Most Common Back Pain Causes
You can develop back pain for many reasons, but some causes are more common than others. Wear and tear on the bones that form your spine (called vertebrae), muscles, and other tissues in your back can occur due to aging or overuse, leading to aches and pains. Injuries from accidents, falls, and other forms of trauma are another common cause of back pain. Others include autoimmune diseases that trigger chronic inflammation in your spine and other back structures. Back pain can also be a symptom of some diseases, such as cancer, or can be linked to certain infections.
Your back has three distinct regions, which you can think of as upper, middle, and lower. While most of the major causes of back pain can affect all three regions, some causes of aches and stiffness strike more often in the lower back, while others tend to affect the middle and upper sections. And while back pain is one of the most common physical complaints, its causes can vary greatly from one person to another.
Upper Back Pain Causes
The vertebrae in your upper back and neck form the cervical spine. Some common causes of upper back pain include:
Poor posture. Your spine works best when you stand or sit up straight. Poor posture or slumping increases pressure on some joints and can irritate nerves, which can cause pain. Simply sitting or standing in one position for a long time can cause back pain, too.
While poor posture can affect your entire spine, some bad habits target the upper back. For example, if you sit at a computer in a chair that’s too low and need to tilt your head upward to see the screen, a posture doctors call “poking chin,” you may develop pain in the upper back, as well as neck and shoulders.
Muscle strain and sprains. Every time you bend or twist, an elaborate network of muscles, tendons (bands of tissue that attach muscles to bones), and ligaments (tissues that attach bone to bone) swing into action to manipulate your spine. Stretching or tearing one of these important tissues while exercising or trying to lift a heavy object, for example, can result in pain. Muscle strain can happen anywhere in the back.
Spinal stenosis. Your spinal canal is a cavity that runs through the spine and contains the spinal cord, which is nerve tissue that communicates messages back and forth from the brain to the rest of the body. Spinal stenosis occurs when this canal becomes too narrow. While spinal stenosis can affect the upper back, it is a major problem in the lower back; read more about this common cause of back pain below.
Degenerative disk disease. Your bony vertebrae are separated from one another with cushiony pads of tissue called disks that act like shock absorbers. As you age, disks can shrink and dry up, causing them to become less effective, known as degeneration. As your shock absorbers wear away, your vertebrae may grind against one another, causing pain. Degenerative disk disease is common in the cervical spine and lower back.
Cervical radiculopathy. As the name suggests, this problem affects the cervical spine. Cervical radiculopathy occurs when a nerve root in this part of the spine becomes compressed, which can cause intense pain. Trauma and disk herniation (see below) are common causes among younger people, while cervical radiculopathy is typically caused by other problems, such as disk degeneration and arthritis, among older men and women.
Upper back pain when breathing
If you feel pain in your upper back when you take a breath, there’s a good chance it’s due to a simple problem, such as a strained muscle. However, if the pain lasts longer than a week or becomes unbearable, see a doctor. In rare cases, problems arising from the lungs can cause back and chest pain. A doctor can examine you and determine if a more serious condition might be causing your painful symptoms.
Middle Back Pain Causes
Your thoracic spine is the region beneath the cervical spine, in the middle of your back. Some common back pain causes are less likely to occur in your middle back, but it can still develop problems and leave you aching and stiff.
Compression fractures. Like any bone, your vertebrae can break or fracture. Small cracks or breaks that can occur in the vertebrae are known as compression fractures, which typically happen in the thoracic spine in the middle back. Often, a compression fracture will cause back pain that occurs suddenly and may be worse when you move. Accidents can cause compression fractures, but osteoporosis (which weakens bones) is a major cause, too. Less often, cancerous tumors weaken vertebrae and cause fractures.
Psychological stress. When you’re feeling anxious and freaked out by life, changes in the way you breathe can create strain and tension in your middle back. You may also tense up the muscles in your shoulders, which can cause pain in your upper back and neck.
Lower Back Pain Causes
Your lower back, also called the lumbar spine, supports most of your weight. It’s not surprising that more than 80% of people develop low back pain at some time in their lives. Common causes include:
Herniated disk. Your vertebrae are separated by rubbery pads called disks that act like shock absorbers. If the exterior of one of your disks cracks or tears, some of its contents (called the nucleus) can seep out. That may not cause symptoms, but it can put pressure on your spinal canal and nerves, which can cause pain, weakness, and numbness. It may affect not only your back but also your neck or legs. This problem is sometimes called a “ruptured,” “bulging,” or “slipped” disk.
Degenerative disk disease. Over time, the protective disks between your vertebrae can start to break down. That’s due to daily wear and tear, as well as drying out as you age. Injuries can cause damage to disks, too. As a result, your shock-absorbing disks don’t work well and vertebrae rub against one another, causing pain. Disk degeneration tends to be more common in the lower back, as well as in the cervical spine.
Spinal stenosis. Your spine is formed by vertebrae stacked atop one another. Vertebrae are shaped to create a canal that runs through the spine. If your spinal canal narrows, it can put pressure on your spinal cord. You can have spinal stenosis and not even know it, but many people develop pain, numbness, weakness, or a “pins and needles” sensation. Spinal stenosis frequently affects the lower back; about 11% of adults in the U.S. have lumbar spinal stenosis, which is the most common reason people over 65 have spinal surgery.
Sciatica. Some people mistakenly use this term when referring to back pain in general, but sciatica is a specific type that affects the lower back and other parts of your body. The longest and thickest nerves (actually a bundle of them) in your body are the two sciatic nerves. You have one sciatic nerve on each side of your body. They run from your lower back, through your hips and butt, then down to the knees. Other back problems, such as herniated disks and spinal stenosis, can cause these nerves to become inflamed, irritated, or “pinched.” If you have sciatica, the pain and weakness may extend from your lower back down to your legs.
