10 Causes of Low Back Pain
The origin of the pain is often unknown, and imaging studies may fail to determine its cause. Disk disease, spinal arthritis and muscle spasms are the most common diagnoses; however, other problems can also cause back pain.
Strain and injury to the muscles and ligaments supporting the back are the major causes of low back pain. The pain is typically more spread out in the muscles next to the spine, and may be associated with spasms in those muscles. The pain may move to the buttocks but rarely any farther down the leg.
Sciatica is not a diagnosis but a description of symptoms. Anything that places pressure on one or more of the lumbar nerve roots can cause pain in parts or all of the sciatic nerve. A herniated disk, spinal stenosis, degenerative disc disease, spondylolisthesis or other abnormalities of vertebrae can all cause pressure on the sciatic nerve.
A herniated disk, sometimes (incorrectly) called a slipped disk, is a common cause of severe back pain and sciatica. A disk in the lumbar area becomes herniated when it ruptures or thins out, and degenerates to the point that the gel within the disk (the nucleus pulposus) pushes outward.
One study shows how the fear of pain more than the pain itself actually predicts who will transition from acute to chronic low back pain (LBP). And fear that is linked with pain is also linked with restricted physical movement. In the end, the acute LBP patient sees himself as more disabled than he really is based on pain-related fear.
As the disc dries and cracks, it is likely to develop bulges, ruptures and tears. As the disc deflates, spinal stenosis and degenerative spondylolisthesis are the possible results. These secondary problems are the reason an aging spine can go from being asymptomatic to having symptoms of pain, stiffness, and sciatica-symptomatic disc degeneration.
Osteoarthritis occurs in joints of the spine, usually as a result of aging, but also in response to previous back injuries, excessive wear and tear, previously herniated discs, prior surgeries and fractures. Cartilage between the joints of the spine is destroyed, and spinal discs become more brittle. The rate at which these changes develop varies between people.
Spinal stenosis is the narrowing of the spinal canal, or narrowing of the openings where spinal nerves leave the spinal column. This condition typically develops as a person ages and the disks start to shrink. At the same time, the bones and ligaments of the spine swell or grow larger due to arthritis and chronic inflammation.
Spondylolisthesis occurs when one of the lumbar vertebrae slips over another. In children, spondylolisthesis usually occurs between the fifth bone in the lower back and the first bone in the sacrum area. It is often due to a birth defect in that area of the spine. In adults, the most common cause is degenerative disease (such as arthritis).
Osteoporosis is a disease of the skeleton in which the amount of calcium present in the bones slowly decreases to the point where the bones become fragile and prone to fractures. It usually does not cause pain unless the vertebrae collapse suddenly, in which case the pain is often severe. More than one vertebra may be affected.
Other factors can also contribute to back pain, including infections in the bone, cancer, trauma to the back, fibromyalgia, ulcers, kidney disease, ovarian cysts and pancreatic.