Almost 30% of Americans have some sort of pain in the lower back, and it’s a top cause of disability worldwide. Age plays a role, but the causes can include injures, an inactive lifestyle, poor posture, illnesses, and obesity, among many other things.
If you’re having pain, it’s important to figure out why.
Could it be my lifestyle?
Your back is at the mercy of bad habits like:
- Slouching at your desk
- Lifting and pulling heavy objects with your back rather your legs
- Being overweight
- Not exercising enough
- Wearing high heels
- Carrying an overloaded backpack
All of these things can lead to lower back pain.
Is it in my head?
You may carry your stress in your back -- the muscles feel like they’re in knots. And the pain can feel much worse if you’re also depressed or anxious.
Is it because of something I did?
Falling down, getting into a car accident, or even overdoing it in that pick-up game over the weekend can cause problems you feel in your lower back, like:
Spine/vertebral fractures: Your back may have a broken bone if it gets hit hard or you fall from a great height.
Sprains and strains: Lifting and twisting at the same time, or swinging a golf club, can pull or tear the ligaments, muscles, and tendons in your back.
Spasms: These are muscle contractions, and they hurt. They generally happen when you sprain or strain your lower back.
Is it a mechanical problem?
In many cases, the pain happens when parts of the back -- the spine, joints, tissues, muscles, and the discs that cushion the spinal bones (vertebrae) -- are out of sync. If your back isn’t feeling quite right, have your doctor check for:
Herniated or slipped discs: The bones of your spine are cushioned by discs, often referred to as “shock absorbers.” When they wear down, the soft tissue between them begins to squeeze out. This is when you start to feel it -- especially if they rupture. It can happen if you’ve had a sudden injury, or because of simple wear and tear.
Bulging discs: The stuff inside your discs “bulges,” but not as much as with a herniated disc. They often cause no symptoms on their own, but they can bring pain if the disc pushes up against a nerve root.
Degenerative disc disease: The discs that separate your vertebrae wear down. This sometimes causes the bones to rub together. Age is usually the reason, but sports and injuries can be culprits, too.
Inflammation and movement problems of the sacroiliac joint: This joint sits at the bottom of the spine, on either side of the pelvis. It transfers the weight of your upper body to your lower body. This can start to bother you after you’ve been injured, if you have an infection, if you have arthritis, or if you’re pregnant. Abnormal movement, such as too much movement of the joint, can also cause long-term pain.
Lumbar spinal stenosis: If you’re over age 60, there’s a decent chance this is your culprit. As you age, your spinal canal narrows. That change can put pressure on the nerves running through your spine. Your shoulders and legs will then start to feel numb.
Cauda equina syndrome: This happens if a ruptured disc pushes down into the nerve roots in your spine. It may be what’s causing your pain if bladder and bowel control have been an issue for you lately.
Sciatica: This may be your cause if you have a sharp pain in your lower back or hip. It happens when a herniated disc presses on the nerves in your lower spine.
Arthritis: This causes stiffness, swelling, and inflammation in your joints. If your doctor mentions “ankylosing spondylitis,” he’s talking about a type of inflammatory arthritis that affects the joints and ligaments along your spine.
Osteoarthritis: This is when your cartilage and bone begin to break down and there is inflammation.
Scoliosis: You may hear this called “curvature of the spine.”If you have it, chances are you were born with it. Pain tied to it usually starts at about middle age.
Spondylolisthesis: If your doctor mentions this, a bone in the spine has slipped out of place, probably in your lower back. This can be seen by X-ray or MRI.
Spinal stenosis: This is a narrowing of the spinal canal that causes pressure on the spinal cord or nerve roots. It's usually from arthritis or bony growth from wear and tear.
Could a health condition I have be to blame?
Lower back pain can also be caused by other things that are going on in your body.
Pregnancy: All that weight out front can put a real strain on your back.
Tumors: They usually don’t start in the back, but are part of the spread of a cancer in the spine that started somewhere else in your body.
Infections: Osteomyelitis, discitis, and septic sacroiliitis are uncommon infections that affect the bones, discs, and joints of the spine. Any one of these can cause pain in your lower back. Kidney infections can also cause your back to feel the brunt.
Other issues: Low back pain can also happen because of things like:
- Kidney stones
- Endometriosis, a buildup of uterine tissue outside the uterus
- Fibromyalgia, a condition that causes widespread muscle pain