Eighty to 90% of people in the United States will suffer from back pain during their lifetime. Back pain is the second most common reason for visits to the doctor. It is also a direct cause of enormous health care expenses.

What are the causes of low back pain?

Back strain is by far the leading cause (80% to 85% of cases) of low back pain in the United States. Other causes include:

  • Disc herniation: A herniated disk is a rupture of the fibrocartilage surrounding the invertebral disk. Pressure from the vertebrae above and below the disk squeeze the cushioning substance (nucleus pulposus) out of the disk. The nucleus pulposus can press against spinal nerve roots. This can be very painful and cause nerve damage if not treated properly.
  • Osteoarthritis/spinal stenosis: This is characterized by the constriction or narrowing of the vertebral canal.
  • Spondylolisthesis: Spondylolisthesis is the partial forward dislocation of one vertebra over the one below it. Usually the fifth lumbar is dislocated over the first sacral vertebra.
  • Ankylosing spondylitis: Ankylosing spondylitis is a chronic inflammatory disease that first affects the spine and adjacent structures. As the disease progresses, vertebrae will fuse together. This disease has a strong hereditary tendency and primarily affects men under 30 years of age.
  • Infection
  • Cancer
  • Fracture
  • Nonspinal causes: Nonspinal causes of low back pain include abdominal aortic aneurism, kidney stone, infection, or stomach ulcer.

Last reviewed by a Cleveland Clinic medical professional on 11/01/2016.


  • National Institute of Neurological Disorders and Stroke. Back Pain Information Page. Accessed 12/29/2016.
  • American Academy of Orthopaedic Surgeons. Low Back Pain. Accessed 12/29/2106.
  • Bhangle SD, Sapru S, Panush RS. Back pain made simple: an approach based on principles and evidence. Cleve Clin J Med. 2009;76:393–399.
  • North American Spine Society. Chronic Low Back Pain. Accessed 6/26/2020.

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