Up to 80% of Americans report experiencing back pain at some point during their life. Often, it’s lower back pain. However, pain can occur anywhere along the spine or the broad canvass of the back and may be caused by any number of conditions—some acute and some chronic.
Despite working as a spine surgeon caring for patients with back pain, I often find the solutions are not surgical. There is a robust range of treatments that can effectively address many of the most common causes of back pain, before considering surgery.
Here’s a look at some of the most common causes of back pain and what to know about each.
1. Muscle or myofascial strain
This is probably the most frequent source of lower back pain. It can be caused by anything from sleeping wrong to lifting something improperly. Strains occur when one of the muscles running on either side of the length of the spine is injured and the pain works its way into the connecting tendons, becoming a type of tendonitis.
2. Hip joint pain
It may seem odd, but a lot of back pain is not due to something wrong with your back. Rather, it’s due to an issue with the hip joint, such as arthritis and merely presents as back pain.
3. Trochanteric bursitis
This is also a hip issue yet can manifest as significant lower back pain. There is a tiny sac of fluid on the outside points of the hip, as well as a muscle running from the lower back around the hip points and down the leg. When the sac of fluid becomes inflamed, it can cause pain in that entire muscle causing discomfort in the back. Anywhere from 20-30% of patients seeking care for low back pain acute actually have hip bursitis.
4. Disc herniation
Occurs when a piece of disc in the spine (the rubber-like layer of cushion between the bones of the spine), slips out of place and hits a nerve. In addition to back pain, a herniation may cause a shooting pain that goes down the buttocks and/or thigh. It may take two or three months, but about 90% of disc herniation repair themselves without surgery.
5. Lumbar disc degeneration/spinal stenosis
This happens when the roots of nerves that run down the spinal column get pinched (stenosis) between a disc that has been worn down and an area of arthritis in the back. As with a herniation, it is often accompanied by shooting pain in the buttocks, thigh or further down the leg. Pain often subsides when sitting or laying down.
The spine is composed of blocks of bone stacked on top of one another. When one block slips forward from the one above it, it can result in back pain. There are several types of spondylosis, but it usually only takes a small shift forward (a few millimeters) to pinch a nerve and cause not only pain in the back, but in the buttocks or legs as well.
The anatomical purpose of the spine is to keep the head in line with the hips. Misalignment due to kyphoscoliosis—or curvature of the spine forward—can result in the muscles of the back trying to compensate to keep the head aligned. Once the muscles become fatigued, back pain follows.
8. Osteoporotic fractures
The elderly and those with low bone density are at greater risk of bones in the spine becoming weak and brittle. At that point, any minor fall, impact or even a big sneeze can cause the bones in the spine to experience a compression fracture. While these typically heal on their own, it’s important to connect with a bone health specialist to help prevent future issues.
9. Pathologic back pain
Most back pain is caused by aging or injury. However, sometimes it can be caused by a spine infection or even cancer (metastatic cancer that has spread from another part of the body). People who are immunocompromised or on dialysis are at increased risk of any number of spine infections.
Figure it out, then work it out
Although back pain is rarely life-threatening, anyone who has experienced it knows how easily it can spoil day-to-day life.
Though surgery may be the answer in some cases, it’s usually worth trying other approaches first. Rest, stretching, massage, physical therapy, injections, medications and, of course, time can relieve many of these conditions.
The first step, though, is getting it checked out. Talk to your doctor or learn more about our back and neck care today.
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- How to talk to your doctor about back pain
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- How do you know when back pain is serious?
About the author
Haariss B. Ilyas, MD, is a spine surgeon on the medical staff at Baylor Scott & White Medical Center – Waxahachie. Dr. Ilyas specializes in managing a wide range of back and spine conditions.