscles help to prevent recurrences.


Surgery is a treatment of last resort and is rarely needed for back pain. It is usually reserved for structural abnormalities that have not responded to conservative treatment, severe, unremitting pain, and nerve compression that cause muscles to become weak.

Spinal fusion is a surgery in which painful vertebrae are fused into one single, more solid bone. It helps eliminate painful motion of the spine.

Surgery to partially remove and replace disks and vertebrae may be done to relieve pain caused by degenerative bone diseases.

Alternative Medicine

According to the Mayo Clinic, devil’s claw, (Harpagophytum procumbens—a plant in the sesame family) and willow bark (Salix alba) taken orally and capsicum (Capsicum frutescens—chili pepper) plaster applied topically may relieve low back pain. These herbs are known to have anti-inflammatory properties.

Other alternative therapies include: acupuncture, massage, chiropractic adjustments, cognitive behavioral therapy, and progressive relaxation.

According to the National Institutes of Health, acupuncture is a proven remedy for chronic pain such as low back pain.

Be sure to talk to your doctor before undergoing any alternative or complementary treatment. 

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Possible Causes - Listed in order from the most common to the least.


Sprains & Strains

Sprains and strains are injuries to the body, often resulting from physical activity. These injuries are common and can range from minor to severe, depending on the incident. Most don

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Slipped (Herniated) Disk

The vertebrae in your spine are cushioned by disks composed of a hard outer ring with a gelatinous material inside. Injury or weakness can cause the inner portion of the disk to break through the outer portion.

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The sciatic nerve begins at the spinal cord, stretching through the hips and buttocks, and down each leg. When this nerve is irritated, you will experience sciatica, a painful, weak, or numb sensation in these areas.

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Whiplash occurs when a person

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Kidney Stones

Kidney stones are solid masses of crystalized calcium or other substances that originate in the kidneys but can pass through the urinary tract. The greatest risk factor is making less than one liter of urine per day.

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Painful Menstrual Periods

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Ectopic Pregnancy

This condition is considered a medical emergency. Urgent care may be required.

Ectopic pregnancies occur when a fertilized egg fails to attach to the uterus. In most ectopic pregnancies, the egg will attach to the fallopian tubes. Less common, it may also attach to the abdominal cavity or cervix...

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What is Fibromyalgia?

Fibromyalgia is a chronic disorder characterized by unexplained pain in muscles and joints throughout the body. Read our doctor-reviewed articles and learn about fibromyalgia now.

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Compression Fracture of the Back

A compression fracture of the back occurs when the bones of your spine (vertebrae) collapse. Compression fractures can cause your vertebrae to collapse, leading to poor posture, pain, loss of height, and a variety o...

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Radiculopathy refers to disease of the spinal nerve roots. Radiculopathy produces pain , numbness, or weakness radiating from the spine.

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Scoliosis is an unnatural curvature of the spine. The normal shape of the spine includes a top-of-the-shoulder curve and a lower back curve. If your spine is curved from side to side or in an "S" or "C" shape, yo...

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Heart Attack Overview

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In the movies, heart attacks are always very obvious. In reality, heart attacks aren't always so sudden or dramatic. Read our brief overview for information about heart attacks.

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Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the reproductive organs in women. The pelvis is located in the lower abdomen and includes the fallopian tubes, the ovaries, the cervix, and the uterus. According t...

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Ovarian Cysts

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Many people can develop gallstones and never know it. Gallstones are hard deposits in your gallbladder, a small organ that stores bile, a digestive fluid made in the liver. Gallstones may consist of cholesterol, salt...

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Spinal Stenosis

The spine is a column of bones. It provides stability and support for the upper body. It enables us to turn and twist. Spinal nerves run through openings in the vertebrae and conduct signals from the brain to rest o...

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Infective Endocarditis

Infective endocarditis is an infection in the heart valves or endocardium. The endocardium is the lining of the heart. This condition is usually caused by bacteria entering the bloodstream and infecting the heart...

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.