Back Pain: Causes

By McBratney, Susan PhD

What causes back pain?

Understanding the parts that make up your back and how it works can help you understand why you have back pain. Your back is made up of  bony structures called vertebrae that surround and protect the spinal cord. Within the spinal cord run nerve roots from the brain that send and receive messages to and from the rest of the body. Between the vertebrae are spongy sacs of cartilage, called discs, that act as a cushion and provide range of motion to the back. Muscles, ligaments and tendons provide additional support.

Any of these structures in the back can become irritated or inflamed in response to a variety of mild to serious conditions. A common cause of mild to severe back pain is a sudden or awkward movement during activities, such as gardening and sports, particularly in people who normally lead a relatively sedentary lifestyle. A problem in another part of the body, such as the heart or the reproductive organs, can also radiate to the back. This is called referred back pain.

Structural causes of back pain

Back pain can be due to injury, inflammation, or infection of the bones and tissues including:

  • Herniated disc
  • Muscle spasm
  • Osteoarthritis
  • Osteomyelitis (infection or inflammation of the spinal bones)
  • Osteoporosis (metabolic bone disease)
  • Paget’s disease of the bone
  • Sciatic nerve damage due to spinal stenosis or degenerative disc disease
  • Spinal degeneration (degenerative disc disease, also called spondylosis)
  • Spinal stenosis (a narrowing of the spinal canal that presses on the spinal cord or nerves)
  • Spine fracture
  • Spondylitis (infection or inflammation of the spinal joints)
  • Sprains and strains due to overuse or injury

Other possible causes of back pain

Back pain can also be due to systemic problems or problems affecting other body systems including:

  • Fibromyalgia
  • Pelvic inflammatory disease
  • Premenstrual syndrome
  • Uterine prolapse

Life-threatening causes of back pain

In some cases, back pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Possible life-threatening conditions that involve back pain include:

What are the risk factors for back pain?

Although anyone can experience back pain, there are certain risk factors that make you more likely to encounter back pain at some point in your life. Back pain most often begins between 30 and 50 years of age. The activities associated with this age group, along with the increasing age of the spine and associated tissues, are the most influential factors in back pain. Risk factors include:

  • Congenital (present at birth) or acquired back deformities, such as scoliosis)
  • Family history of back pain or disease, such as degenerative disc disease)
  • Increasing age
  • Obesity
  • Poor posture
  • Sedentary lifestyle
  • Smoking
  • Stress and anxiety
  • Weak abdominal (core) muscles

What are the potential complications of back pain?

The complications associated with back pain depend on the underlying disease, disorder or condition. For example, back pain resulting from a degenerative condition such as spondylosis can lead to inactivity and its associated complications. Fortunately, most cases of back pain can be alleviated or minimized by physical therapy, basic self-care measures, and the treatment plan outlined by your doctor.

However, in some cases the degree and duration of your back pain may become overwhelming and affect your everyday living. Research into the diagnosis and treatment of back pain is ongoing, so contact your health care professional for the latest information.

Over time, back pain can lead to complications, including:

  • Absenteeism from work or school
  • Chronic pain or discomfort
  • Permanent nerve damage (due to a pinched nerve), including paralysis
  • Permanent physical disability
  • Physiological and psychological response to chronic pain
  • Poor quality of life


  1. Low Back Pain Fact Sheet.
  2. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
  3. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.

What is back pain?

Back pain is any type of pain or discomfort throughout the posterior (back) portion of your trunk, from the pelvis up through the neck. (However, most people who have pain around their neck would describe it as neck pain, not back pain.) Back pain is a very common problem in the United States, second only to Read more about back painintroduction


What other symptoms might occur with back pain?

Back pain may occur with other symptoms depending on the underlying disease, disorder or condition. For instance, if your back pain is due to arthritis, you may experience pain in other parts of your body. Back pain due to a pinched nerve can even lead to loss of bladder control. Back pain is often a major symptom of fibromyalgia, which is also characterized by Read more about back painsymptoms

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: Aug 23, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

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Many women experience back pain during pregnancy. According to the American Pregnancy Association, possible causes of back pain include increases in hormones that loosen the joints for childbirth; a change in center of gravity because of your developing baby; weight gained during pregnancy; poor posture made worse by pregnancy; and stress.