You may be familiar with that feeling — you stand too quickly or turn too suddenly and feel that slight “tug” in your back. But while a muscle pull may put you out of action for a few days, back pain can sometimes last far longer.
In fact, lower back pain is the leading cause of disability worldwide, according to a 2023 study from the World Health Organization. More than 600 million people experience lower back pain each year. In the U.S., more than 8 million adults have chronic low back pain, defined as lasting longer than three months.
Among the patients I see in my office, the following are the five most common causes of lower back pain:
Muscle spasms and sprains
This pain is caused by common, everyday back injuries that frequently occur during falls or through activities such as heavy lifting. Patients report feeling a dull ache across the lower back. This usually goes away after just a few days of rest and taking over-the-counter anti-inflammatory medication.
Arthritis
Arthritis is the wear and tear of joints, which help with movement. Joints and the cartilage that lines them are smooth. However, as they begin to show wear and tear, they start to roughen, causing pain. Arthritis is common as people get older but also occurs in people who frequently participate in high-impact activities. Obesity and smoking can also be contributors to arthritis, which can be treated through physical therapy and anti-inflammatory medication.
Worn-out discs
Discs act as cushions between the vertebrae, the individual bones that make up the spine. When discs begin to wear down, they can pinch nearby nerves, causing pain. They can also bulge — known as a herniated disc — which can hit nerves and cause pain.
While the hope is to treat disc issues with physical therapy and anti-inflammatory medication, sometimes surgery is needed to fix the problem and eliminate the pain.
Osteoporosis
Osteoporosis is a condition in which bones weaken and become brittle. It is most common in the aging population and in women. While the bones in the spine are rectangular in shape, with osteoporosis, the weakened bones begin to crunch downward and deform, causing pain.
I’ve found that osteoporosis is likely underdiagnosed and more common than people think. Individuals come in with back pain and don’t realize they have fractures in their spine. But, along with medication, recent medical advancements have led to new injections that are available to restore strength and help avoid surgery, which is only required in the most severe cases.
Spinal stenosis
Spinal stenosis is a condition that causes narrowing of the spine, leading to the painful pinching of several nerves.
A sign you may have spinal stenosis would be if you have to get into a certain position to be comfortable. As an example, picture having to lean on your grocery cart instead of simply pushing it.
Combined with medication and physical therapy to strengthen the back, epidurals may be needed to ease pain. Additionally, surgery may be required to take the pressure off the nerves.
The bottom line is that if your lower back pain is impacting your daily life, it’s time to see a doctor.
Many people pull muscles from time to time and become sore for a few days. But if it lasts weeks, or you’re feeling any kind of tingling in your back or legs, you need a physician to develop a treatment plan.
No one should try to live through chronic back pain. Together, you and your doctor can come up with a strategy to get you back to your regular activities without pain.
Dr. Matthew Follett, is a spinal surgeon affiliated with Sharp Memorial Hospital.
