The Most Common Causes of Back Pain Explained

Page content

Muscle Strains

Muscle strains represent the most common cause of back pain. Muscle strains occur when you put too much pressure on the muscles during physical activity. Common causes of muscle strain include heavy lifting, vigorous exercise, competitive sports participating and sudden physical activity. When a strain occurs, it can tear the tendons or muscle fibers of the muscle. Muscle tearing may also cause bleeding because of damage to capillaries (tiny blood vessels) in the body.

In addition to back pain, this injury can cause muscle weakness, bruising and pain even when you are resting. If you experience a muscle strain, try self-care measures for 24 hours. If rest and heat do not relieve the pain, seek medical attention. Your doctor may recommend rest, restricted activity, the use of crutches or physical therapy exercises. If your injury produces a popping sound or you cannot walk after the injury, go to the emergency room for immediate treatment.

Herniated Disk

The spine consists of vertebrae, tiny bones cushioned by disks made of an inner and outer layer. When the inner layer of a disk pushes through a tear in the outer layer, doctors refer to the condition as a herniated disk. This condition most commonly occurs in older people who have age-related degeneration of the spine. This happens when the spine loses some of its flexibility. In some cases, disk herniation happens when someone lifts a large object incorrectly. Lifting with the back muscles instead of the leg muscles increases the risk of injury.

Some risk factors also increase the risk of herniated disk. Overweight and obesity strain the disks in the spine, particularly those in the lower back. Smoking decreases the amount of oxygen in the blood, which deprives the disks of the nutrients they need. Tall people also have a higher risk of disk herniation. Working at a physically demanding job, such as those that require frequent bending and lifting, make it more likely that you will herniated a disk. Without treatment, a herniated disk may cause bladder dysfunction, loss of sensation in the thighs and back of the legs, increasing pain and numbness, bowel dysfunction and leg weakness.

Treatment options for this condition range from rest to surgery. Rest and modified activity relieve some of the strain and pressure on the herniated disk. This reduces the pain and weakness associated with this condition. Physical therapy involves ultrasound, application of heat and ice, electrical stimulation and traction. These treatment methods reduce pain and the risk of complications. Anti-inflammatory medications and muscle relaxers treat spasms and pain associated with herniated disk. Microdiskectomy, the most common surgical treatment for herniated disk, involves removing the herniated portion of the disk to relieve pressure on the compressed nerves.


Doctors refer to a weakening of the bones as osteoporosis. Johns Hopkins estimates that 10 million Americans have osteoporosis, with 8 million women and 2 million men affected by this disease. As bone density decreases, the risk of bone fracture increases. People with osteoporosis have very brittle bones, which makes something as simple as coughing difficult. Coughing, sneezing and even moving can cause fractures. Some risk factors increase the likelihood that you will develop this condition. They include tobacco use, lack of physical activity, low calcium intake, frequent alcohol consumption and some medications.

Bone density loss does not cause symptoms when it first begins. As the loss of bone mass worsens, symptoms appear. These symptoms include back pain, stooped posture, height loss and tiny fractures of the bones. Women over the age of 65 and women over the age of 70 should get a bone density test to look for signs of osteoporosis. Those who have risk factors for the condition should get a bone density between the ages of 50 and 70, depending on the number and severity of risk factors present. Treatment for this condition includes medications to preserve bone mass, physical therapy to improve bone strength and hormone therapy to help women preserve their bone density.

Ligament Sprain

The body contains ligaments, which connect the muscles to the bones. Many activities can cause a ligament sprain, including twisting the wrong way, getting hit by a large object, falling or lifting heavy objects without using proper lifting techniques. Symptoms of a back ligament sprain include back pain, bruising and swelling. If the sprain is severe, you may feel a tear at the time of your injury. Mild sprains only require self-care measures, such as rest and the administration of the over-the-counter drug for pain relief. More severe sprains require immobilization of the affected area and rest. Surgery is an option for the most severe ligament sprains.

Spinal Stenosis

Spinal stenosis, or narrowing of the canal that contains the spinal cord, causes back pain and other symptoms. This condition usually occurs in people over the age of 50, but can also occur as the result of bone spurs, arthritic changes to the spine and thickened ligaments in the spinal cavity. The complications of spinal stenosis depend on the location of the narrowing. Cervical stenosis affects the cervical portion of the spine, which is at the neck. This type of stenosis may cause weakness, incontinence and paralysis. Lumbar stenosis refers to a narrowing of the lower back portion of the spine. This can cause a serious complication known as cauda equine. In this complication, the lower end of the spine compresses the nerve roots. This may lead to paralysis.

Several treatments ease the symptoms of spinal stenosis. Anticonvulsants, which doctors typically use to prevent seizures, ease pain caused by damaged nerves. Drugs in this class include Neurontin and Lyrica. Antidepressants help relieve the pain caused by this condition. Percocet and Vicodin, opioid drugs, also relieve pain. These drugs contain addictive substances, so you should only use them when needed to control pain. Physical therapy may help improve your flexibility, ease pain and build your strength. Steroid injections relieve inflammation caused by spinal stenosis. Because these injections may cause weakness of the nearby structures, you may only get these injections a few times each year. Doctors only consider surgery if other treatments do not ease your symptoms or if spinal stenosis has disabled you.