Fractures. Trauma to the spine is a leading cause of back pain, with car accidents responsible for more than one-third (38%) of spinal cord injuries in the U.S. Meanwhile, falls are a common cause of spinal cord injuries in the elderly, accounting for about three-quarters of all cases in people 76 or older. Spinal fractures tend to occur most commonly in the lower or middle back, or at the point where the middle and lower spine meet, called the thoracolumbar junction.
Sacroiliitis. The two junctures where your lower spine and pelvis meet are called the sacroiliac joints. Sacroiliitis occurs when one or both of these large joints become inflamed, which can result in pain in the lower back and buttocks. You can develop this type of back pain simply from wear and tear on the joints, but it can also be related to other medical conditions, including some forms of arthritis and even cancer.
Spondylolisthesis. This condition happens when a vertebra slips out of place and presses against the vertebra beneath it, which puts painful pressure on nerves. Spondylolisthesis can affect any part of your spine but is most common in the lower back.
Smoking. If you smoke tobacco, here’s yet another reason to quit — it could be causing your back pain. Scientists aren’t sure why, but studies have indicated that puffing away could increase the risk for back pain by 30%. It’s possible that smoking damages tissue in the lower back, in particular, preventing your body from delivering nourishing blood and nutrients.
Obesity. Carrying extra weight puts pressure on the protective disks between vertebrae. One study found that obese people are about four times more likely than others to develop disk degeneration.
Lack of exercise. Getting too little physical activity causes muscles in your core to weaken, which promotes back injuries and makes pain feel worse. A brisk daily walk of 30 to 60 minutes can help combat and ease lower back pain.
Lower back pain from kidneys
If you have pain in your lower back, it’s unlikely to be caused by a problem with your kidneys. Some kidney problems, such as kidney stones and infections, can cause back pain. But the discomfort tends to be higher up on the back. If you have persistent back pain anywhere along your spine, see a doctor.
How Accidents and Injuries Cause Back Pain
Car accidents, falls, muscle sprains, strains, and fractures can often cause back pain. Injuries can lead to some of the physical problems, but others can cause pain all on their own.
Spine or vertebral fractures. These can be caused by a direct blow to the back, a fall, or if you have osteoporosis, a condition that weakens your bones.
Sprains and strains. Injuries to ligaments, muscles, and tendons that support the spine and its joints can lead to back pain. This often happens when you lift something and twist at the same time. It can also happen because of car accidents and sports injuries.
Spasms. You can get these when muscles and tendons are torn in your lower back. They usually happen when you’re weightlifting or playing sports.
Other Back Pain Causes
Back pain can also be caused by medical conditions, such as:
Arthritis. This is a joint disease that causes stiffness, swelling, and inflammation. One common type is osteoarthritis, which happens when your cartilage and bones break down. This most often affects people from middle age onward. It also includes inflammatory forms of arthritis, such as ankylosing spondylitis, which affects the joints and ligaments along your spine.
Scoliosis (curvature of the spine). If you have this condition, you were likely born with it. If it causes pain, it typically starts in mid-life.
Pregnancy. The weight you gain when you’re expecting can strain your back.
Tumors. In rare cases, you may develop malignant tumors in your back, which are spread by a cancer that started somewhere else in your body.
Less common causes of back pain are:
- Kidney stones and infections
- Endometriosis, a buildup of uterine tissue outside the uterus
- Osteomyelitis or diskitis, infections in the bones and disks of the spine
- Fibromyalgia, a condition that causes widespread muscle pain
Depending on the cause of your pain, your treatment could include lifestyle changes, medication, or possibly surgery. Talk with your doctor if your back isn’t feeling right. They can help you discover what’s causing the hurt and can help you feel better.
How to Avoid Common Back Pain
If you have struggled with back pain, you can reduce its frequency and severity with some common sense strategies:
- Do some form of muscle-building and stretching exercises at least two days a week.
- Sit up and stand straight — no slouching or slumping in chairs or on the sofa.
- Learn to lift heavy objects without straining your back muscles — keeping your back straight will force your legs to do the bulk of the work.
- Keep your weight under control.
Takeaways
Back pain can come for many different reasons, but a few common causes include wear and tear on the bones that form your spine, muscles, and other tissues in your back, leading to aches and pains. Injuries from accidents, certain autoimmune diseases (that trigger chronic inflammation in your spine and other back structures), cancer, or some infections might also play a role in back pain. If you feel pain for longer than a week, speak to your doctor to confirm the causes of your back pain.
Back Pain FAQs
What is the main reason for back pain?
There is no single main reason for back pain. A few common causes include wear and tear on the tissues that form and support your spine, strain from overuse or trying to lift a heavy object, and injuries from accidents or falls, for example.
How to reduce back pain
Getting regular exercise and keeping your weight under control are two all-around healthy strategies that can help prevent back pain. Maintaining good posture when you sit and stand will help reduce back pain, too.
How do I know if my back pain is serious?
Most back pain goes away by itself, but you should seek medical attention if:
- You’ve been in serious pain for more than a week.
- You had an accident that’s causing back pain.
- Your back pain is accompanied by problems with pooping or peeing.
- You have lost weight without trying.
- You have pain in other body parts, such as your legs.
- Your back pain is accompanied by numbness or tingling.
- Your back feels weak and tired.
- Your back pain wakes you up at night.
- Your back pain is worse in certain positions.
Can back pain be cured?
Most cases of back pain go away on their own. If you have persistent back pain, your doctor can recommend ways to ease and prevent it. For the minority of people whose back pain doesn’t respond to conventional treatments, surgery can often bring relief.
