Most of the time, low back pain is caused by strained back muscles. But in some cases, problems with your spine can lead to pain in your lower back.
Examples of this include:
Bulging or ruptured disks. Your spine has rubbery disks that cushion the bones in your spine (your vertebrae). Injury, age, or overuse can cause these disks to bulge or rupture. Sometimes, it won’t cause any problems. But those damaged disks can press on nerves in your lower back.
Disk degeneration. Your doctor may call this intervertebral disk degeneration. As you age, the disks in your back can break down. If this happens, they won’t cushion your vertebrae as well.
Spondylolisthesis. This is when one of the vertebrae in your spine slips out of place. That pinches the nerves in your spine, which can make your lower back hurt.
Axial spondyloarthritis. This is a set of disorders that cause inflammation in your spine and pelvis. There are two types of axial spondyloarthritis. Non-radiographic axial spondyloarthritis doesn’t show joint damage on an X-ray but still causes inflammation and pain. Ankylosing spondylitis also causes inflammation and pain, and it does show joint damage on an X-ray.
Osteoporosis. Your bones get thinner, which makes them weak and more likely to break. If you have osteoporosis, the vertebrae in your spine can break. This can cause sudden, severe back pain that can get worse if you stand or walk.
Spinal stenosis. This is when the space around your spinal cord (your doctor may call it your spinal column) narrows. This puts pressure on your spine and can lead not only to pain in your lower back, but numbness and weakness in your legs. Spinal stenosis is often a result of arthritis.
Spine irregularities. Scoliosis, an abnormal curve in your spine, can cause your back to hurt. Lordosis, an abnormally arched lower back, can too.
Spine infections. These are rare. But if you do get one, it can make your back hurt. Infections usually cause other things, too, like fever, chills, and a headache.
More recently, doctors have started to use the term vertebrogenic low back pain. It's caused by compressed nerves in your vertebral endplates, the layers of bone and cartilage in your back bones.
What to Do
If you’re having back pain that’s affecting your day-to-day activities, see your doctor. They’ll take a health history and, if needed, use tests, like X-rays and an MRI, to figure out if a spinal problem is causing your pain. If so, your doctor may order more tests.
Many of the things that can ease pain in your back from more common causes (like muscle strain) can help with spinal problems, too. For example:
Medication. Your doctor may recommend a prescription nonsteroidal anti-inflammatory drug (NSAID) to ease pain and inflammation and make you feel better.
Maintaining a healthy weight. Extra weight strains your lower back, which can bring pain.
A nutritious diet can help you feel better. And getting enough calcium, vitamin D, and phosphorus from foods like salmon and leafy greens can help keep the bones in your spine healthy.
Exercise can also help keep your weight where it should be. Your doctor or a physical therapist can help you learn ways to exercise safely. You may do activities that make the muscles in your back and abdomen (your core) stronger, improve your flexibility, and help you sit, stand, and move in a way that helps your spine.
Surgery for Spinal Problems
Your doctor will recommend surgery for your spine problems only if other treatments don’t work. For example, if you have a disk problem, you may need to have a discectomy. That’s when a surgeon removes a disk in your back to ease pain and prevent more problems.
If you have spinal stenosis, your doctor may recommend a procedure called a spinal laminectomy (also known as a spinal decompression). That involves removing any bone spurs as well as the bony walls of your vertebrae. That opens up the spinal column and relieves pressure on the nerves, which makes you hurt less.
