7 Back Pain Causes: Symptoms, Causes, and Treatment

Craig Primack, MD, FACP, FAAP, FOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Vanessa Gibbs

Published 04/13/2024

Ask a room full of people if they have back pain and you’ll probably get a room full of nodding heads. So if you ask, “Why does my back hurt?” you’ll likely get 100 different answers about potential back pain causes.

Lower back pain is the leading cause of disability around the world, and many things can trigger it.

Common back pain causes include:

  • Trauma

  • Bad posture

  • Medical conditions

  • Infection

  • Inflammation

  • Age

  • Having overweight or obesity

Sounds bleak, but there are ways you can prevent and treat back pain. Keep reading to learn more about the causes, symptoms to look out for and what to do when back pain hits.

Wondering Why does my back always hurt? There are many, many causes of back pain — and to make matters more confusing, your pain might be triggered by more than one cause.

Common causes of back pain include:

  • Trauma. Maybe you’re suffering from whiplash, a sports injury, a back muscle strain or a sprain from lifting something heavy, moving awkwardly or doing too many repetitive movements. This physical trauma could cause back pain.

  • Bad posture. You’re not the first person to Google “why does my lower back hurt.” You might have constant lower back pain from spending long periods standing up or being in a certain position for your job (think: sitting at a desk all day). Body changes during pregnancy can also cause bad posture, making it one of the key causes of lower back pain in women.

  • Medical conditions. Get ready — the list is long. Medical conditions behind back pain include osteoporosis, osteosclerosis, chronic pain syndromes, degenerative disk disease, kyphoscoliosis (excessive curves in the spine), scoliosis, sciatica, compression fractures, a ruptured or herniated disk, osteoarthritis, endometriosis, kidney stones or kidney infection.

  • Infection. This could be an infection in your back area or one that’s spread from elsewhere in your body.

  • Inflammation. Inflammation in the joints of your spine can cause back pain, and chronic inflammation can trigger arthritis.

  • Age. Yup, it’s true. With age, your musculoskeletal structure slowly degenerates, causing more back pain with every birthday.

  • Having overweight or obesity. Excess weight puts pressure on the spine and can contribute to poor posture. Obesity can also cause chronic inflammation, which may contribute to back pain.

Symptoms of back pain include, well…back pain.

But in all seriousness, lower back pain symptoms include:

  • Stiffness

  • Muscle spasms

  • A dull ache

  • Sharp pain

  • Restricted movement

  • Pain in other parts of your body, like your legs

Symptoms will look different for everyone, though. For example, back strain symptoms may differ from symptoms of an infection.

How long you feel these symptoms depends on the type of back pain you have.

Types of back pain include:

  • Acute back pain. This is back pain lasting less than six weeks.

  • Sub-acute back pain. This is when it lasts six to 12 weeks.

  • Chronic back pain. This is back pain lasting more than 12 weeks.

Some concerning symptoms to look out for:

  • Severe pain

  • Back pain after a serious blow or fall

  • Pain that’s worse when you lie down

  • Pain that wakes you up in the night

  • Pain that radiates down your legs, below the knees

  • Redness or swelling in your back

  • Unexplained fever

  • Weakness or numbness in your butt, thighs, legs or pelvis

  • A burning sensation when you pee or blood in your urine

  • Loss of control over urine or stool

  • Unintentional weight loss

Reach out to a healthcare provider if you notice or experience any of these.

Anyone can throw their back out in the gym, and we all grow old eventually. *Sob.* But some risk factors up your odds of experiencing back pain.

Risk factors for back pain include:

  • Having a physically demanding job

  • Having a physical or mental health condition

  • Smoking

  • Having obesity

  • Not doing much physical activity

If you’re unsure why things are hurting, make an appointment to be seen by a medical provider.

To diagnose your back pain, your healthcare provider will probably start by asking questions about your pain, getting your medical history and doing a physical exam.

A healthcare provider might ask:

  • When your back pain started

  • What makes the pain worse or better

  • Whether the pain is localized to one area

  • If you sit or stand for long stretches

  • Whether you have any other symptoms, like a fever

  • If you have a history (or family history) of certain medical conditions

A physical exam may involve looking at your back for signs of inflammation and feeling your back to check for tenderness.

Your provider might also ask you to do certain exercises — don’t worry, nothing too strenuous. They can assess your range of motion and ask about pain during these exercises to look for an underlying cause.

Most of the time, a physical and medical history are enough to diagnose back pain and figure out what’s causing it.

However, your healthcare provider might recommend further tests in some situations.

The early use of diagnostic imaging isn’t recommended for everyone. But it may be used in people who’ve had back pain for six weeks that hasn’t improved with medical management or physical therapy.

Further tests might also be needed if you have signs of an underlying health issue, such as a fracture, infection or cancer.

