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Different kinds of back pain

Description

Back pain can have many different causes, especially when we get older. In younger adults, though, there are fewer causes for back pain.

One single event is rarely the cause of your pain. You may have been doing many movements improperly -- such as bending or lifting -- for a long time. Then, suddenly, one simple movement, such as reaching for something or bending from your waist, causes acute onset of pain.

You are at greater risk for low back pain if you:

  • Are over age 30
  • Are overweight
  • Are pregnant
  • DO NOT exercise
  • Feel stressed or depressed
  • Have a job in which you have to do a lot of heavy lifting, bending and twisting, or that involves whole body vibration (such as truck driving or using a sandblaster)
  • Smoke
  • Have injured your back in the past
  • Had surgery on your back in the past

Health care providers use certain terms to describe how long your back pain has been present:

  • Acute back pain is more severe pain that develops suddenly. This pain usually goes away within a few weeks. Acute back pain is the most common type of back pain.
  • Sub-acute back pain is more severe pain that lasts up to 3 months.
  • Chronic (long-term) back pain can begin suddenly or more slowly. It lasts longer than 3 months. Once it begins, it may come and go. In about 5% to 10% of people with chronic back pain, the pain will come and go for the rest of their lives.

Common causes of back pain

Slipped disk: A slipped disk is also called a herniated disk. Normally, disks in your spine provide space and cushioning between the bones in your spine. A slipped disk occurs when part of the disk bulges out and pushes against nearby nerves. This causes pain and other symptoms.

Spinal stenosis:Spinal stenosis is a narrowing of the spaces between the spinal nerves and the spinal cord. It is often caused by changes in the spine that get worse over time due to degeneration of the spine and arthritic changes.

Sciatica: Sciatica is pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. This nerve starts in the lower spine and runs down the back of each leg. Sciatica is a symptom of another medical problem, not a medical condition on its own. Sometimes a condition called piriformis syndrome leads to sciatica. This condition affects a muscle in the buttocks and may cause pain or a dull ache in the buttocks.

Back strain: Back strain is injury to the muscles and ligaments in the back. The pain usually spreads to the muscles next to the spine. Muscle spasms (pain from muscles tightening in quick movements on their own) may also occur from back strain. The pain may move to the buttocks, but it does not usually go down the leg.

Arthritis and degenerative spine disease: Many people with chronic back pain have arthritis and extra wear and tear on the spine. Osteoarthritis can affect any joint in the body, including the spine. The spinal disks dry out and become stiffer and can rupture more easily. You can lose movement in your spine. These changes can also develop in areas where you have a slipped disk or a spinal fracture. This problem may also be called spondylosis.

Facet joint pain: Facet joints are joints that connect the vertebrae (bones of the spine). They allow the spine to move and make twisting and bending movements. Facet joint pain cannot be diagnosed using x-rays or MRI scans. A doctor who treats back pain may be able to diagnose this problem based on your symptoms and physical exam.

Other causes of back pain

Osteoporosis occurs when the body does not form enough new bone, when too much old bone is absorbed by the body, or by both of these things.

  • Your bones contain the minerals calcium and phosphate, which make them strong. As you age, your body may absorb these minerals, and this weakens your bones. Weak bones are brittle and fragile, and they can break easily, even without injury.
  • A compression fracture of the vertebra occurs when one of the vertebra collapses.
  • When more than one vertebra may be affected. Osteoporosis is the most common cause for problems with multiple vertebrae.

Other types of arthritis, besides osteoarthritis, can also cause back pain. They make the joints of the spine become swollen and inflamed, and this leads to pain. These types of arthritis are called psoriatic arthritis, reactive arthritis, ankylosing spondylitis, and rheumatoid arthritis.

Stress fractures in the spine (also called spondylolysis) are a common cause of back pain in young athletes. Sometimes a stress fracture may not show up for a week or two after an injury. Stress fractures are more common in athletes who are gymnasts, defensive football linemen, weightlifters, and cheerleaders. Spondylolysis can cause spondylolisthesis, a condition in which the spine becomes unstable and the vertebrae slip over each other.

Back pain may also be caused by spine problems that need to be treated right away.

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Review Date: 4/3/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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