America Asks About Back Pain

When you've got back pain, one of the best questions you can ask is, "Why is it happening?" That can be the first step to helping the problem.

Common causes for back pain include:
Muscle and ligament injuries. These are the most common causes of back pain. Shoveling snow or helping a friend move her couch can sometimes overstretch the muscles or ligaments. You can wind up with strains or sprains. Most of these injuries heal in a few days to weeks.


Disc injuries. Discs are like padded cushions between the bones of your spine. They act like shock absorbers. Physical stress or injury can break one open. This is called a ruptured or herniated disc. Ruptured discs can cause inflammation and pressure on nerves, causing pain such as sciatica.


Osteoarthritis. Arthritis can affect the joints in the spine -- called facet joints -- just as it can affect your knees or wrists. As you get older, discs break down and shrink. The facet joints may start to rub against one another. Your back may feel stiff when you wake up or hurt after standing or walking.


Osteoporosis. Weaker bones make fractures more likely, including fractures in your spine.


Spinal stenosis. The bones of your spine surround your spinal cord -- a bundle of nerves that send signals between your brain and body. If the space around your spinal cord narrows, it can put pressure on the nerves and cause pain. The most common cause is osteoarthritis, which can lead to bony growths called spurs that press into the area around the spinal cord.


Spondylolisthesis. Joints and ligaments keep the bones of your spinal column lined up. If they're too loose, the bones can slip or slide against one another. They can also press against sensitive nerves.

Many other conditions, such as scoliosis, can cause back pain, too. It is important to see your doctor for back pain if:
Your pain is not better after 10 days.
Your pain is associated with trauma.
You are having numbness or tingling, bowel or bladder problems, or unexplained weight loss.
You have a history of cancer, osteoporosis, or immune system problems.
You are age 70 or older.


No Clear Reason?

"A lot of the time, we can't find the cause of a person's back pain," says Steven P. Cohen, MD, a pain medicine professor at Johns Hopkins School of Medicine.

Doctors call those cases "nonspecific." The pain is real. It's just that tests and scans don't show the cause.

There is good news. Even when doctors can't find the cause of back pain, they still have treatments that can help, Cohen says.