Potential tests include:

  • Magnetic resonance imaging (MRI). An MRI can help a healthcare provider find potential soft tissue lesions — like in your nerves, tendons or the disks between your vertebrae — or signs of inflammation and cancer.

  • Computed tomography (CT) scan. A CT scan can help a provider look at the bones and tissues in your back to detect abnormalities.

  • Electromyography (EMG) or nerve conduction studies. These tests measure electrical activity in your muscles and nerves. They can detect nerve disorders and lumbar spinal stenosis (narrowing of the spinal canal).

  • Blood tests. Tests like a complete blood count can show signs of infection, inflammation and cancer.

  • X-rays. X-rays might be used if you have a suspected fracture or broken bone.

  • Bone scans. Bone scans can detect stress reactions, osteomyelitis (inflammation or swelling of the bone tissue) and discitis (infection of the disks between the vertebrae).

Prescribed online

Weight loss treatment that puts you first

Most of the time, acute lower back pain goes away on its own. While you’re healing, there are things you can do to ease the pain and methods to treat lingering chronic back pain symptoms. A healthcare professional can recommend the best treatments for you.

Here are some treatment options to consider:

  • Heat. Grab a heat pack, thermal wrap or hot water bottle, or run a hot bath. Low-level heat can increase blood flow to the area and reduce muscle spasms, stiffness and pain. Research shows that heat plus exercise can be more effective at reducing pain than exercise alone. And heat may be more effective than pain medication. Plus, it just feels nice, right?

  • Limiting bed rest. Even though it feels like your back is telling you to just lie down, that won’t help you in the long run. Cut down on activity in the first couple of days, but then slowly get back to your normal activities as much as possible.

  • Exercise. You might want to wait two to three weeks after a back strain to start exercising. But when you can, slowly incorporate more movement into your routine. Any exercise can help treat a bad back, but research shows that Pilates, McKenzie therapy (physical therapy focusing on back pain) and functional restoration (rehab for chronic pain) are more effective than other types of exercise, like yoga and aerobics. Structured programs, like multidisciplinary biopsychosocial rehabilitation, have been shown to reduce chronic back pain.

  • Pain-relief medication. Medication for back pain includes over-the-counter pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Muscle relaxants and — if serious enough — opioids are sometimes recommended. Opioids can help in the short term, but there’s not much research on their long-term effectiveness, and they do come with risks.

  • Weight loss. If excess weight or obesity are contributing to chronic low back pain, moving toward a healthy weight can help. Focus on eating nutritious foods, incorporating more steps into your day, getting enough sleep and drinking plenty of water. Weight loss medication, like Ozempic® or metformin, can also be beneficial for some people.

  • Steroids and surgery. If other treatment methods are unsuccessful, steroid injections or back surgery are sometimes recommended to resolve back issues.

You can’t exactly cover yourself in bubble wrap and never leave the house — but you can lower your odds of acute lower back pain happening in the first place.

Keep in mind you’ll have a higher risk of back pain if you smoke, have poor posture, don’t do much movement or have obesity.

So, you can try to control the controllables:

  • If you smoke, make a plan to cut down and quit.

  • Avoid slouching and aim for a straight spine and good posture — make ergonomic adjustments to your work setup if needed.

  • Prioritize getting regular physical movement. This can help improve your posture, strengthen your back muscles and aid in weight loss.

  • Focus on healthy lifestyle habits that can help you lose weight and maintain a healthy weight.

Beyond lowering your risk factors for back pain, avoid doing too much heavy lifting. That might not be possible if you have a physical job, have young children or enjoy lifting weights at the gym. But when you do lift, lift safely.

Keep these tips in mind when lifting something heavy:

  • Warm up or stretch before you lift anything.

  • Spread your feet about shoulder-width apart.

  • Stand as close to the object as possible.

  • Bend your knees — not your waist or back.

  • Engage those abs.

  • Slooooowly lift and stand up with the object.

  • Don’t twist your back as you’re lifting or carrying the object.

  • Squat to set the object down — again, bending your knees, not your back.

And, of course, if you’re in a lot of pain or think you pulled something, seek medical attention.

When you have back problems, everything feels harder.

What causes back pain in females versus lower back pain causes in males? Unfortunately, backs are complicated, and it’s not always clear what’s causing back pain.

Here’s what to keep in mind about possible back pain causes:

  • Think back to what you’ve been doing recently. Pain could be from an isolated incident, repetitive daily movement or body positioning.

  • For instance, lifting your kid awkwardly could cause sudden lower back pain, whereas sitting in the car for a long drive could trigger lumbar back pain.

  • Having excess weight or obesity can also increase your odds of back pain.

We can’t do much about the kid or the car, but we can help with weight loss if that’s something you’re considering.

Incorporating healthy habits into your routine — like eating more veggies and going for a walk on your lunch break — can help. Weight loss medication like metformin can also help your weight loss journey.

Learn more about weight loss treatments from Hers.

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