Back pain can range from a muscle aching to a shooting, burning or stabbing sensation. In addition, the pain may radiate down your leg or worsen with bending, twisting, lifting, standing or walking.
When to Call
Most back pain gradually improves with home treatment and self-care, usually within a few weeks. Contact your doctor if your back pain:
- Persists past a few weeks
- Is severe and doesn’t improve with rest
- Spreads down one or both legs, especially if the pain extends below the knee
- Causes weakness, numbness or tingling in one or both legs
- Is accompanied by unexplained weight loss
In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:
- Causes new bowel or bladder problems
- Is accompanied by a fever
- Follows a fall, blow to your back or other injury
Back pain often develops without a cause that your doctor can identify with a test or an imaging study. Conditions commonly linked to back pain include:
- Skeletal irregularities such as scoliosis (a curvature of the spine), lordosis (an abnormally exaggerated arch in the lower back), kyphosis (excessive outward arch of the spine), and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
- Sprains (overstretched or torn ligaments), strains (tears in tendons or muscle), and spasms (sudden contraction of a muscle or group of muscles)
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
- Nerve and spinal cord problems
- Spinal nerve compression, inflammation and/or injury
- Sciatica (also called radiculopathy), caused by something pressing on the sciatic nerve that travels through the buttocks and extends down the back of the leg. People with sciatica may feel shock-like or burning low back pain combined with pain through the buttocks and down one leg.
- Spinal stenosis, the narrowing of the spinal column that puts pressure on the spinal cord and nerves
- Spondylolisthesis, which happens when a vertebra of the lower spine slips out of place, pinching the nerves exiting the spinal column
- Herniated or ruptured discs can occur when the intervertebral discs become compressed and bulge outward
- Infections involving the vertebrae, a condition called osteomyelitis; the intervertebral discs, called discitis; or the sacroiliac joints connecting the lower spine to the pelvis, called sacroiliitis.
- Cauda equina syndrome occurs when a ruptured disc pushes into the spinal canal and presses on the bundle of lumbar and sacral nerve roots. Permanent neurological damage may result if this syndrome is left untreated.
- Osteoporosis (a progressive decrease in bone density and strength that can lead to painful fractures of the vertebrae)
- Kidney stones can cause sharp pain in the lower back, usually on one side
- Endometriosis (the buildup of uterine tissue in places outside the uterus)
- Fibromyalgia (a chronic pain syndrome involving widespread muscle pain and fatigue)
- Tumors that press on or destroy the bony spine or spinal cord and nerves or outside the spine elsewhere in the back
- Pregnancy (back symptoms almost always completely go away after giving birth)
Anyone can develop back pain, even children and teens. These factors might put you at greater risk of developing back pain:
- Age. Back pain is more common as you get older, starting around age 30 or 40.
- Lack of exercise. Weak, unused muscles in your back and abdomen might lead to back pain.
- Excess weight. Excess body weight puts extra stress on your back.
- Diseases. Some types of arthritis and cancer can contribute to back pain.
- Improper lifting. Using your back instead of your legs can lead to back pain.
- Psychological conditions. People prone to depression and anxiety appear to have a greater risk of back pain.
- Smoking. Smokers have increased rates of back pain. This may occur because smoking prompts more coughing, which can lead to herniated disks. Smoking can also decrease blood flow to the spine and increase the risk of osteoporosis.
You might avoid back pain or prevent its recurrence by improving your physical condition and learning and practicing proper body mechanics. To keep your back healthy and strong:
- Exercise. Regular low-impact aerobic activities — those that don’t strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices. Talk with your doctor about which activities you might try.
- Build muscle strength and flexibility. Abdominal and back muscle exercises, which strengthen your core, help condition these muscles so that they work together like a natural corset for your back.
- Maintain a healthy weight. Being overweight strains back muscles. If you’re overweight, trimming down can prevent back pain.
- Quit smoking. Smoking increases your risk of low back pain. The risk increases with the number of cigarettes smoked per day, so quitting should help reduce this risk.
- Avoid movements that twist or strain your back. Use your body properly:
- Stand smart. Don’t slouch. Maintain a neutral pelvic position. If you must stand for long periods, place one foot on a low footstool to take some of the load off your lower back. Alternate feet. Good posture can reduce the stress on back muscles.
- Sit smart. Choose a seat with good lower back support, armrests and a swivel base. Placing a pillow or rolled towel in the small of your back can maintain its normal curve. Keep your knees and hips level. Change your position frequently, at least every half-hour.
- Lift smart. Avoid heavy lifting, if possible, but if you must lift something heavy, let your legs do the work. Keep your back straight — no twisting — and bend only at the knees. Hold the load close to your body. Find a lifting partner if the object is heavy or awkward.