Back Pain Causes: Overview of Conditions That Can Create Back Pain

By: Stephen H. Hochschuler, MD

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By far the most common cause of lower back pain is a muscle strain or other soft tissue damage. While this condition is not serious, it can be severely painful. Typically, lower back pain from a muscle strain will get better within one to three weeks.

Treatment usually involves a short period of rest, activity restriction, use of hot packs and/or cold packs for local discomfort, and pain medication. Over the counter pain medication used to treat muscle strain may include acetaminophen (e.g. Tylenol), ibuprofen (Advil), Motrin, or naproxen (e.g. Aleve). Prescription pain medications may be recommended for severe back pain.

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Different Causes of Back Pain

Typically, younger individuals (30 to 60 year olds) are more likely to experience back pain from the disc space itself (e.g. lumbar disc herniation or degenerative disc disease). Older adults (e.g. over 60) are more likely to suffer from pain related to joint degeneration (e.g. osteoarthritis, spinal stenosis).

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In some instances, a patient may experience more noticeable leg pain as opposed to back pain as a result of certain conditions in the lower back, including:

Lumbar herniated disc. The inner core of the disc may lead out and irritate a nearby nerve root, causing sciatica (leg pain).
Lumbar spinal stenosis. The spinal canal narrows due to degeneration, which can put pressure on the nerve root and cause sciatica.
Degenerative disc disease. As the disc degenerates it can allow small amounts of motion in that segment of the spine and irritate a nerve root and cause sciatica.
Isthmic spondylolisthesis. A small stress fracture allows one vertebra to slip forward on another, usually at the bottom of the spine. This can pinch the nerve, causing lower back pain and leg pain.
Osteoarthritis. Degeneration of the small facet joints in the back of the spine can cause back pain and decreased flexibility. May also lead to spinal stenosis and nerve pinching.

It is important to know the underlying condition that is causing the low back pain, as treatments will often differ depending on the causes of back pain.