There are numerous possible causes of lower back pain. In some cases, it may be due to a serious condition such as degenerative disk disease or cancer. Doctors can diagnose the cause of lower back pain and recommend treatments on the basis of the condition.
According to the American Academy of Orthopedic Surgeons (AAOS), most people’s lower back pain is muscular and results from overdoing strenuous activities.
However, if the pain comes from the bones in the spine itself, the person may need prescription medication or surgery to resolve the issue.
This article explores why people may have lower back pain and what symptoms to look for. It also explains some of the more common causes of back pain.
Most cases of lower back pain resolve within a few weeks. However, if the pain continues, the person may have a more serious condition.
Degenerative disk disease
If the disks that cushion the vertebrae in a person’s back start to break down, the bones may rub together. This can happen due to:
- drying out of the disk over time, with most people aged over 40 years experiencing some disk degeneration
- tears in the outer portion of the disk due to physical activity
- injury
Symptoms of degenerative disk disease can include:
- pain in the lower back and neck
- pain that may extend to the arms, hands, buttocks, and thighs
- pain that worsens after bending or when sitting, twisting, or lifting
- pain that may come and go
- weakness in the leg muscles
Learn more about degenerative disk disease here.
Herniated disk
Sometimes, the disks between the vertebrae become squashed, causing them to bulge out between the bones. This is a herniated disk.
A herniated disk can happen anywhere along the spine, but it most commonly affects the lower back. It usually happens as a result of wear and tear over time, though it can also happen due to an injury.
Symptoms of a herniated disk include:
- weakness, numbness, or tingling in the leg or foot
- sciatica, which is a sharp and often shooting pain from the buttocks down the back of one leg
- loss of bladder or bowel control in rare cases
While most people recover without surgery, the AAOS explains that doctors may recommend a microdiscectomy if symptoms do not go away or do not respond to other treatments.
Learn more about herniated disks here.
Osteoporosis
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Doctors describe osteoporosis as a reduction in bone mass. This means that the person’s bones become thinner and weaker. They are also more likely to break.
A person may not experience any symptoms of osteoporosis. This means that there may not be a diagnosis until they experience a broken bone. This can happen
- minor falls
- bending
- lifting
- coughing
Learn more about osteoporosis here.
Degenerative spondylolisthesis
Degenerative spondylolisthesis occurs when one of the vertebrae in the back slips forward. This usually happens when the ligaments connecting the bones weaken and become unstable.
Symptoms of degenerative spondylolisthesis include:
- lower back pain
- leg pain
- legs feeling weak with prolonged walking or standing
- numbness or tingling in the legs
A person with degenerative spondylolisthesis may find relief from symptoms when sitting or bending forward. This is because it helps to open up the space in the spinal canal.
Learn more about spondylolisthesis here.
Ankylosing spondylitis
Ankylosing spondylitis is a type of arthritis that often affects the person’s sacroiliac joints. The joints connect the spine to the pelvis. This type of arthritis can affect a person’s other joints as well.
The most common symptom of ankylosing spondylitis is pain in the:
- lower back
- buttocks
- hips
Learn more about ankylosing spondylitis here.
Cancer
Cancer is not a common cause of lower back pain.
However, the Hospital for Special Surgery points out that doctors may consider cancer as a possible cause if a person has a prior history of cancer or if the back pain occurs alongside a loss of appetite or unexplained weight loss.
The American Association of Neurological Surgeons explains that, while lower back pain can be debilitating, for approximately 9 in 10 people it is temporary and surgery is not necessary.
Some common causes of back pain include:
- poor posture
- strenuous exercise
- heavy lifting
- sprains, caused by sudden twisting damaging a person’s ligaments that support the spine
- strains or injuries to muscles or tendons — the bands of tissue that connect muscles and bones
- pinched nerves or nerve damage
Lower back pain varies depending on the cause. The pain may be sharp or dull and it may come and go. Other symptoms may include:
- stiffness, especially first thing in the morning
- pain when bending or lifting
- pain when sitting
- pain that spreads, or radiates, from the back into the person’s buttocks or outside of the hips
- numbness or weakness in the legs or feet
A person with lower back pain should let their doctor know about any symptoms they are experiencing. This will help the doctor to reach an accurate diagnosis.
A person with lower back pain should contact a doctor if the pain lasts longer than two weeks or if it gets worse during this time.
Pain that occurs alongside progressive weakness or numbness may indicate nerve involvement and requires prompt attention.
The AAOS advises people to talk with their doctor if they have an accompanying fever or any unexplained weight loss.
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Loss of bowel or bladder control or problems urinating are also signs that a person needs to see a doctor.
Very occasionally, lower back pain is a sign of a medical emergency. Injuries from accidents, falls, and other traumas can cause back pain, but it may also be a sign of different internal injuries.
A person should seek immediate medical help if they experience any of the following, with or without lower back pain:
- inability to stand
- inability to put weight on their legs
- shooting pains down their legs
Many people experience lower back pain, but it is not usually serious. Occasionally, people with lower back pain have a more serious condition.
Lower back pain may be serious if it results from disk degeneration, a herniated disk, or osteoporosis. Degenerative spondylolisthesis and ankylosing spondylitis are also possible causes that require medical attention. In rare cases, cancer may cause lower back pain.
A person experiencing lower back pain should contact a doctor, particularly if they experience a fall or other injury, if the pain lasts for more than two weeks, or if the pain worsens during this time.