The costs associated with diagnostic procedures alone are estimated at $50 billion yearly. Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. The personal costs are immeasurable from chronic pain alone, pain sometimes so great that it interferes with a healthy and satisfying lifestyle.

Also, it is recognized that most cases of back pain are mechanical in nature, and the pain is usually not caused by very serious conditions, such as cancer, fracture, infection, etc. The anatomy of the spine and the many conditions that negatively impact spinal health are complex. The following information provides a simplistic explanation of the causes for back pain:

SOME COMMON CAUSES OF LOW BACK PAIN

On many occasions you first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, sustain an injury or have been in an accident. Prior to that moment in time, there was often a pre-existing weakness, or loss of tissue integrity in your spinal structures.

The specific structures in your back responsible for your pain are difficult to determine in many cases. Whether identified or not, there are several possible sources of low back pain:

1. Bulging or herniated discs
2. Injury or overuse of muscles, ligaments, facet joints, and the sacroiliac joints.
3. Muscle spasm (very tense muscles that remain contracted)
4. Degeneration of the discs
5. Poor alignment or fixations of the vertebrae
6. Spondylolisthesis
7. Osteoarthritis
8. Spinal stenosis (narrowing of the spinal canal)
9. Small fractures to the spine from osteoporosis
10. Strain or tears to the muscles or ligaments supporting the back
11. Spinal curvatures (like scoliosis or kyphosis), which may be inherited and seen in children or teens

Less Common Causes of Low Back Pain

• Ankylosing spondylitis, which is a form of joint inflammation (arthritis) that most often affects the spine
• Prostate Cancer
• Bacterial infection, in which bacteria are often carried to the spine through the bloodstream from an infection somewhere else in the body or from IV drug use. However, bacteria can also enter the spine directly during surgery or injection treatments, or as the result of injury. Back pain may also be the result of an infection in the bone (osteomyelitis) or in the spinal cord (most often in the material covering the spinal cord, called an epidural infection).
• Spinal tumors, or growths that develop on the bones and ligaments of the spine, on the spinal cord, or on nerve roots.
• Paget’s disease, which causes abnormal bone growth most often affecting the pelvis, spine, skull, chest, and legs.
• Scheuermann’s disease, in which one or more of the bones of the spine (vertebrae) develop wedge-shaped deformities. This causes curvature of the spine (rounding of the back, or kyphosis), most commonly in the chest region.

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

• Work in construction or another job requiring heavy lifting, lots of bending and twisting, or whole body vibration
• Smoke, don’t exercise, and/or are overweight
• Are over age 30
• Are pregnant
• Have bad posture
• Have arthritis or osteoporosis
• Have a low pain threshold